Tennis Elbow (right arm)

March 23, 2007 at 03:46 AM · Hi, I think the best thing to do is to rest your arm for the time being until all the pain goes away. Playing with pain is never a good thing, no matter how small the pain is. My own belief(not that it is very original, but I think its really true) is that there must be something in the way you play(technically) that causes the problem when you do intense practicing. Maybe your teacher can figure out what it is? It could be as simple as loosening up a muscle in your shoulder. Hope this helps somewhat!

March 23, 2007 at 04:05 AM · This happened to me, only in my wrists--at the end of my freshman year of college, I developed tendonitis in my wrists. I had the same shooting pains, and as the condition worsened, I also started going numb.

It is something you can recover from. There's no hard-and-fast "cure" (i.e. surgery, medicine, etc.), it's a matter of letting the inflammation die down, and then keeping your tendons supple enough and adjusting your habits so that you don't develop it again. That said, here's a few things you should do:

1.) Ice can help, mostly for pain management but also to treat the inflammation a little bit. Don't go crazy with the ice, just use it after practicing/typing or something else that's really strained them. I'd say 10 minutes max, you don't want frostbite! A company called "Pro-Ice" makes great ones that wrap around your wrists, they probably make elbow packs too--check their website. I'm so glad I invested in one.

2.) My orthopedic doctor suggested heat therapy, as well. This is most helpful on a health front, it relaxes the muscles around the tendons and increases circulation. Plus it feels really great when you're sore or in pain! Use moist heat--your best bet is a heating pad with an insertable foam pad. My doctor suggested doing it religiously, i.e. every single day, for about 20-30 minutes on each wrist (your elbow, in your case). You really will notice you're tighter and more sore on days you don't do it, after awhile.

3.) The most important thing you can do, however, is prevent it from happening again. It's easy for it to pop up in college, your practice habits and technique are both changing. Make sure you're not tensing muscles when you play, and you should be taking breaks every 20-30 minutes or so. Don't just get in a practice room and play runs for hours straight!

STRETCH STRETCH STRETCH. 99% of musicians who don't stretch get injured. I stretch before and after every practice session now, as well as during the day--I try to stretch at least three times a day. If you go to an occupational therapist (my insurance covered this, hopefully yours will too), they can show you some really great stretches, as well as help with heat therapy and some others that will bring down the inflammation more. You will also work on strengthening exercises with an OT, that will also help prevent future injuries.

An OT can suggest other things that will help, too...for instance, I sleep in immobilizing wrist braces, and I use some really great support gloves to type on the computer.

Hope this helps, I know it was a book! But trust me, this is something I went through too.

March 25, 2007 at 08:51 AM · well, i too play tennis and i really don't want to give one up for the other so i do what i can to minimize the damage done to my arm

1. use the best shock absorber you can find... theres this wilson kind..it's pretty ugly.. but it practically covers the entire bottom portion of the racquet.. it might also affect balance... but you can adjust to that easily. there's also a racquet that head makes it's called the protector it's odd looking but it really does minimize the vibrations that cause tennis elbow.

2. your bow style might also be something that is damaging i know an old guy who just ripped away at it until one day his hands just collapsed

3. when you're at the point of damaging yourself it is a sign to slow down... it's a sad thing to not be able to go at tip top form but it's part of life..

good luck i hope things will work out

March 25, 2007 at 12:22 PM · whatever it is, tennis elbow or not, i am not a big fan of chiro for that, or 99% of things that chiro do for that matter. chiro's entire training is on one thing: manipulation of the facet joints of the spine. of course, what chiro does with that joint is yet another story. you will probably find it funny if a luthier insists on getting your bridge adjusted 2 times a week...forever.

if you are on a balanced diet, and a regular over the counter MVI, you really do not need vitamins from chiro. if it "works", be thankful to the placebo effect.

the main mechanism of injury for tennis elbow if resulting from playing tennis is due to an improper backhand motion. specifically, it is the wrist motion during high speed racquet-ball contact. a good solid backhand involves a LOCKED wrist at impact. problem arises when the wrist tries to "scoop" up to help... thus a big difference between tennis and table tennis.

the best bet is to see a qualified physical therapist (preferably one that works with athletes). you may have to seek them out because in that field the best ones are usually spending more time treating patients than marketing themselves. you do not need to find one that is specialized in musicians. if the clinician is any good, he or she will ask you to demonstrate the motion involved, the extent of the involvement and he should be able to identify the problem and come up with a plan in less than one second. what matters is the motion, not what you do with it.

you need to first control the inflammation by rest and treatment, whatever is indicated, and then totally retrain or start to learn the proper muscular motion of the upper limb.

btw, vitamins and protein supplements whatever they are DO NOT control inflammation. for one, ice does.

March 25, 2007 at 07:36 PM · nigel "tennis elbow" is the term applied to the condition because tennis players often get it, but it doesn't necessarily come from playing tennis. It's just the name of the condition, so even though you get it from violin it's still called "tennis elbow".

March 25, 2007 at 08:44 PM · Al and Amanda are correct. It also comes from constant shock to the arm. A qualified PT should be able to fix it. Rest and ice are also called for.

I had so-called Tennis Elbow twice and the second time an almost painless shot of cortisone into the elbow cured it and it never came back.

April 22, 2007 at 12:26 AM · I have also have a similar problem with "tennis elbow" in my right arm which I found out was actually coming from a spot in my back about 5 inches down my spine and 2 inches to the right of the spine center. The best way I found to help it, is to lie on a mattress and then roll 3 tennis balls under my back in random positions near that area. If you raise that arm you will feel that the pain changes in the arm in different positions. The pain is quite intense at first but you will get used to it and sometimes even fall asleep that way as the muscles relax. Try this a few times and see if it helps. God Bless!!

April 22, 2007 at 06:45 AM · I've had tennis elbow. I know exactly how I got it-- playing tennis. I saw the most amazing american twist serve at a tournament and the next day I played three sets imitating the grip and the motion of that serve. The day after that, I couldn't hit a one-handed backhand because of the pain in my elbow. I couldn't bear giving up tennis till it healed, so I switched to a two-handed backhand, which gave no pain. The tennis elbow was about six to eight months in curing, if I can remember. The next season I went back to the one-hander and I've never had a recurrence, because I never used the grip and service motion that caused it. The pain of classic tennis elbow comes from the rubbing of one of the tendons of the forearm over a protuberance of the elbow. There are adjustable forearm belts that seem to help some people, but they didn't help me. The only cure was complete abstinence from the motion that caused the injury. In my case figuring out the culprit motion was easy. Analyzing a violin bowstroke could be difficult, unless you changed something in your motion that you can recall. If you're doing anything extreme with your bow grip or motion, and you're playing too much with it, voila...tennis elbow.

April 22, 2007 at 02:18 AM · I know it's little comfort but I 2nd Josh--complete rest--and yes, I find it difficult to follow my own advice here.

April 22, 2007 at 08:58 AM · Sometimes it is not possible to rest it completely as long as it needs. I do highly recommend resting until the pain is gone. I have a similar tendinitis, and after about three weeks of rest, I finally had a day with no pain. Unfortunately, that same day I had to rehearse with the symphony.

Eating well and getting lots of sleep will speed recovery. You don't necessarily want to stretch an injured muscle a lot, so wait until you heal. While my muscles were healing, I massaged the area regularly. I don't know if it helped, but it felt nice. I took a lot of ibuprophen, too, but don't do this while playing because you will further injure yourself.

My injury is a little different than yours, though.

April 22, 2007 at 12:12 PM · I have had problems with elbow tendinitis for years and now have chronic tendinosis which is a minor nuisance but nothing worse. What you have to realize about tendinitis is that you get it because your muscles are not strong enough for what you are doing and the burden of doing it falls on the tendons which attach your muscle to the bone. You end up putting more strain on them than they can take. Thus, what you ultimately want to do is strengthen the muscles so that you do not get the tendinitis again.

You should see an orthopedist if rest does not do it. The orthopedist may have other suggestions and will undoubtedly send you to a physical therapist. The physical therapist will give you exercises to strengthen the appropriate muscles and other ones that can help bear the burden. That should take care of it. Good luck!

April 22, 2007 at 01:17 PM · I had "tennis elbow" in my left elbow for years. And it wasn't from playing tennis (Although I played a lot of tennis when I was younger, I'm right-handed). I did try all of the usual rememdies, and in fact was in physical therapy for several years.

One of my doctors said that I could cure it completely if I avoided ALL movement in the arm for a couple of months. So I tried not even lifting my arm and keeping it totally limp. However, that is almost impossible to do for a day (let alone 3 months).

Finally, when it reached a point that it was so painful that I literally could not lift my arm, we decided on surgery. The surgery absolutely cured it. I haven't had a problem since. The doctor thought that the years of violin playing (for over 55 years now, even though I'm an amateur) took its toll.

Please understand, I am NOT advocating that everyone with tennis elbow run to their surgeon immediately. Try EVERYTHING else first. In most instances, something is likely to make the difference. But, if it is intractable and nothing else helps.....

It's a tough problem. Good luck with it.

Cordially, Sandy

April 22, 2007 at 01:51 PM · I had "tennis elbow" for a number of months. Couldn't even lift a glass with my right hand. I tried all the usual stuff: Rest (couldn't use it anyway), heat, ice, NSAIDS. Nothng seemed to help.

I finally took it upon myself to start doing wrist curls with light dumbells, front, back, and lateral, doing the reps slowly, starting with light weights, and increasing as it felt right. Tendonitis started to improve almost immediately, and went away in a couple of weeks.

April 22, 2007 at 06:17 PM · Aside: My left forearm since beginning violin is buff! ;).

April 22, 2007 at 06:10 PM · Wow, so many remedies here but those are just for the symptom, in my opinion, not the problem.

I know exactly what you are talking about I had it myself. When exactly does it occur with you? In fast sautille/spiccato passages? Or also in slow legato passages? I'll venture a guess that it's the former...

You're also not alone, check this video of Perlman and Zuckerman playing and you'll see Zuckerman suddenly stop and shake his hand, clearly because he got that "shooting pain" that you describe (it feels like an electric shock, right?). If I am wrong about that assumption my apologies to Mr Zuckerman, but it seems reasonable to assume.

Here's the video: http://www.youtube.com/watch?v=SR_oJXyokww

It happens to him on a downbow too. I think I have found a medical reason too:

I refer to this page: http://www.getbodysmart.com/ap/muscularsystem/forearmmuscles/pronatorteres/tutorial.html

There is a muscle called the "pronator teres" which is in your forearm near your elbow, connected to your median nerve. What is happening (in my opinion, I am no doctor but I have done a lot of investigation to solve my problem, successfully) is that by being too tense in your arm you are pinching the median nerve, and when you release it (by playing a downbow, usually a longer downbow from my experience) the nerve sends a barrage of pain down your arm.

Now, the solution, as has successfully worked for me:

I am assuming that you do not get sharp shooting pains while doing normal day-to-day tension-free activities. This means that you are doing something which is causing the pain. The first thing is that your bow must be 100% independent from your left hand. Practise the passage without the left hand, only bowing the open strings. When you can do that, you can add the first note of the passage, and when you can do that you can play the first note and then add the second note and play the second note repeatedly, and keep adding notes until you can play the entire passage completely evenly and in tempo.

Next, you should not do the sautille by trying to move your bow from the shoulder. It is physically impossible to move your shoulder fast enough to play a fast sautille passage (think of the last pages of the Zigeunerweisen, or the Partita no. 3 by Bach, which is the one that really caused me the problems...there it wasn't sautille but the string changes that were causing tension).

Therefore, the faster you play, the smaller the body component you need to use to move the bow. Preferably a combination of the fingers and wrist with a little forearm movement and only minute movement at the shoulder as a result of everything else moving (passive movement, not active movement. Your shoulder should not be "blocked", but should be free and allowed to move).

Next, you need to concentrate on the weight of your bow being transferred through your first finger. Don't try and bounce the bow, just plant the bow firmly into the string with the first finger and use a small amount of bow in the middle and a short impulse at the beginning of each couple of down strokes (depending on the speed) and the bow will bounce on its own.

This is all rather hard to describe in words, but I hope you get the idea. Just remember that if you're relaxed you won't get the pain. I also found that if my elbow was too low it caused this pronator teres muscle to tense up. When it tenses up, it sortof feels as if the point of your elbow is tense, though of course that is impossible. So watch out for that feeling. This happens most often if the elbow has dropped too low, so watch out for that too.

Ok, this was a long post but I hope that something rings a bell with you and can help you!

Best Wishes

Larry