Tennis elbow

Where are you Supafreak?

Mate from experience do not do cortisone again.......it will be tempoary at best and make you worse in the long run.Prp injections are the go.Fully recommend it cause its worked for me.

https://www.qdi.com.au/impact-prp-injections-sports-injuries/

Cortisone has never worked for me ..
For elbow exercises I drink beer and lots of it.

Supa,well i went and had it done with these guys
https://orthoclinics.com.au/contact-us/

but do your homework cause they will all vary...reason i asked where you were is that if you were in melbourne would have been a snack but i have been to the one above...few years ago now and i think it was 240 $ research it and try and have two injections a couple weeks apart but ones better than nothing if it comes down to it.

It can take 6 months or more to come right, wouldn't bother with injections they are a short term fix.

Advice I got was common sense really - try and avoid lifting too much, twisting etc with the problem arm. Fairly common problem so have a look online for exercises. You can get forearm bands that are meant to alleviate the ache and but didn't do much for me although I've seen sportspeople wearing them so must work for some.

Surfing helped mine mend I reckon, like any injury give it a chance to heal.

I'm coming out of the golfers version (don't play golf, you mentioned you had this previously supafreak). As others have said physiotherapy and exercises and time. I did rock the forearm brace but only for a month or so.
But also think about how you did it and address. Was it rsi or a single strain event? For me I think it was a single strain but daily walking of two sizeable dogs didn't help and I became more conscious of strong pulls on the lead.

If your physio didn’t give you straight advice what to do now and as a maintenance program find one that will. Soft tissue always a physio.

i had it in the inner elbow a few years back that just came up one day after a long surf. it persisted for a few months, couldn't really carry even a shopping bag without a fair bit of pain.

The most effective relief I got from it, and it seemed to clear it up over
a couple of weeks, was rolling an olympic bar along my forearm like in the video below. do both sides of the forearm though (bloke in the vid just does one) and I ended up going over the elbow a bit too, controlling the bar there though to make sure it didnt grind the joint itself. If you havent done it before, it hurts like a bastard but it's really good to do just generally.

But yeah, aside from that like GS said see a physio for exercises.

Wife had tennis elbow a couple of years ago,physio and medication didn’t seem to do much,then she had acupuncture,fixed in 2 weeks. I’m a skeptic though,I reckon it was a placebo effect.

Wrist curls. Forearm supported eg flat on table with wrist over edge then with light weight 10 reps one way then 10 the other 3 times a day- build up as you go. This builds strength in forearm muscle that connects to elbow and will stabilize it. G S 100% right- a good physio should advise how to , but wont cure the condition-that's up to you and the work you do.

Similar to what H20 said but with some difference has helped me.
Same exercise where you have the forearm on a table with wrist over the edge. From a wrist bent upwards position lower your wrist very slowly so all you are doing is controlling the speed it falls.... then dont lift it up with same hand but use the other hand to get back to the start position. So you are only putting in effort on the way down.
This has fixed some of the forearm muscle problem that for me have caused lots of elbow and wrist problems.

The same concept has helped with lots of knee pain i was getting (patellar tendonitis).

Yep, Nomad, they are called eccentric exercises (muscle is contracted but lengthens during contraction) and have shown to have benefit in tendinopathies.
Isometric (muscle length stays the same during contraction) are also shown to help and may be good to start with.

Rest it and cold pack for 20 min then heat for 20 minutes.
The injury is due to strain.
Let the body heal itself through rest.
Doesnt mean you cant do anything or surf, but be realistic in the way you want it to recover. This will mean rest it.
Dont do cortisone. Shit drug. And every drug has a side affect. Ask your quack this too. true story.

LD- Eccentric exercises! thats the word i was trying to remember! Yeah those have been great for me. Also for hamstrings ..nordic hamstrings have been a bit of a revelation for injury prevention for me.

Hindsight and everything, but resting for 6 weeks was not the answer.
As when you then try to return to movement and loading it, it is not prepared and the symptoms will return.
Initial rest after a flare-up, modifying use based on aggravating activities and gradually increasing load that is tolerable (your exercise plan) and progressing from there. Set a baseline of tolerable activity and load and you can measure how you progress. I'm sure this or similar is what your physio would have told you anyway and I know it's easier said than done.
Patience, diligence and a positive mindset. Sometimes the reassurance your physio can give you is the most beneficial.

Acupuncture.

This is great:

I periodically get both tennis and golfer's elbow from rock climbing.
These exercises help.
http://drjuliansaunders.com/dodgy-elbows/

I was having a whinge to my GP about my surfers elbow. He asked me to show him how I held my hands when I paddle (he is a surfer). When I showed him, cupped hand and thumb tight against pointer finger he said that was my problem. Too much tension through the tendon inside my elbow.
Solution was to have my thumb sticking out sideways and hand flat when paddling. No perceptible loss of paddle power and no more surfers elbow.

Those commentators advising gradual loading of your tendon are on the money.
Lateral epicondylagia (tennis elbow) is a well researched area and in the best systematic reviews the ONLY thing that has good evidence is strengthening.
Cortisone, prp etc have no good supportive evidence.
This is a self limiting condition,,
It will settle one day. Problem is it can be somewhere between 6 weeks and 18 months.
The main thing about your strengthening is dosage. Those ‘wrist extension’ exercises need to be performed with a load that doesn’t stir you up too much. Gradually progress the weight as able (ie: 0.5kg -1kg-1.5kg-2kg) ~ slow.
Keep elbow bent at first with arm supported on a table, once confident do exercises with a gradually straighter arm.
Once you can reach out grab the milk or jug with your arm outstretched and no pain you know you’re starting to get there.
Good luck

Cortisone, prp etc have no good supportive evidence.
Well i have used Prp on two seperate occasions on tennis elbow that i put up with for a couple months before having the injections and both times it dissappered within a week.....Cortisone is shit but in my case prp did work.

Yeah Supa. If you’re having a sore day, doesn’t mean you’re going backwards.
Just keep trucking and slowly increasing your reps / load / position etc.
if you’re having ‘good days’ than you are getting better. Just try remember your tendon still isn’t up to scratch and go easy on the things that you know specifically aggravate (repetitive upper limb tasks, fast heavy tasks, lifting with elbow straight and palm down (pronation)).
Those good days will become more frequent.

FWIW - evidence regarding cortisone and tennis elbow:
Short term gives relief as opposed to doing nothing but at 12 months cortisone group is significantly worse than those who did nothing (let alone good physio care)

Simba - fair enough but that is what you call anecdotal evidence. It’s great that you had that response though.

However quality studies have not shown your experience over large populations and with long term follow ups. I can’t really see it being something GP’s, physios, orthopods will be recommending into the future. But as you say it’s an option.

Another negative is PRP is generally very costly.

I'm not sure if I had tennis elbow, but the outside/top of my elbow joint would get really sore, plus I would get pins and needles in my hand and would struggle to hold a coffee-cup sometimes. I got dry-needling (more intense version of acupuncture) from the physio all the way from my neck to my hand.... worked a treat after two sessions. You have to find a good dry-needling physio though, some I have used since aren't as good. I know a good guy here in Brisbane.

The physio I go to is from Hong Kong so they study needling as part of their physio studies. I think the Australian physios have to do it as an optional add-on. I suspect that is some of the reason other physios I've seen don't seem to be as keen or have the knack.

Hey supa , i had a classic case of T E a few years ago on and off for 6 months or more. Tried everything- physio , acupuncture , trad doctors etc etc . A friend suggested Bowen therapy - i was pretty sceptical throughout the process , It can be a bit trippy with the indian music , the therapist leaving the room etc , but by hell it worked !!
3 sessions and it was pretty much gone . Might be worth a try if there are any good Bowen practitioners in your area ?
All the best getting on top of it , I remember even grabbing a carton of milk out of the fridge was hell ...

The truth about Tennis Elbow what really causes it -
Athlean-X youtube

Reminds me of the following conversation I overheard at the hospital the other day.

"I've just had steroids injected into my arm."

"Anabolic?"

"No, just my arm."