Give Me My Elbow Back

Me at ATI physical therapy

Did I sleep wrong? Did I work out too hard? It was those triceps exercises that are the bane of my existence that did it I bet. Maybe it was going up in weight in bicep curls. I need to adjust the arm of my chair at work. This numbness and tingling while I type is reminiscent of when I had ulnar neuropathy. I’ll give it a few days and see what happens. I’ll try not to sleep on it. I’ll skip my work out for a few days too. Hmm, this is not resolving like I thought it would. Ouch, it should not hurt to squeeze out my washcloth. Aww, it should not hurt to open a door. Omg, why did I let him shake my hand? I should have waved or given him a fist bump. I sure could use some ibuprofen.

Let me pull out my mother’s old heating pad that miraculously still works. Ok, that helps a little. Good, some relief. Then the next day it still feels terrible. Oh my, I can’t open my own water bottle without wanting to cry. What in the world is going on? Ok, so I’m going to rest my right hand, which is my dominant hand as much as I can and use my left because this is not resolving like I thought it would by now. Ooh I remember having some leftover diclofenac from when my hips were acting up a while back. Let me take that with some food and see if helps. If I only take one every other day or so, it shouldn’t upset my stomach too much and maybe not cause those horrendous ulcers to recur. Ahh yeah, that helped. Feels much better. But wait I can’t go on like this. I only have like ten diclofenac plus I don’t want to be reliant on those alone anyway. I should be able to pull out my own chair and pick up my own bag without contemplation.

Maybe this isn’t the consequence of sleeping wrong. I haven’t been to work out in two weeks and it’s still the same level of pain. This is weird. Lord, am I developing some rheumatological or musculoskeletal condition? Lord, I know perimenopause has been giving me a run but don’t let it take my arm too. Wait, Lord don’t let me have sarcoma or some other rare cancer. Lord knows I see enough of that. Do I need an MRI? Cue the negro spiritual. “Nobody knows the trouble I see; nobody knows my sorrow, nobody knows the trouble I see, glory hallelujah. “

I know what, I should get a massage. I’m long overdue for one. Maybe that will help. This could be stress manifesting in my limb. Yeah, let me schedule an appointment.

Ok, so yes, the massage helped. It was therapeutic and seemed to calm my arm down for a bit, but it still didn’t make the problem go away. Ok, this self-diagnosed muscle strain has got to go. Maybe my tendons are inflamed. But why and what do I need to do about it because so far, it’s been a month and I don’t feel like I’m making adequate progress.  Hmm, maybe I should call my sports medicine doctor and see what he thinks about what I have going on. Yeah, this has gone on long enough and clearly, I’m not a sports medicine practitioner.

I've modified my work outs to accommodate my injury and I always wear this compression sleeve.

I make it in the doctor’s office, and he listens to my symptoms with the soft nod of his head. He then has me get up and performs an exam which is basically a series of mechanical moves that has me wanting to scream at varying intensities due to the discomfort it causes. After the torture is done, we sit back down and he says simply, you have lateral epicondylitis. Tennis elbow, I say. Yes, tennis elbow he says and then it all starts to click. Why didn’t I think of that? Oh, I know why. It never occurred to me that I could have it because well, I haven’t played tennis but yes, you can absolutely get tennis elbow without playing tennis. I know this and I’m proof. It can develop from repetitive movements. I have been doing repetitive movements and working out regularly including some exercises that I didn't ordinarily do and let's face it, I'm firmly planted in middle age as my dad likes to remind me.

My doctor’s course of action included rest for the extremity to which I thought, that will be a piece of cake. I don’t need my dominant hand for anything right? You’re right, I need it for EVERYTHING…sigh! He also prescribed the anti-inflammatory diclofenac. Yes, the same one that I mentioned above taking sparingly. However, this time he told me to take it as he prescribed it;  twice a day. I was to do this before returning for my follow up appointment. Problem is, I have issues with NSAIDs (non-steroidal anti inflammatory drugs). I have a history of acid reflux and esophageal ulcers and NSAIDs upset that delicate balance but that’s a story for another day. Nevertheless, I began taking them as prescribed and never on an empty stomach. Caution was taken with the one he prescribed given my stomach issues. I took them as directed and they helped. They helped a lot but then the uneasiness in my stomach started and I knew immediately what the problem was. I stopped the NSAIDs.

The other thing my doctor prescribed was physical therapy. I was hesitant because my daily schedule is already a lot without having to add an additional hour two- three days a week for physical therapy. However, by this point I was desperate and if he thought physical therapy could help then I was going to give it a try. Physical therapy is helping but it is not a get-well quick type of modality. Even after a few months of physical therapy, I’m still not where I want to be, but I have made improvements. I’ve even had dry needling. That was a unique adventure for me, but it has helped.

Me getting dry needled at physical therapy

At my follow up appointment, he changed me to a once daily NSAID and gave me a corticosteroid injection. I was hoping the shot made me feel like new but that was too much to ask. It did help some though. The new NSAID helped too and I was able to take it longer than the prior one without any stomach issues. That is until I wasn’t. When the first sign of an aggravated ulcer reared its ugly head. I immediately discontinued the NSAID.

The journey to healing has been ongoing and I have had to make ongoing adjustments such as utilizing a compression sleeve, using heat and ice therapy, topical NSAID and modifying my workouts. By the way, have you ever used a computer mouse with your non-dominant hand? Some days I’ve become quite proficient. I hope that my right arm and elbow will return to its normal state soon but in the meantime let me tell you a little more about lateral epicondylitis aka tennis elbow.

Graphic courtesy of Harvard University

What is lateral epicondylitis?

Commonly known as tennis elbow is when the bony bump at the outer side of the elbow is painful and tender. This bump is attached to the forearm muscles by tendons therefore not only can or does the elbow hurt the forearm can too.

Why does it occur?

It is usually caused by repetition and overuse and as result the tendon becomes inflamed. There are activities other than tennis that can cause this such as typing and knitting. In my case it is typing and certain workout activities.

Symptoms include pain or tenderness on the outer side of the elbow, pain with straightening or raising your wrist and hand, pain when you make a fist, grip something, shake hands or turn door handles. Pain is made worse by lifting heavy objects.

What can you do about it?

Treatment includes:

• ice pack and ice massage

• using a tennis elbow strap or compression sleeve

• taking/using anti-inflammatory medication

• specific exercises such as in physical therapy

• corticosteroid injection

• surgery (in severe cases)

Healing and recovery from tennis elbow varies and unfortunately can be a lengthy process. My healing process has not been as speedy as I had hoped but I am thankful for the improvement that I do have. I am thankful for the ability to still use my limbs even if I’m not at 100%. I will continue to work toward healing and recovery and if I can give one word of advice about this subject it would be to seek help quickly when you notice symptoms. The longer you wait to address the issue the longer the road to recovery. I just want my elbow back. I'll wait.

Are you seeking help in a timely fashion when you notice something is wrong?