Critique Golfer's Elbow Rehab Plan, Please

[Brad Davis]

Rip,

Here's another one for you, seeing as how I'm Mr. Tendinosis lately. I've had a chronic case of GE for 25 months now. First got it doing towel pullups. Laid off for months and re-started regular pull-ups (doesn't matter what grip) and it comes right back. I've probably done this 4 times by now. As I understand it, I've screwed up the rehab badly enough to now have a chronic case. It doesn't hurt during everyday life, but I can't do pull-ups or anything else that requires much grip or it starts hurting.

After doing some research, I came up with the following plan. Please let me know if you think it's OK or if you have a better idea.

Cross-friction massage as many times during the day as possible, usually 1-3 min., 5-10 times/day.

Stretch just shy of pain after massaging.

Once per day, strengthen grip using a gripper, linear progression. I've started with the easiest CoC gripper which is 60 lb, I think. One night, do 3 sets of 5, then 3 sets of 6, etc. Not training to failure--tonight was 8 reps and the last rep was a little difficult, but not bad. When I get to 15, I'll buy the next stiffer model and start over. Also, strengthen extensors using those little rubber band things. Superset these with gripper.

After strength exercises, ice the area for 20 min.

Repeat until I don't feel GE and I'm on a pretty stiff gripper or hades freezes over, whichever comes first.

Thanks for your time and opinion.
DBD

[Mark Rippetoe]

Looks good, except for strict reliance on the gripper. Do a variety of grip work, since it is highly variable in terms of effects and recovery times. Include chins in this work.

[fullpen]

i used to have endless amounts of tendinitis problems in my arms until i started a physical job as a welder. i'd suggest you pick yourself up a nice drilling or engineering hammer and beat the snot out of a lot of stuff for 2 or 3 weeks straight. i never have tendintis issues now.

[lukeBW]

i used to have endless amounts of tendinitis problems in my arms until i started a physical job as a welder. i'd suggest you pick yourself up a nice drilling or engineering hammer and beat the snot out of a lot of stuff for 2 or 3 weeks straight. i never have tendintis issues now.

Ironically that is how mine started LOL.. welding and drilling especially drilling, the vibration will destroy your ligaments

[j5coleman]

Everybody seems to be affected differently, but for me, my 12 months of golfer's elbow came under control when I:

Did the exercises you list
Added in one where you sit down, rest your elbow on your leg, put a hammer in your hand and rotate your wrist back and forth between pronation and sup.
Did some hand and wrist stuff in a bucket of sand.
Ditched the ice and went with heat as many times a day as possible. Ice consistently set me back, and it took me far too long to realize it.

Good luck.

[Brad Davis]

Thanks again for the reply. Of course, I have a follow-up question.

The last few times I've re-started pull-ups or chin-ups, I'd start with sets of about 3, add a rep linearly and keep going. No problem until I got to about 8-10 reps. Then the GE came back and just got worse and worse until I laid-off chinups again.

Why should I not think this will happen again?

fullpen, thanks for your reply also. Interesting idea that I'll look into. Cool user name also. I'm a professor of steel design, so I get "fullpen," LOL

[Mark Rippetoe]

Why should I not think this will happen again?

It might. It probably will. Get used to the idea that you may hurt from training occasionally.

[Brad Davis]

LOL. Pain is not the concern. Not being able to train is! If it would just hurt moderately and not deteriorate, I would never miss a beat.

Maybe I'm not understanding what I'm trying to do with this rehab plan. I thought the idea was to try and get rid of the GE, make the grip strong enough, and then not over-do it, so that it'll never come back. Is this too ambitious? From your post, it seems like you might think that the inevitable path is to keep the GE (forever?) and train around it. Is this the case from your experience?

Thanks again for your responses.
DBD

[Brad Davis]

Everybody seems to be affected differently, but for me, my 12 months of golfer's elbow came under control when I:

Did the exercises you list
Added in one where you sit down, rest your elbow on your leg, put a hammer in your hand and rotate your wrist back and forth between pronation and sup.
Did some hand and wrist stuff in a bucket of sand.
Ditched the ice and went with heat as many times a day as possible. Ice consistently set me back, and it took me far too long to realize it.

Good luck.

Thanks for your reply. Have you been able to get rid of it and keep it gone while returning to normal exercises like pullups, deadlifts, and cleans?

I'm interested in the heat vs ice idea. I've felt like the ice was helping, but perhaps not. Definitely something to stay aware of. I think I read an article by Coach Sommers (?) in which he also said he had his gymnasts use heat for these types of injuries. Don't quote me on that, though. My understanding is that we use ice because the body rushes fluids back in there to warm up the area once the ice is removed, not to decrease inflammation because we're dealing with tendinosis, not tendinitis. By that reasoning, I would've thought alternating ice and heat would be the way to go. I'd be interested in Coach Rippetoe's opinion of this also.

Rip also recommended a larger variety of exercises, so I think I should add the hammer and bucket.

[Mark Rippetoe]

Maybe I'm not understanding what I'm trying to do with this rehab plan. I thought the idea was to try and get rid of the GE, make the grip strong enough, and then not over-do it, so that it'll never come back. Is this too ambitious? From your post, it seems like you might think that the inevitable path is to keep the GE (forever?) and train around it. Is this the case from your experience?

It has been my experience that overuse injuries tend to recur, and that you need to develop ways to deal with them. Yes, you will see GE from time to time, but it need not stop you from training.