My windsurfers / tennis elbow has flarred up again! So I thought I'd better go and see someone to hopefully prevent too much interuption to my TOW. What would be the best praticioner for this ailment? GP, Osteo, Physio??

The tendons are sore and muscles in the forearm are rock hard when flexed. All the stuff I've found on the web, exercises,massage etc dont seem to be helping ATM.

I had the tennis elbow for a while about 18 months ago, if you have strength with underhand grip and no strength when picking up things overhand then its the same as i had. It actually didnt effect my sailing that much but had a fair bit of pain on the drive home.
I went to the Physio once a week and massage at night followed by ice pack for 5 mins.

The main thing with the massage is to work your fingers right into the tendon to get the blood flowing i was told.

I also wore 1 of those support strap things just below the elbow at work.

It took about 4 months to come good but it hasnt come back... yet!

I think you just have to persivere with the treatment and be prepared to pop some anti inflamitries for a week to settle it down.

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Jman said...


I did the Physio once a week ……..

That's all well and good Jman, but but I think Waiting4wind wants to know if you got any treatment for your elbow??

I had to stop building full time because of "Tennis Elbow" I would wake up at night with no feeling in my forearm after a day using nail guns. I had lazer, ultra sound and massage but the best treatment was rest. Sorry Try the arm band it does work but it will move the sore point over time and you have the same problem again. Only sail on the good days and rest on the crap days.Also try and relax your hands while sailing and take the load on the harness. An opp may help too. Good luck with it

It's a tricky one.
There is no reliable treatment.
80% of cases will resolve within one year regardless of treatment or no treatment.
I had it from a week of house-cleaning using a pressure cleaner, gripping the wand for extended periods while getting really cold. Musicians get it a lot, and there is always a lot of chat on TGP about it.
The most important thing I've learned is to keep the arm warm. This aids circulation, which is very important. I really feel the hypothermia I go while having water mist over me was a big contributor to mine.
There was study a few years ago that showed that using a nitrate patch over the sore spot helps a lot, but the side-effect of headaches is quite limiting. The nitrates are vasodilators, which increase circulation also, promoting healing.
It often involves the whole extensor complex too, right down the arm, as it did in my case, and that is harder to treat.
Splinting your wrist in 30 degree extension (called the "functional position) takes a big load off the extensor muscles, because even though the pain is at the elbow, the majority of the work extensors do is to stabilise the wrist against the action of the flexor muscles.
I avoided cortisone injections, because even though they can produce good relief, it always weakens things, and I preferred to avoid that.
At the end of the day, your activities will be limited for a good while. Mine took a year to resolve.
Did I mention to keep your arm warm.
I bet most people would suggest ice, but good blood circulation is vital.

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kato said...

I had to stop building full time because of "Tennis Elbow" I would wake up at night with no feeling in my forearm after a day using nail guns. I had lazer, ultra sound and massage but the best treatment was rest. Sorry Try the arm band it does work but it will move the sore point over time and you have the same problem again. Only sail on the good days and rest on the crap days.Also try and relax your hands while sailing and take the load on the harness. An opp may help too. Good luck with it

Did you ever consider giving up windsurfing instead? I know, you have your priorities right.

I have noticed that I have elbow problems if I windsurf and do a bit of weight lifting in the gym. Either on their own are okay, but if I am using the weights during sailing season the elbow starts to give a bit of a twinge.

I have the same bloody thing. Very annoying. Makes doing weights very frustrating and have been limited to leg workouts only. Doc said to keep it wrapped and do light exercises and maybe some voltarin but I think as kato said rest is the best remedy. Not what I want to hear coming on to summer.

PM me with where in NSW you live and i will send you the details of someone best for the job

i use this for all my injuries, half hour before sailing put a 1 foot long piece of old wetsuit on your arm,this will get the muscle warm ready for use, also if real bad keep it on doubling over/under wetsuit while sailing.

while sailing try putting front arm the opposite way on boom,under or over.

reduce gybes by sailing long reaches and stopping at shore. powering up harness to max, using little arm strength should help too.

1)You will need to stretch these muscles before exercise.
2)Sounds like you should be eating protein rich food for muscle recovery 1-2 hours after a session.
These foods include lean chicken steak even nuts like almonds.You can also obtain protein muscle building meathead milk/ n body building mixes.
Once the muscles are damaged they chace protein for repair.
This protein helps recover torn damaged muscle.
Try eating lean steak and aviod carb rich foods.
Problem is your body is chacing protein to fuel muscle but arent feeding it
Change your diet !!!!
Dont eat **** food.
HINT
Another quick trick for overweight is to skull water 3-5 litres before you eat. This will reduce your appetite!

Actuolly while im on the subjet i will critise process food.
e.g
take away processed food.
Body eats it goes wtf? cant process It is not giving me any valuable nutrients so im goin to place it in fat cells and deal with it later. body says ill store it.
e.g
You wouldnt plant a tree and expect it to grow in yellow brick sand.It requires nutriens to function and grow.
This is what your body is tryn to do.

I hear you busterwa, I have been using Musashi bulk mass gain protein blend and eating proper foods plus the stetching before and after exercise. No improvement yet but will keep persevering.

The other thing I forgot to mention is the most important.
Google "eccentric loading exercises".

I'd love to see anyone skull 3-5L of water anytime. That would be good TV !!

i had that problem a couple of years ago, the thing i used was a wrist band, the one that loops over your thumb and wraps tight around your wrist and fasten-es with velcro, it also takes a lot of pressure off the forearm aswell

I have 2 that play up occasionally.I was told by my chiro that it is often a problem in your neck that ends up creating it.I know that by ignoring it and continuing to sort mail & use the bike throttle as a postie for 15years it really caught up & spread to my whole upper back.I thought I was smart by inventing ways to get around it but it just spread the problem elsewhere until the body couldn't cope anymore.
As said I wear 2 braces , change my grip , use the harness a lot & avoid short runs or unhooking a lot.The chiro works on me but I generally just try & manage it so it doesn't flare up.I know any posture where you hold your elbowsup ( riding a motorbike with elbows out or prob sailing with them not dropped & relaxed) can stir it up so I'm very mindful of posture.
Also i had a few strectches for the forearm muscles....press your hands together like your praying ( stretch the underside ) & bend the hand down & back ( stretch the upper muscles ) after sailing.

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Donk said...

I hear you busterwa, I have been using Musashi bulk mass gain protein blend and eating proper foods plus the stetching before and after exercise. No improvement yet but will keep persevering

As its not a muscle that's causing the problem, any extra protein isn't going to make a difference. I was using VP2 and it made no difference to this pain.

I have been smitten 3 or 4 times - about once a decade. Just getting over the last attack, I didn't sail for the first 6 months of this year. Have tried all the remedies including cactus juice but couldn't say one is better than the other or that any in fact work. So will back Ken's comment " 80% of cases will resolve within one year regardless of treatment or no treatment."

You mostly get it in the right arm, which suggests windsurfing, being a symmetric activity, is not a primary cause. The one time I did get it in the left arm it resolved in half the time - suggesting rest helps. Just take note of how much you do with your preferred arm. It's not surprising they say "enough" every now and then.

So don't do anything that causes pain, try to do more tasks with the left hand. Home renovations can aggravate it so before you do anything go straight down to Bunnings for the appropriate Ozito power tool. Especially avoid percussion - hammers, chipping with shovels, crow bars, and of course tennis.

Gybing race sails is percussive, I'm giving cams a rest for a while. Get a RAF sail in your most used sizes until you're fully recovered.

..Just reading KA43s post, better add - tried all remedies except the cortisone.

Gday Des, had the same problem a couple of seasons ago. Had to keep stretching my arm etc after 2 runs. Had no strength in it. Underhand grip helped.
saw my GP who straight away gave me a cortisone injection. Bloody sore for 2 days then the pain went away. After that it was gone. Sailed the whole season with no ill effects.
I did follow what he said and what most on here have said about stretching etc.
It came back about a year later but then disappeared just as quickly.
Hope this helps.

Thanks for all the suggestions, I'm prepared to try anything except maybe amputation.

I first got his when I took a year off the season before last and sailed 5 days out of 7 (hope this is not karma). It's just recently flarred up again.

Funnily enought it is not my primary hand, it's the left one. But I think that one may get the strain in the NE'r run at Botany - typical sailing spot

I've now set my harness lines for 2 finger boom pressure on that arm (except when it's ballistic) May be I need to limit my sailing to quality sessions as suggested and lay off the hamburgers after the big session.

I'm confused onthe heat / ice thing. I allways assumed that get it warm beforehand to aid circulation and then icing afterwards to reduce swelling & inflamation was the go.

I did notice recently that my circulation was poor on that arm as it got colder more quickly.

ice and stretch, sail less

I know this is not supposed to work, but I tried it anyway. I used one of those elbow support elastic wrap things for my left elbow when it was playing up, while I was sailing, and it seemed to help. It felt better, even though it was obviously reducing the circulation a little.

I know it is not supposed to work, but somehow the compression helped. Maybe I was just blocking the pain by the reduction in circulation.

Thanks guys, I guess i just have to cometo terms with, unfortunately, that I need to do less of what's causing the aggrevation.

Ian what this about giving up my cammed sails? I suppose you'll be asking me to keep the speed down to under 40 knots as well.

Go to a sports medicine physician (ie. doctor who specialises in sporting injuries).

The most likely "cure" is a cortisone injection. That will relieve the pain and inflammation while the injury heals itself.

You can try alternate therapies if you like. I have. In my opinion they achieve nothing. The best you can expect is to spend money and feel like you are doing something and maybe get a short term placebo effect. In the end your body will heal itself.

I have had some nice massages from very cute physios and osteopaths. It's a nice way to spend an hour paid for by the medical insurance extras.

The other thing to do is to modify your technique. You're probably gripping the boom too hard and over controlling the rig. Relax. Let the gear do the work.

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KenHo said...

It's a tricky one.
There is no reliable treatment.

Ken,
I hate to disagree, but for the last 5 years or more physiotherapy programs developed by the researchers at UQ, have a success rate of 90% or more in my clinic. We have treated more than 30 cases in the last 2 years and settle the bulk within 6-8 weeks. No recurrences to date, and without the need or steroids, or nitrate patches. Actually, I'm sure you know of the benefit of eccentric exercise in rehabilitating tendinopathies, well this is really no different, except for the manual therapy techniques to de-load the extensor tendons.

W4W the problem is the tendon becomes painful and degenerates a bit. However, studies have demonstrated that there is rarely any inflammatory cells, thus your cortisone and traditional anti-inflamms tend not to work.

The best clinical management is in my opinion by a physio that is using the latest clinical techniques to deload the extensor tendons, modify your activities for a few weeks, and progressively rehabilitate (strengthen) the muscles. The braces generally don't do anything, but may work for some - but they will not help the problem.

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FormulaNova said...

I know this is not supposed to work, but I tried it anyway. I used one of those elbow support elastic wrap things for my left elbow when it was playing up, while I was sailing, and it seemed to help. It felt better, even though it was obviously reducing the circulation a little.

I know it is not supposed to work, but somehow the compression helped. Maybe I was just blocking the pain by the reduction in circulation.

Have had tennis elbow several times over last decade - always from pruning or hammering, never from tennis which I play about 4 hrs per week.

Got to agree with Dale re compression bandage being the best practical thing when participating, but treatment (as always) can be a very individual thaing.
Good info here:
http://www.smasa.asn.au/resources/elbow_pain.htm

- particularly the stretchs/exercises, they work for me. The brace or tape around thick part of arm just below elbow is very effective.

Once had a physio give really painful massage of that muscle group, working thumbs from elbow joint down into the muscle - fixed it good.

(Edit: but I will defer to Dam71 & KenHo on this - always enjoy & appreciate your input guys - be it prof'l or not.)

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Waiting4wind said...

Thanks for all the suggestions, I'm prepared to try anything except maybe amputation.

I first got his when I took a year off the season before last and sailed 5 days out of 7 (hope this is not karma). It's just recently flarred up again.

Funnily enought it is not my primary hand, it's the left one. But I think that one may get the strain in the NE'r run at Botany - typical sailing spot

I've now set my harness lines for 2 finger boom pressure on that arm (except when it's ballistic) May be I need to limit my sailing to quality sessions as suggested and lay off the hamburgers after the big session.

I'm confused onthe heat / ice thing. I allways assumed that get it warm beforehand to aid circulation and then icing afterwards to reduce swelling & inflamation was the go.

I did notice recently that my circulation was poor on that arm as it got colder more quickly.

My chiro says don't put heat on muscles that are inflamed as it justs encourages more blood flow & makes it worse..use ice..Pity I used to love lying on a heat pack.. Second the watch what other activities you use your stuffed arm for & note what are problems & then avoid..I'm so used to living like that I forgot that one..+ become ambidextris..

Can't butt heads here.
Check back a few posts and see me suggest eccentric loading exercises.
I have had good results referring patients for Achilles tendonitis.
I recall that I did some research on teh interwebz for myself, which yielded little, but I think I did some exercises I adapted from the Achilles programme, which I felt helped me turn the corner.

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DAM71 said...

KenHo said...

It's a tricky one.
There is no reliable treatment.

Ken,
I hate to disagree, but for the last 5 years or more physiotherapy programs developed by the researchers at UQ, have a success rate of 90% or more in my clinic. We have treated more than 30 cases in the last 2 years and settle the bulk within 6-8 weeks. No recurrences to date, and without the need or steroids, or nitrate patches. Actually, I'm sure you know of the benefit of eccentric exercise in rehabilitating tendinopathies, well this is really no different, except for the manual therapy techniques to de-load the extensor tendons.

W4W the problem is the tendon becomes painful and degenerates a bit. However, studies have demonstrated that there is rarely any inflammatory cells, thus your cortisone and traditional anti-inflamms tend not to work.

The best clinical management is in my opinion by a physio that is using the latest clinical techniques to deload the extensor tendons, modify your activities for a few weeks, and progressively rehabilitate (strengthen) the muscles. The braces generally don't do anything, but may work for some - but they will not help the problem.

That should be OK Des, you may continue sailing at 40knots.

I googled eccentric exercise, sounds logical. Do gyrotwisters/power balls qualify as an eccentric exercise? I think they probably do.

Des, go & see trudi. she sorted mine out the first time. when it recurred, i saw a dr who gave me a cortozone shot into the elbow. hurt like hell for a few days, then good as new !!!

I had the tennis elbow issue last season in my left (weaker) arm. Six visits to a young female physio and lots of stretches for the tendon later and it is all good. Have to keep up the stretches most days but thankfully it has not come back, touch wood. Underhand grip helps.

But I do have achilles tendonitis in one leg at the moment.
Flares up after a session with lots of gybing. Guess it's the foot action involved in the gybe. Hard not to do.

Am trying the stretches I found on the interweb and hope they work. If not then back to the physio. Cortizone is the second last option and surgery the last as far as I am concerned. Don't even like taking anti-inflamatories.

Good luck.

Windsurfers elbow, oh ya.... mine plays up when I do too many vulcans... not sure why... probably the sail switch thats putting pressure on the elbow. So if ur doing those kind of tricks, its probably that

My TE isn't happy & arms generally are whinging. Did a lot of gybing practise subplaning with the 6.6m today trying to pull the sail right in on the entry & they didnt like it. I think I need to build up my arms with some weights..