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 worsened it. She 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 several points to remember about injuries. They apply to tennis elbow but all damages when you are using exercise to help them recover.
4 Key Things to Remember when Exercising for an Injury
1. Intensity
How aggressively you do the exercises affects your injury recovery. I always suggest being conservative when starting an exercise program for an injury. Go easy and light. See how things feel after the exercises, a few hours after the workouts, and the next day. You should feel like you have done something, but your symptoms should not increase.
2. Resistance
Once again, your resistance will determine the stress on the injured area. We want to stress the injury but not irritate it. It is a delicate balance. Once again, start light and see how it feels.
3. 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 that add stress to the injury, this will lead to more irritation and pain. Make sure to look at things that are putting pressure on your injured area and decrease or eliminate them.
4. 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. It relaxes the tissues, and then the tissues get a chance to heal while you are sleeping.
Nutrition
Staying hydrated, adequately fueled, and focusing on inflammation-lowering food is also essential. This will help you in your injury recovery.
Now let’s get to the shoulder bursitis.
I am unsure of the cause of the shoulder bursitis (inflammation of the bursa in the shoulder). I would focus on shoulder position | 404, rotator cuff, and scapular stabilization exercises.
When it comes 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 suggest you do the tennis elbow pain exercises with your arms supported. In the program, you can look at the exercise descriptions and videos for Exercises 9b and 10b.
“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 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 will give you ideas of what you can do if you get hurt from the activities. Here are a few things to remember:
- Conditioning – If you get elbow pain from doing the exercises, do exercise #3 for two to three weeks. This will help work on the movement of your elbow muscles. By being in stage 2 so early, you are getting pain because of the points 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 more significant 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 movement.
“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: I have seen in many people that a shoulder injury leads to tennis elbow pain.
I know you have the Shoulder Pain Solved program | 404 of mine. Make sure to use the pain techniques I talk about in that program for your shoulder but remember the key points I discussed 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 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, get your diagnosis confirmed by a qualified health professional and have them rule out something else is happening. Then take the programs to someone that can help you with the program. You can go to a fitness professional focusing on injuries or another health professional. The critical thing is that they will spend 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 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
