Dr. S Goes to a Doc For Elbow Pain
MG: You experienced an elbow injury. Managing pain and injuries is a key part of trying to stay healthy, so you can get a cardio buzz every day. Tell us about your experience fixing your elbow.
Dr. S: I went to an orthopedic surgeon for a steroid injection after more conservative measures were ineffective. I started out the appointment by introducing myself to the doc and saying, “I’m a doctor, too. A psychiatrist. So, I know that we all have… bones… inside us.” He snarfed coffee out his nose and I thought, “Hmm. Unplanned mission accomplished!” Then I went on to say I took out my anatomy book and poked all the parts of my elbow and forearm that hurt and decided I must have right-sided lateral epicondylitis as well as a less intense triceps tendonitis. He did an exam and totally agreed! Turns out, one gets this from extending their middle finger too much, which made me cackle but he gave me nothing but crickets in response.
He said steroid injections work temporarily, but they’ve stopped recommending them because the pain comes back. He recommended PT, a wrist splint and needling. Needling is when a misanthropic orthopod sticks a needle into the frayed tendon repeatedly up by the elbow and you bleed out of all the little holes. Reparative immune cells are attracted and, in theory, come help fix the situation…
I sat, still and silent until I figured out how to convey “What the fuck no!” in doctor speak which went something like this:
“I value evidence-based medicine. I aspire to be rational enough to choose needling, but I’m about to vomit at just the thought, so I’m going to go with No. You can not needle my tendon. Holes are disgusting and this remedy sounds reminiscent of leeches, vapors, humors and miasma in the aether. Mainly I’m just grossed out by someone putting holes in my tendon.”
So, I convinced them I was actually an excellent candidate for steroid injections, and I’d get a splint (I really did and I wear it) and learn some PT. My arm feels amazing, but I know it’s not healed yet, so I’m not doing any weights in the workouts with my right arm. I’m imagining that I can still feel it hurt and am behaving accordingly so I don’t re-injure it.
It’s tennis elbow, but a friend of mine called it Doctor’s Elbow, so I’m going with that.
Most cases of Doctor’s Elbow take 12-18 months to heal. That’s way too long.
I want like three exercises max to do that will prevent further injury by strengthening other muscles NOT required when flipping the bird.
MG: You have stumbled upon one of the major themes of our opus: trying to minimize pain in the body. As you know, we value exercise that raises our heart rate to 80%+ of HR max, and this often requires pushing muscles, tendons, bones and other assorted parts of the body beyond what they might do while going through daily activities. Most HIIT programs focus primarily on the “high intensity” by trying to push the body as far as it will go. At Cardio High we aim to minimize pain in the joints and muscles. There are a few techniques we use that we believe achieve HIIT with MIN body pain.
1. We use a dynamic warm-up that borrows from Yoga, Corrective Exercise and training for various sports. We focus on constant motion versus static stretches. We start with some of the most simple movements. Slowly warming up the body reduces the risk of muscle or tendon tears. It also helps to reduce the number of micro tears that can lead to soreness.
2. We use low impact movements in our HIIT portion of the programming.
3. We train clients to properly decelerate and to land properly when jumping.
4. We employ dynamic stretches and corrective exercise throughout the workouts.
5. We train balance, so falls can be minimized.
6. We do not do any movements that are known for high-injury risk.
7. We advise clients to cut down on sugar and other foods that create inflammation – as inflammation can create body pain.