Inflammation: It's the ultimate, unspoken sacred cow of Tennis Elbow! (Also known as 'Lateral Epicondylitis' or 'Elbow Tendonitis')...
But, if you’re still fighting, treating or otherwise chasing it, here's why you can stop right now – You're chasing a ghost – A sacred "ghost cow."
Podcast: Smashing The Tennis Elbow Inflammation Myth
Here's part one of two short podcast episodes on the "Tendonitis / inflammation" myth:
Here's the long version of this inflammation podcast that you can download and keep by clicking the "download" link under the player below - And subscribe on your favorite platform:
No Real Evidence Of Inflammation In Tennis Elbow
Medical researches first started finding evidence decades ago that the original persistent or Chronic inflammation / “Tendonitis” theory on Tennis Elbow was incorrect.
(And this goes for most other tendon problems, generally known as ‘Tendinopathies,’ as well.)
Since that time, it’s been conclusively proven that the vast majority of Tennis Elbow cases do not involve any significant inflammation (especially long-term/chronic cases)...
And therefore should not be classified as TendonITIS, EpicondylITIS – Or anything ending with “ITIS” that would suggest an inflammatory condition.
Any Science Out There? “Besieged By Myths”
“As orthopaedic surgeons, we are besieged by myths that guide our treatment of lateral epicondylitis, or "tennis elbow."
…The term epicondylitis suggests an inflammatory cause; however, in all but 1 publication examining pathologic specimens of patients operated on for this condition, no evidence of acute or chronic inflammation is found”
Lateral Tennis Elbow: "Is there any science out there?" J Shoulder Elbow Surg.
And yet, a large number of Doctors, medical websites, Physical Therapists and other professionals, seemingly unaware of their sacred cow’s demise, continue to perpetuate the inflammation fallacy...
By writing prescriptions, making therapeutic recommendations and performing treatments based on it.
Here’s more from a paper in the British Medical Journal, entitled:
“Time To Abandon The ‘Tendinitis’ Myth”
“Most currently practicing general practitioners were taught, and many still believe, that patients who present with overuse tendinitis have a largely inflammatory condition and will benefit from anti-inflammatory medication.
Unfortunately this dogma is deeply entrenched. Ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs for treating painful conditions like Achilles and patellar tendinitis despite the lack of a biological rationale or clinical evidence for this approach.”
Time To Abandon The “Tendinitis” Myth – British Medical Journal
Just Because It FEELS Inflamed Doesn't Mean It Is
Yes, I understand your Tennis Elbow may feel like it’s inflamed to you!...
Those burning sensations, that achy, swollen feeling, and the occasional jolt of searing pain would lead any sensible person to think that there must be inflammation in there somewhere!
It’s just that the research doesn’t support it. (It sure sells a lot of anti-inflammatories and boosts big pharma’s bottom line, though.)
The symptoms, in this case, are extremely misleading and rest assured there’s nothing sensible or straightforward about Tennis Elbow.
What researchers started discovering decades ago (and I’m only citing a fraction of them) is that inflammation is actually missing in action (most of the time) and there’s a sneaky, insidious degeneration process going on in the tendon, which, I’m sorry to have to say, is a lot worse than a little inflammation.
It's Tendinosis, Not Tendinitis
“Numerous investigators worldwide have shown that the pathology underlying these conditions is tendinosis or collagen degeneration.
…One factor that may interfere with optimal treatment is that common tendinopathies may be mislabeled as tendonitis.
…An increasing body of evidence supports the notion that these overuse tendon conditions do not involve inflammation.”
The Physician and Sportsmedicine 'Overuse Tendinosis, Not Tendinitis Part 1'
I first wrote about this and quoted some of these sources over ten years ago in my ebook “Escaping The Tendonitis Triple Trap”
(I still referred to it as Tendonitis in the title, because it seemed like so few, outside the medical research community, were aware of Tendinosis at the time.)
These past couple of years I’ve been encouraged to see more and more correct references to the true nature of Tennis Elbow in the mainstream, by Gretchen Reynolds, in the NY Times, for instance.
And I just did a quick check and saw that WebMd no longer cites inflammation as the main issue with Tennis Elbow…
That's a big change, BUT, they talk about the need to "reduce it" on at least one page, and they STILL recommend ice, anti-inflammatories and Cortisone shots in several places.
Medical Mixed Messages - Is It Inflamed Or Not?
"Even though inflammation isn't usually present in long-term (chronic) tennis elbow..."
"To reduce the pain and inflammation of tennis elbow, try:"
[List, including ice, rest, pills and shots - WebMD]
Not a big surprise. There is clearly still widespread support for this inflammation fallacy out there.
Not Just Chasing A Ghost And Wasting Time - But Worse: Interfering With Your Healing Process!
I think it’s a tragedy that many if not most Tennis Elbow sufferers are still told to chase the inflammation ghost…
Still encouraged to ice repeatedly, take ridiculous amounts of anti-inflammatories – and then resort to painful Cortisone shots if the first two interventions don’t banish the ghost.
That’s not to say that these treatments don’t work. They do often work very effectively – When it comes to relieving, or should we say, “suppressing” symptoms temporarily.
(That’s probably one of the reasons it’s so hard to kill this sacred inflammation cow!)
But the problem is all three of these treatments have increasingly higher risks of slowing your healing process down or even causing significant harm or damage, Cortisone shots in particular...
Although those seemingly innocuous pills can be pretty harmful, too, when taken for weeks on end.
To top that off, neither your Doctor nor the medical websites will tell you the simple fact that inflammation is a natural and necessary part of your healing process.
Which means you’re essentially trying to stop your own healing process!
Inflammation = Step 1 In Your Healing Process
You see, any time there’s injury to tissue, including muscle, tendon, skin and bone, inflammation is the first stage of the healing process – Without it there is no healing.
“Acute human tissue response is characterized by three phases:
1) Acute vascular-inflammatory; 2) Repair-regeneration; 3) And maturation.
In normal tissue healing, inflammation plays an important role in this complex dynamic process. ...In this context, inflammation is often defined as a normally occurring, localized protective response…”
Tendon Injuries Basic Science and Clinical Medicine
To Simply Sum Up The Inflammation Facts:
- There is no significant inflammation present in Tennis Elbow, (usually) so it’s not Tendonitis or Epicondylitis…
- Inflammation is not a bad thing anyway! (when it comes to muscle and tendon healing) and it NEEDS to happen long enough to kick off the healing process…
- So, don't risk harming yourself with pills, ice and shots attempting to chase away something that isn’t even there in the first place – And which you actually NEED!
But don't be too hard on yourself if you didn't have a clue about any of this until now, and you've been following the "common wisdom" and the advice everyone's been giving you about "reducing" your inflammation.
How bizarre is it to find out that inflammation is something you didn’t know you wanted, because you can’t have healing without at least a bit of it!
Learn To Treat And Heal Your Own Tennis Elbow Right Here:
I'll be your personal tutor guiding you through easy-to-follow lessons, where you'll get the therapy techniques, key stretches and essential exercises you need to treat and recover from your injury at home.
Just watch the videos, follow along and start putting an end to your elbow pain today.
Learn more, and get started here: Tennis Elbow Self-Help Program
Golfer's Elbow sufferers, get started here: Golfer's Elbow Classroom