A deeper look at the nature of Tennis Elbow tendon pain and injury
If Tennis Elbow is just an irritated, inflamed tendon at your elbow "Tendonitis" – or even a minor tendon tear – WHY doesn’t it get better with a little ice, a little rest and a few anti-inflammatories?
Clearly, there must be more to your elbow pain than it seemed at first, (especially if you've been in pain several months!) so let’s take a closer look… (Previous video: What is Tennis Elbow? )
Since the essence of the typical, chronic Tennis Elbow injury is usually TendinOSIS not TendonITIS - (Degeneration, not inflammation) this makes a huge difference when it comes to choosing the right treatment approach and program.
Tendinosis Is A Very Different Kind Of Injury
The first key to healing your elbow injury and relieving the pain starts with understanding that it’s usually NOT the kind of injury it’s so often described as.
It’s usually not an ‘acute’ injury – like a cut, tear, sprain, strain or fracture – In other words, it’s not a sudden crisis. (Often even when it feels like one!)
Why does this matter so much? Because it completely changes how you need to treat it.
It means that you pretty much need to do the complete opposite of what they usually tell you to do.
You can’t expect it to get better with time, with rest, and certainly not with ice therapy or wearing a brace or splint (which will become clearer in a moment)…
And sometimes not even doing the right exercises is enough (by itself) to heal and recover from it.
What you’re usually up against is a sneaky, degenerative condition that creeps up on you very gradually.
The Essence of Tennis Elbow = Stagnation
For a long time now I’ve been trying to clearly describe what the essence of Tennis Elbow IS – To distill it down to a simple concept.
And then the other day I suddenly thought of the word that gets to the root of this incredibly aggravating, painful and sometimes debilitating injury…
Stagnation.
What I pictured was a pool of stagnant water; it’s not flowing, there’s little or no oxygen in it – And it smells pretty nasty; kind of rotten.
Well, that’s pretty much what’s going on in our tendons when we have Tennis Elbow. (If it’s a moderate to severe case, anyway.)
- The tissue is stuck and stagnant,
- There isn’t good circulation,
- The healing process is failing,
Instead of healing it’s gradually breaking down or even rotting, so to speak. I’m sorry – I know that’s not a nice image and I’m not trying to be scary and dramatic!
That’s just basically how the medical researchers describe it. Technically, they call it Tendin-OSIS.
Tennis Elbow Is Usually TendinOSIS – NOT Tendonitis: It’s Not Inflammation Causing The Pain
The “OSIS” at the end of Tendinosis means that it’s more of a degenerative condition.
So, first of all, forget about this Tendon-ITIS theory. (Lateral Epicondylitis) You can stop worrying about inflammation and inflamed tendons, because Tennis Elbow is usually not inflammatory.
What it also means is: Forget all about these references to a 2 to 4 or 3 to 6 week time frame they often give you for recovering from Tennis Elbow.
This time frame for healing assumes it’s an acute injury – It assumes it’s TendonITIS – that’s it’s supposedly inflamed.
As I’ve said, inflammation is part of your healing process – And if your tendon is a little inflamed that would be a good thing! Because at least it would be in the process of healing.
But, since most Tennis Elbow sufferers don’t actually have inflamed tendons/Tendonitis – and healing isn’t happening…
What they really need is not to try and chase the ghost of inflammation away – but to reverse that process of stagnation and degeneration at the root of the problem.
And that may even mean causing some inflammation in the process!
Look at it this way – Your tendons are either:
- In the process of healing (which involves inflammation at first)
- Nothing is happening / little or no healing (think stagnation)
- Or worse, it’s going the other way / breaking down (degeneration)
Therapy That Breaks The Cycle Of Stagnation And Helps Tennis Elbow Truly Heal
The good news is my program should help you at whatever stage you may be at.
If you have a really mild case you should be able to recover fairly quickly.
But if you have a more severe – or even a typical / moderately bad case of Tennis Elbow you’re going to need a little more patience dealing with it… (Especially if it’s Tendinosis.)
In that case, I think it will be a big help to have the support of someone like me, who actually treats people clinically.
I know for a fact that you can heal and recover fully from this kind of injury – it just takes time, persistence AND the right therapy!
The right therapy is the missing link – and in my opinion, it has to include hand’s-on treatment of your muscles and tendons.
It’s the best way I know of to reverse that stagnation we’ve been talking about.
- You need to get deep into your muscles and tendons and physically break up and release that stuckness – And all the scar tissue that’s often there…
- You need to stimulate circulation and healing – with pressure and friction – and break that cycle of degeneration!
Ideally not with just general massage (which is still okay) – But with something I have that’s a lot more focused and effective.
It’s the most important technique I teach my members here at Tennis Elbow Classroom, and I’ll show you how. All you need to do is join, log in – and follow along with the videos... Check it out, and I hope to see you in class!
Learn To Treat And Heal Your Tennis Elbow Through Video Lessons:
I'll be your personal tutor guiding you through easy-to-follow video lessons, where you'll learn all the therapy techniques, key stretches and essential exercises you need to help you take charge and break your vicious elbow pain and injury cycle... (No special equipment or gimmick devices needed!)
Just watch the videos, follow along and start putting an end to your elbow pain today.
Learn more and get started here: Tennis Elbow Classroom Self-Help Program
Hi Allen,
I have a case of elbow tendon pain, which I believe is tendonosis. It is golfers elbow, on the inside, as a result of rock climbing for many years. Will your videos and tutorials be beneficial to my injury as well, or are they not applicable?
Thanks,
Chris
Hi Chris,
The free “Tendon Tutorial” videos may be of help to you in better understanding your injury process. The members program is specifically for Tennis Elbow, though. I haven’t gotten around to making a program for Golfer’s Elbow yet.
You may be able to extrapolate a lot of the program to Golfer’s Elbow if you want to give it a try. (It’s guaranteed, after all.) I would suggest considering doing a Skype consultation with or without the program – that way I could give you some individual recommendations.
Hi Allen,
I have a case of flexor tendon discomfort in my hand, which i think is tendonosis, (there’s no inflammation). It developed as a result of playing guitar for years. I tried to give it time and rest but it did nothing for the healing, however I noticed that increasing bloodflow to the hand helps. Can your videos be applied to this injury as well?
Thanks
Hi Filip, thanks for asking. My program does not address that one specifically. I need to finish the Golfer’s Elbow program and get that up, because that will help deal with the flexor side of the hand / forearm. I’m sorry I don’t have that for you now.
You need to be more careful in dismissing tendonitis.
You see, the vast majority of people suffering from tennis elbow never have a biopsy or surgery.
Those that come to a biopsy or surgery of the tendon are the distinct minority of patients with the worst and most protracted cases of tennis elbow.
(No one with an early case of tennis elbow, or the vast majority of patients that eventually get better ever come to having a biopsy or surgery to remove the degenerated, tendinosis plagued, tendon.)
So using the biopsy and removed tendon studies that show tendinosis to be present in the small numbers who come to surgery/biopsy can not be taken to show that there is no tendonitis in the vast majority of early tennis elbow sufferers.
Now aside from being more careful in your claims about being no tendonitis, you are doing great work encouraging early range of motion gentle motion movements to help break up or prevent adhesions from inflammed tissue.
You are doing great work in having people avoid exercises that can actually worsen their symptoms.
You are doing great work in outlining a graduated exercise plan to eventually make the muscles and tendons so strong that recurrent tennis elbow is much less likely,
Keep up the great work!
Although, it is true that most Tennis Elbow sufferers never have surgery or a biopsy, more and more MRIs (and sometimes Sonograms) are being done, (especially in affluent areas like where I live) which often reveal degenerative areas within the tendon(s.)
I’m not saying Tendonitis doesn’t exist, I just don’t see the evidence supports the “chronic inflamed tendon” model when it comes to most T.E. cases.
And I don’t always point this out, but I’ve been helping people with Tennis Elbow in person for about a decade now, so I have a decent pool of anecdotal experience to draw on.
I (almost) never see any signs of swelling, redness or any other symptoms of inflammation. There may be some, which, ideally for healing to take place, there should be – I just don’t buy this raging, excessive “needs-to-be-managed” inflammation you’d expect to find with true “Tendonitis.”
Thank you for the criticism and the compliments!
Hello Allen,
I find your videos very informative and like the fact that you don’t sugarcoat it and tell it like it is. My question is regarding stagnation. If I walk, run or bike will that help with the healing process of my tennis elbow?
Thanks,
Neil
Hi Neil, Cardiovascular exercise should be helpful in aiding the healing process and reversing stagnation and degeneration! Although biking, with all the gripping you have to do, can be tough on Tennis Elbow. (I also believe heat is usually helpful, whereas ice seems to inhibit circulation and healing.)