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Ibuprofen seems to have cured my tennis elbow...


Original Post
Ted Pinson · · Chicago, IL · Joined Jul 2014 · Points: 190

So I've had a chronic case of tennis elbow pretty much since September. It's lasted as long as it has largely because I'm a stubborn bastard who hasn't been willing to cease climbing completely. I've tried a variety of different methods (hammer drills, stretching, gyro balls, antagonist training) which have had varying degrees of success at managing and/or reducing the pain, allowing me to carefully continue climbing, I haven't been able to shake the chronic aches and soreness. I'd read somewhere that NSAIDS should be avoided, as they can slow the healing process, and that you especially don't want to use pain meds to mask the pain while continuing to apply stress to the tendons, so the one thing I hadn't tried was drugs.

This weekend, I came down with a nasty case of the flu AND twisted my ankle on a nasty lead fall, so I started taking Ibuprofen to help manage the fever and body aches (plus to make my ankle STFU). As an added bonus, my tennis elbow pain went away completely, which made me understand completely how people could get addicted to pain meds, having lived with this for the better part of 5 months. After my fever broke, I went to sleep without an extra dose of ibuprofen, and woke to find...my tennis elbow pain still gone. For whatever reason, being hopped up on pain meds for a weekend seems to have kicked the condition completely.

My theory is that perhaps the pain was creating a positive feedback loop, causing muscles to tense up and spasm and prolonging the condition. The causes of tennis elbow and other climbing-related injuries are not well understood, but it is believed that excessive muscle tension in the shoulder can play a role, as well as muscle imbalance (too much pulling, not enough pushing). So, I guess the moral of the story is: don't rule out pain meds. We'll see just how healed I am once I return to climbing after getting over the flu, but this is the best I've felt (without currently taking any meds) since September, so...I'm encouraged. Of course, as always: YMMV, see a Dr, etc.

Charlie S · · Ogden, UT · Joined Aug 2007 · Points: 1,546

It will be interesting to see if it stays gone after you return to climbing. My guess is that it will return.

Imbalance has some strong proponents and opponents. For what it's worth, I can bench 240lbs, but still get medial epicondylitis. So in my experience, it doesn't fix the problem, but does make you look jacked.

The cure for me was the Armaid. Forget wrist curls and funky stretches!

Steve Sangdahl · · eldo sprngs,co · Joined Mar 2002 · Points: 735

Drink more really cheap swill and cut back on the coffee intake. I'm serious. Coffee dries out the tendons etc. You can substitute water for swill ifna ya have to. Keep pullin down. Now puke.

Gunkiemike · · Unknown Hometown · Joined Jul 2009 · Points: 2,745
Ted Pinson wrote:I'd read somewhere that NSAIDS should be avoided, as they can slow the healing process, and that you especially don't want to use pain meds to mask the pain while continuing to apply stress to the tendons, so the one thing I hadn't tried was drugs.
Well, NSAIDS ARE prescribed for a reason. Long term tendon pain can have a large degree of inflammation involved. My guess is you should have addressed that months ago.
ScoJo · · Boulder, CO · Joined Jun 2014 · Points: 120
Steve Sangdahl wrote:Drink more really cheap swill and cut back on the coffee intake. I'm serious. Coffee dries out the tendons etc. You can substitute water for swill ifna ya have to. Keep pullin down. Now puke.
Source? What would be the mechanism for coffee "drying out" the tendons?

If by swill you mean booze, alcohol can wreck your recovery. If I have even a couple drinks after an intense bout of training, I'm noticeably achier the morning after.
Gargano · · Oakland, CA · Joined Jan 2011 · Points: 1,280

Hmmm. My understanding of the timeline for epicondylitis is that once past the 6-8 week mark things begin to shift towards tendinosis, which is a chronic degenerative condition of the tissue. After this the basic anti-inflammatory treatments (NSAIDs & Ice) tend to stop working, and a more regimented rehabilitation program is necessary to stimulate micro-inflammatory processes that progress healing. Given that you've been working on and climbing through it since September makes me wonder if it isn't in the "-osis" camp. At this point it takes 6-8 weeks for the tissue to heal properly and be fully functional under loads. Seems like a few doses of anti-inflammatory meds couldn't just make this all happen magically.

Either way, it'll be interesting to see if you stay pain free.

I've been working through medial epicondylosis since November. Healed it up, to a pain-free level, after 4-6 weeks of eccentrics, lacrosse ball self massage (upsteam and downstream of the elbow), and rest. What I soon learned was that just because the pain is gone doesn't mean the tissue is fully healed. After getting back into it, the pain came right back. I can only speak for myself, but sticking with the program for the whole 6-8 weeks and addressing poor motor pattern and movement issues was key to fixing things. Still working through it.

Check out selftreatment.com Put together by a PT and Pilates teacher in SLC. They do solid one-hour videos addressing different issues (golfer's elbow, tennis elbow, etc) with an emphasis on how to treat it and work on issues that can prevent it from coming back. Reasonable priced, too.

Brendan Blanchard · · Boulder, CO · Joined Oct 2010 · Points: 590
Steve Sangdahl wrote:Drink more really cheap swill and cut back on the coffee intake. I'm serious. Coffee dries out the tendons etc. You can substitute water for swill ifna ya have to. Keep pullin down. Now puke.
Don't quit the coffee and booze! Nuh uh, no way. You'll end up with heart disease and early-onset alzheimers. Plus, at least initially, you'll climb worse without the caffeine, AND you won't have the booze to console yourself. It's a lose-lose situation really.
Ted Pinson · · Chicago, IL · Joined Jul 2014 · Points: 190

Yeah, there are family members I would give up before coffee...

Gargano: I know, that's what I thought! Again, this was totally by accident, just happened to coincidentally be taking ibuprofen.

Charlie: interesting that the Armaid worked for you, as that one is also controversial. I found it helped reduce symptoms but didn't seem to have any long term effects. How often did you wear it, and for how long?

Gunkie: possibly, although my understanding is that NSAIDS are usually prescribed for acute inflammation usually associated with the start of the condition. It may be that I'm wrong about that and that delaying treatment simply prolongs the inflammation, but I like to assume that the body can sort most things out on its own, given time.

Daniel Winder · · Unknown Hometown · Joined Jul 2009 · Points: 70

Hate to tell you Ted, but you're not cured. I regularly used up to 800 mg ibuprofen to manage medial epicondylitis (golfer's elbow) pain. I could get pain free for up to a day or two but the next time I climbed it flared right back up again. Keep doing your usual PT and it will heal slowly over time.

Ted Pinson · · Chicago, IL · Joined Jul 2014 · Points: 190

Yeah, I'm fully expecting the pain to return next time I climb. It's just weird that my baseline shifted that much.

Charlie S · · Ogden, UT · Joined Aug 2007 · Points: 1,546
Ted Pinson wrote:Charlie: interesting that the Armaid worked for you, as that one is also controversial. I found it helped reduce symptoms but didn't seem to have any long term effects. How often did you wear it, and for how long?
We must be talking about different things. You don't wear the Armaid. It's a self-massage tool which looks about as mideval torturesque as cams. I use the big orange roller as opposed to the 3-ball roller to really dig into the elbow. Symptoms began to disappear after a week of consistent use. Now I only have to use it after a day of climbing.

rockandice.com/climbing-acc…
Matt Himmelstein · · Orange, California · Joined Jun 2014 · Points: 125

NSAIDs are not addictive. Could it be, just perhaps, since you twisted you ankle, you took a few weeks off of climbing and the rest cured your tennis elbow?

Highlander · · Ouray, CO · Joined Apr 2008 · Points: 255

I had a bad case of "tennis elbow" last Summer, tried climbing through it while doing exercises and basically just made it worse. I ended up not climbing for nearly 2 months and followed the protocol listed here:

http://drjuliansaunders.com/ask-dr-j-video-elbows-explained/ drjuliansaunders.com/ask-dr…

Go through the testing protocol he recommends and find the right angle that elicits pain, and that is the angle you want to hit with the eccentric exercises. Once I figured that out I really began to make progress. I also use the arm aid and self massage, which does seem to help. I now try to those exercises once a week as maintenance work and hit the arm aid regularly as well.

Good luck.

Video Testing Protocol

snowhazed · · Oakland, Ca · Joined Aug 2008 · Points: 275

+1 for the armaid

gotta watch the appropriate training video and be consistent, but it keeps those elbows from screaming

Ted Pinson · · Chicago, IL · Joined Jul 2014 · Points: 190
Charlie S wrote: We must be talking about different things. You don't wear the Armaid. It's a self-massage tool which looks about as mideval torturesque as cams. I use the big orange roller as opposed to the 3-ball roller to really dig into the elbow. Symptoms began to disappear after a week of consistent use. Now I only have to use it after a day of climbing. rockandice.com/climbing-acc…
Aaah, yeah I was picturing a compression strap. Interesting.

Matt: although they may not be chemically addictive, anything can be addictive if it stimulates a positive response (consider how many people are addicted to climbing!). I don't like the idea of feeling like I have to take a painkiller every day indefinitely...that seems like a bad road to go down.

Also, it was not a serious twist, so I was not out for weeks. I twisted it Thursday, got sick Friday and started Ibuprofen, and woke up Sunday morning with no elbow pain. Usually, it takes over 1 week for the pain to fully subside, and since it's turned chronic, it does weird things like get worse if I don't climb. I also was obviously not doing any of the PT exercises or wearing the compression strap, so it normally would have felt much worse at that point of time between climbs.
Matt Himmelstein · · Orange, California · Joined Jun 2014 · Points: 125

For my aches and pains (anything more serious that just the fact I am an old fart), I go to my physical therapist. She is working on the three fractured bones in my left foot at the moment while shaking her head at the fact that I am still climbing.

reboot · · . · Joined Jul 2006 · Points: 125

I've had it explain to me that it's probably the nervous system being out-of-sync with the condition of the body: the body part may have already healed but the nervous system is still trying to protect it. Dry needle/e-stem, high effort exercise, prolonged stretching, pain meds or other types of out-of-ordinary exertion on the nervous system can help reset it. I've had the first 3 things alleviate the symptom from forearm (medial & lateral) to groin muscles almost immediately to overnight; I don't think a long term injury typically heals that fast.

The problem is: how do you tell if you are still injured vs the nervous system being out-of-sync.

highaltitudeflatulentexpulsion · · Colorado · Joined Oct 2012 · Points: 35

It's almost like some old cartoon doctor routine. Patient comes to the doctor with a sore arm, doctor stomps on his foot and asks "does your arm still hurt"

Rick Blair · · Denver · Joined Oct 2007 · Points: 268

Ibuprofen is awesome. Do not take it chronically though. My mom did that for 2 years and ended up on the kidney transplant list. Fortunately, her kidneys recovered. Ibuprofen can be abused like anything else.

Brendan Blanchard · · Boulder, CO · Joined Oct 2010 · Points: 590
Rick Blair wrote:Ibuprofen is awesome. Do not take it chronically though. My mom did that for 2 years and ended up on the kidney transplant list. Fortunately, her kidneys recovered. Ibuprofen can be abused like anything else.
Can't overstate this enough: NSAIDs are NOT for long-term use. I have a family member with ITP (look it up, basically chronic blood thinning) that now needs upwards of several thousand in additional medical expenses for even simple procedures because she can't have them without platelet transplants to prevent excessive bleeding. I've had multiple orthopedic surgeries, and won't use NSAIDs because of that history, despite chronic pain. It's just not worth it in the long run.

However, Ted, your assertion that you understand painkiller addiction after having moderate chronic pain go away from using some Vitamin I is silly. Cute, but silly.
rafael · · Berkeley, CA · Joined Jul 2009 · Points: 50
Ted Pinson wrote:  The causes of tennis elbow and other climbing-related injuries are not well understood, but it is believed that excessive muscle tension in the shoulder can play a role, as well as muscle imbalance (too much pulling, not enough pushing). 

Sort of, muscles get strong faster then tendons, this causes muscles rip off the tendons, the tendons rip off the bone, or the tendons rip apart from themselves. 

Keep up the PT, including pushups, every day. Every Day, EVERY DAY.

 It might take a year to fully recover, and the problem could easily resurface after then, just do PT again for a while.... Did you check this rock and ice article?http://www.rockandice.com/rock-climbing-injuries/elbow-elbow-pain-and-dodgy-elbows

Guideline #1: Don't be a jerk.

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