Rest Doesn’t Work
As with most tendon injuries purely resting the tendon will often not make it go away. In the lucky cases where the pain does subside it will usually exhibit a flare-up relatively easily or with very minor rises in load or tasks.
Each time our tendons have a flare up and we use them less, they get weaker. Each time they get weaker we reduce their capacity to handle everyday tasks. When the tendons reduce capacity they become more easy to flare up. Thus, creating an unfortunate cycle of pain, weakness and rest then pain, weakness and rest.
Stretching and Massage Won’t Help
This is counter-intuitive as when we are sore, particularly in the forearm, our natural reaction is to give it a good stretch or rub it. Again some people MAY get short term relief but often after the massage the pain can return, sometimes worse, 2-3 hours later.
We believe the tendon problem is caused by an increase in load to the tendon particularly compressive loads. Often stretching and massaging just adds to this.
So How Do I Get Rid of This Thing?
Guided and graded loading and a hell of a lot of patience. Exercise selection in the early phase. Not everyone can start at the exercise Hayden shows in the video above. We need to select an exercise and monitor symptoms. The best evidence tells us some pain is ok.
Once we feel the tendon and your symptoms are stable in comfort and symptoms we want to progress the intensity or load of the exercise without too much increase in symptoms. For example we would like to keep the pain at or below 4/10 with our first exercise. Once you have mastered it the pain should drop.
At that point in time when the pain drops we would normally increase the load again to continue along that 3-4/10 spectrum. Doing this for 8-12-16 weeks is the only way to get your tendon happy, healthy and strong again.
Cortisone for Tennis Elbow is very common practice but we always ask our patients have they committed to their rehab of graded exercises for at least 8-12 weeks. In most cases this will be enough to get the condition significantly better.
In extreme cases when we can’t progress load and symptoms are intolerable we can consider cortisone as a pain relief strategy and a vehicle to being able to do the exercises.
Cortisone alone in tendon injuries is not a solution and may even be detrimental to the long term health of your tendons.
Don’t live with your tennis elbow or think you’re on top of it with stretches and massage. Make sure you are getting guided and graded loading to fix it once and for all.
As always feel free to message us on the drift chat box, email or book in online at 1 of our 3 locations in Sydney;