Can a small tear heal itself or do I need surgery?

[dsiomtw]

So I've had chronic "tennis elbow" for the past 4+ months that hasn't gotten better at all despite my trying everything e.g. RICE, Vitamin I protocol, eccentric exercises, flossing with the voodoo band, high rep chins, on and on.

Started to think something might be up so I got an MRI that revealed "low-grade partial tearing of the common extensor tendon at the lateral epicondyle origin, on a background of moderate tendinosis."

F*CK!

I had shoulder surgery a few years ago for a bad SLAP tear that needed many anchors and would have never healed, but can a small tear like this heal on its own?? I'm no radiologist but I've looked at tears on MRIs before and this thing looks pretty small...

The sports med doc I saw is recommending a PRP shot, which some people seem to have had luck with.

At this point I haven't deadlifted in 2+ months and this thing is pissing me off. Surgery should be a last resort, but I'm half tempted just to ask for it and get this freakin' over with so I can move on. I imagine it would be a walk in the park compared to my shoulder surgery.

I figure people here have dealt with this shit and I'm curious what ya'll think I should do ...

[Fiddler]

FWIW, I had golfer's elbow (roughly the same thing on the other side of the elbow) for months. Couldn't even pick up a glass of water normally. Followed doctors orders with no improvement. Started doing light wrist dumbbell wrist curls in all directions (supinated, pronated, thumb side up, pinky side up), light weights, high reps. Cleared up completely in less than two weeks. My thinking is that the exercises promoted blood flow to the affected tissues and promoted healing.

I have a nagging, mild wrist sprain that's been hanging on since Christmas. Will probably dig out the little dumbbells and do the same thing again, since it's not getting a lot better on its own. I follow the principle, "if it doesn't make things worse, go ahead and do it." I don't know whether this might help you, but if it doesn't make things worse, you might give it a shot. Most everything heals eventually, and promoting circulation generally helps. IME, the worst thing you can do after the first few days is not use it, but going too hard can aggravate the injury.

[dsiomtw]

Thanks for the reply. I've done all that. Thing is I have an actual tear. Not sure if that type of thing is enough to "heal" a small tear, although I'm certainly going to keep working at it for now ...

[carson]

The only lift that caused me such pain was the squat. I could not even do a descent high squat. I guess arthritis had got the best of me so much so that I've never been able to do a proper LBBS. So I got one of these. Amazon.com : Offset Bar : Weight Bars : Sports & Outdoors

[umairsemail]

No. A small tear cannot magically suture itself back together. What can happen though, is that the body adapts to the tear and merely works around it, but right now, the rest of the tendon/ligament is bearing more stress than it is used to. The torn ends of the tendon/ligament need to be sutured back together. Of course, it will never be back to 100% though, because anything that is stitched back together heals with a lot of scar tissue (type 3 collagen), which is not as pliable and doesn't have as much tensile strength as normal tissue.

[dsiomtw]

So you're saying surgery then?

I don't know about the "it will never be back to 100% though" part.

I had shoulder surgery for a SLAP tear a few years ago and that shoulder is now better than new, and at least twice as strong as before I injured it!

[umairsemail]

So you're saying surgery then?

I don't know about the "it will never be back to 100% though" part.

I had shoulder surgery for a SLAP tear a few years ago and that shoulder is now better than new, and at least twice as strong as before I injured it!

I meant your tendon/ligament complexes will never be at 100%. This relates most to injury risk, since the tensile strength of your tendon will never be at the level of an uninjured tendon. This is why people that get ACL surgery or ankle ligament surgeries have a much greater risk of getting that body part injured than people with perfectly healthy tissues. Your strength potential will most likely not be affected much.

[umairsemail]

After the collagen content of a wound has stabilized, strength continues to increase as a result of cross-linking and reorientation of the already formed collagen fibers. The arrangement of collagen fibers in scar tissue is disorganized, and this is corrected to a degree during maturation; however, some disorganization persists. There is an almost imperceptible gain in strength for at least 2 years; however, the strength of the scar never reaches that of normal tissue. The development of strength in the healing tissue between tendon ends follows reorientation of the collagen fibers between the cut ends of the tendon. It is obviously this same process that leads to restoration of the gliding mechanism. In remodeling of the scar tissue, collagen fibers surrounding the healing tendon will be subjected to less linear tension than the fibers between the tendon ends. Therefore, these fibers seem to disappear and be replaced by thinner and fewer fibers.

From here

[Tom K]

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[MBasic]

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Lol...