For a true gym rat the worst thing about golfer’s and tennis elbow is the effect they have on workouts. I got both conditions on both arms at the same time, but the good news is that I healed without a break in training. These are the things I did to heal golfer’s and tennis elbow while continuing with a level of activity that would make a physio cringe:
- Instead of using lifting straps to relieve forearm stress, I cut down my use of them to strengthen my grip.
- Took time to warm up the forearms before normal gym work.
- I worked around pain, not through it.
- I waited, albeit not very patiently! Poor blood supply means the injured tendons involved in golfer’s and tennis elbow take a long time to heal.
Chin-Ups of Doom
Doing chin ups every day is what caused my golfer’s and tennis elbow. I was using a straight bar with an underhand grip, which is extremely stressful on the elbow end of the forearm tendons. I’d done chin ups that way on and off for years, but never so regularly, and eventually I paid the price.
I awoke one morning with what felt like normal delayed onset muscle soreness from working out, but days went by and it got worse, progressively becoming less like normal workout pain and more just plain sore. Crap.
Taking a healthily type A approach to the situation, I was obsessed with improving my chin-ups, so continued the every day training. Not wise.
It got to the point where almost everything I did in the gym hurt and constantly re-aggravated the injuries.
A Quick Self-Diagnosis Later
A check of the internet shortly after the pain began and it was obvious I had bad lateral and medial epicondylitis, AKA tennis and golfer’s elbow. Both conditions on both arms. Fantastic!
Great to have a diagnosis, not so great that inactivity seemed to be the most widely advised first step in treatment. Also not great is the blood supply to tendons—meaning that healing can take a long time.
Things That Didn’t Work
I just wanted an effective way to get rid of the injuries ASAP. Unfortunately most of the methods I found were useless. Perhaps they’d be some use for sedentary people, but any benefit you might get from twisting a foam cylinder tends to get drowned out by continuing to deadlift hundreds of pounds.
In that vein, here’s what seemed to have no effect:
- Twisting one of those special foam cylinders (designed for the purpose).
- Doing the eccentric portion (the part of the movement where you’re lowering the weight, AKA the negative) of dumbbell wrist curls and reverse wrist curls.
- Foam-rolling my forearms.
- Self-massaging the affected tendons where they in insert into the elbow at the points where they were sore.
Again, if you’re happy to take time off from training, perhaps those things would be of benefit. But we diehard muscle-heads aren’t known for sense regarding time off, and as long as we can hobble towards some weights, we’ll train. In spite of that attitude I healed anyway, which is potentially good news if you’ve got golfer’s and/or tennis elbow and can’t bear the thought of time away from training.
What Finally Worked
My tennis and golfer’s elbow kept me dubious company for years. Partly because I stubbornly insisted on working through pain, and partly because tendons just take a long time to heal at the best of times. Hard won experience taught me these are the important things to heal golfer’s and tennis elbow while still training:
- Work around pain as opposed to through it. This is first and foremost. The injured tendons are stressed in most of what we do in the gym, so chances are you’ll feel the injuries with almost every exercise. But you should distinguish between the stinging, intense pain that feels like you’re exacerbating the injury, and indirect pain. The latter is okay, the prior is a great way to either regress or never heal. You must avoid exercises that re-aggravate the problems.
- Strengthen grip. A disproportionately weak grip seems to be a major factor for getting the injuries in the first place.I’d never given much thought to grip strength, and for most of my training years I used lifting straps for almost every exercise in which I had to hang onto or pull anything.I think the best way to train the forearms (the tendons of which are the bits that hurt in tennis and golfer’s elbow) is just by hanging onto heavy things. Deadlifts in particular are excellent. Of course this means minimal use of lifting straps; I practically stopped using them, and my grip strength improved pretty quickly thereafter.
- Warm up the forearms before working out. My approach was to stretch, then hang from a straight bar and flex and relax my fingers up and down. You could probably do wrist curls, too—the only reason I didn’t was that I find them a mind-numbingly boring exercise.
- The passing of time. As mentioned, tendons are slow to heal because of limited blood supply, and more so if you insist on continuing to train. But it will happen.
What Maybe Helped
In my search for a non-existent miracle cure, I happened on this work by Bryan Chung over at Evidence-Based Fitness. I was particularly interested in the soup-can-dropping part of his method, and noted that the mechanism was tending towards a violent shock to the affected tissue (albeit with light weight).
Anyway, like any quality bro-scientist, I took it to the extreme with my own take. As such, after I’d warmed up, between sets I’d jump up and grip onto a chin up bar, the idea being to suddenly stress my forearm tendons with my body weight.
I couldn’t say whether this helped much, but it felt good, and might have been useful. I should note that this course of action probably isn’t appropriate for a fresh injury. I only did this after months, when the pain had settled into a dull ache instead of an acute sting.
Chin ups and squats are two of the absolute best and most productive exercises there are, but they were also the exercises than hurt my elbows and delayed healing the most. I should probably have stopped them altogether, but I didn’t. This prolonged the injuries, but did have a positive side—I eventually found ways of doing them that minimized forearm stress and allowed my tendons to heal.
Squats: there are a number of options here.
- Use a high-bar position instead of a low-bar one.
- Move your hands out wider on the bar.
- Try a thumbless grip.
- Try not wrapping your little fingers around the bar. This is slightly awkward at first, but can significantly reduce pain and tendon stress.
Chin ups: all common grip variations—palms away, neutral grip, V-grip, and palms towards me—all eventually resulted in pain and had to be avoided.
I found the secret was hand rotation. This means either using a chin up station with rotating handles, or using gymnastic rings. You start from a dead hang with palms facing forward, and as the movement is executed, rotate your hands so that palms are towards chest at the top of the motion. It feels infinitely more natural than having hands locked in one position, and it’s the only way I do them now.
Wrap Up: How to Heal Golfer’s and Tennis Elbow While Continuing to Train
The sensible approach is to take time off from the gym, stretch the forearms, and do special low-impact exercises. This will probably yield the fastest results, but will put your other physique/strength/muscle goals on hold.
The bull-headed approach I took was basically to:
- Avoid exercises that hurt too much, and in particular modify the way I squatted and did chin ups.
- Warm up my forearms.
- Drastically reduce my use of lifting straps to strengthen my grip.
And that’s it. Not necessarily sensible, but in the end it worked.
Questions and comments invited—use the comment box below. I’d love to hear about your experiences.
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