My Tennis Elbow Pain Has Got Worse

As you know, last month’s Injury of the Month was tennis elbow.

It has been a few weeks and I am starting to get feedback on the program.  One person has been having issues with their tennis elbow pain and the program has made it worse.  She has asked me if I could help.  We have been emailing back and forth.  Here are some clips from our email conversation.

“I think my pain has increased a bit so I’m cutting back in intensity but I’m hoping that if I keep at it, it will eventually go away. Bursitis in my shoulder really flared up after starting the program. Not sure if it is related but that is the only thing different that I was doing.”

This brings up a number of points to remember about injuries.  They apply to tennis elbow but to all injuries when you are using exercise to help them recover.

4 Key Things to Remember when Exercising for an Injury

  • Intensity – How aggressively you do the exercises has an effect on your injury recovery.  I always suggest to be conservative when staring an exercise program for an injury.  Go easy and light.  See how things feel after the exercises, a few hours after the exercises and the next day.  You should feel like you have done something but your symptoms should not increase.
  • Resistance – Once again, the resistance you use will determine the stress put on the injured area.  We want to stress the injury but not irritate it.  It is a fine balance.  Once again, start off light and see how it feels.
  • Cumulative Stress – If you are doing exercises for an injured area, you are adding more stress to that area.  If you do not decrease or eliminate other things you are doing that add stress to the injury, this will lead to more irritation and pain.  Make sure to look at things that are putting stress on your injured area and decrease or eliminate them.
  • Pain Techniques – Do the pain techniques in the evening.  Doing the ice, stretching and self massage are most effective before you go to bed or a few hours before you go to bed.  It relaxes the tissues and then the tissues get a chance to heal while you are sleeping.
  • Nutrition – Staying hydrated, properly fueled and focusing on inflammation lowering food is important as well.  This will help you in your injury recovery.

Now let’s get to the shoulder bursitis.

I am not sure what the cause is of the shoulder bursitis (inflammation of the bursa in the shoulder).  I would focus on shoulder position, rotator cuff exercises and scapular stabilization exercises.

When it come to tennis elbow pain exercises leading to shoulder pain, I cover this in the video presentation of Tennis Elbow Pain Solution but also Stasinopoulos 2011 says it well:

“If the affected arm is not supported, our experience has
shown that patients complain of pain in other anatomical
areas distant from elbow joint, such as the shoulder, neck,
and scapula.”

I would suggest you do the tennis elbow pain exercises with your arms supported.  You can look at the exercise descriptions and videos for Exercises 9b and 10b in the program.

“Regarding my bursitis – I took a break this past weekend from exercise and the tennis elbow program and it seemed to be less painful.

I am doing mostly stage 2 exercises but am sticking with a modification of scapular exercises #6.”

It has only been a week or two since you have got the program. You might not be ready for stage 2 exercises.

If you are getting elbow pain from the exercises, look in the exercise descriptions and I give you ideas of what you can do if you get pain from the exercises.  Here are a few things to remember:

  • Conditioning – If you are getting elbow pain from doing the exercises, do exercise #3 for two to three weeks.  This will help work on the conditioning of your elbow muscles.  By being in stage 2 so early, you are getting pain because of the points that I covered at the top of this article.
  • Posture – Look at your posture when you are doing the exercise. Make sure it is ideal which is ear-shoulder-hip in a straight line.  Being out of alignment puts greater stress on the shoulder.
  • Technique – If an exercise is irritating, go back and make sure you are doing the exercise correctly.  Look at the exercise description and watch the video of the exercise.

“My left elbow and left shoulder are super tight. When I do the tennis elbow program my arm feels worse. Should I work on my shoulder first? Should I stop? Would be happy to have your feedback!”

Follow what I wrote above.

What caused what:  What I have seen in many people is a shoulder injury leads to your tennis elbow pain.

I know you have the Shoulder Pain Solved program of mine.  Make sure to the pain techniques that I talk about in that program for your shoulder but remember the key points that I talked about above.  They are very applicable to all injuries.

 

“Does my tennis elbow cause my shoulder pain or does my shoulder pain cause my tennis elbow? Is it possible to work on both at the same time or should I focus on one first and then the other? If so, which should I focus on first? Which program would be most helpful – tennis elbow, shoulder, scapula?”

From my experience, one injury often times leads to others.

I feel you can do both but follow what I said above in the article.

If what I said above does not help, go get your diagnosis confirmed by a qualified health professional and have them rule out that there is something else going on.  Then take the programs to someone that can help you with the program.  You can go to a fitness professional that focuses on injuries or another health professional.  The key thing is that they will spend the time with you to go through the exercises.

Remember the points that I said above.

These would be your priorities:

  • Work on your scapular stabilizing exercises as this will provide stability for your shoulder and decrease the stress on your elbow.
  • Work on improving your posture as this will decrease the stress on your shoulder and elbow.
  • Work on the pain techniques in order to relax the muscles around the shoulder and elbows.
  • Work on strengthening the shoulder and elbow as per the Shoulder Pain Solved and Tennis Elbow Pain Solution program.

Thank you for your question Chris, all the best.

Rick Kaselj, MS

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Facebook comments:

2 Comments

  1. Hi Rick –

    I really appreciate the feedback and the time you took to answer my questions. I will put into practice the things you suggest and will update you as to progress. I hope to give a positive report in a few weeks!

    Keep up the great work!

    [Reply]

    avatar

    Rick Kaselj Reply:

    Chris,

    I am so happy I could help.

    Rick

    [Reply]

  2. Hi Rick, my name is Craig I have been suffering from bilateral epicondilitis for about 1 yr and 5 months, and also have bursitis in my shoulders which started about 5 months ago and has got worse. I have not responded to any treatments or exercise programs at this stage. The next option is a ketamine infusion, what I wanted to know can tennis elbow lead to bursitis in the shoulders.

    [Reply]

    avatar

    Rick Kaselj Reply:

    Yes it can.

    Rick

    [Reply]

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