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Can I still exercise with tennis elbow?

Posted by zhangxiaoqing on

If you have tennis elbow or golfer's elbow, you can certainly continue with cardio and lower body exercises (this is probably obvious and uncontroversial!)  …

The big question is: Should you keep lifting weights or do upper body strength training? (with or without weight or equipment)...it depends...

If your injury was originally caused by lifting weights, you may need to temporarily reduce or stop your upper body workouts.

You may still benefit from tennis elbow specific rehab exercises, but the question remains: When is the right time to start these rehab exercises?

  • If your injury stemmed from other activities, it may not be necessary to stop.
  • But you may still need to reduce: (less weight, less resistance and/or the number of sets you do)...  
  • And you may need to give up some exercises altogether for a while, as they may be affecting your tennis elbow too much - see this post on "Which Exercises Should I Avoid?"

Of course, continuing to do cardio and lower body workouts is not only acceptable, but highly desirable from a "stay fit" standpoint, as well as maintaining good circulation and healing in the injured upper body.

Although swimming is in its own category. It may or may not work -- especially if you have golfer's elbows. Check out my article/video on swimmer's elbow here for more info

Stopping everything just invites more stagnation and degeneration, and these are definitely your worst enemies when you're hurting your tendons!

Below is an overview of the principles of tennis elbow exercise and rehabilitation

Podcast: Exercise Smartly When You Have Tennis Elbow

This is a version of the podcast you can download and keep by clicking the "Download" link below the player below.

One of the main concerns and determining factors is whether you develop tennis elbow from "over-exercising" - such as exercising too often without adequate recovery time, using poor form and/or excessive weight or resistance, whether lifting weights or Do something else in the form of strength training.

If that's what caused your injury in the first place, it's probably ideal (and common sense) to take a break from that activity (or any activity you're fairly certain would cause your injury).

What is Tennis Elbow and the Benefits of Using a Tennis Elbow Brace

But let's consider three other very common scenarios:

Your injury comes from some other high physical but non-athletic cause: construction, landscaping, etc.,

Your tennis elbow is playing tennis or golf the "classic" way.

Or you get injured from something repetitive but less physically strenuous, like using a computer.

1 – Injury due to heavy physical labor:

If you're using your upper body for some serious physical activity throughout the day, such as contract work/building, then more weight lifting in the gym may be too much for your muscles and tendons until you're healing Some progress has been made.

In this case, rest and recovery time makes the most sense for you. Can't take a break from get off work? So, something has to be given.

Be sure to get enough sleep. That's when most tissue repair happens, and you probably need it more than anyone.

2 – Tennis Golf/Short Activity Injuries:

If your injury came from golf, tennis, or some other short-duration, moderate-intensity sport or activity, continuing your gym workouts can be very beneficial—though it's wise to play tennis or golf less often.

If you have severe tennis elbow, you should definitely be prepared to stop playing for a while if necessary—and know that if you continue (whether severe or not), recovery will take longer.

It would be wise to temporarily stop playing tennis or golf and focus on weight training and other structural exercises (as well as core strength, shoulder flexibility, etc.) where you carefully control the load and strength. Muscles and tendons - unpredictable things don't happen like tennis and golf.

3 - Low Intensity/High Duration - Computer Use, etc:

Finally, if your injury was due to computer use or any other type of low-intensity but highly repetitive work, task, or hobby, then you may benefit most from continuing with weight training.

If you don't already have an exercise program - this might be a good time to start a cardio/core/lower body program, at least, for the overall good...  

It might even make sense to start doing some upper body work (light weights very slowly and carefully) - if you haven't done any already.

In your case, part of your problem may stem from prolonged periods of low-intensity, repetitive, and minimal range-of-motion movements that weaken your muscles and tendons, and you should benefit from careful, progressive, low-weight exercise.

If you're going to keep exercising, be smart

In short: warm up! Do less - remember, all grips will challenge your tennis (and golfer's) elbow muscles

1 – Warm up thoroughly: Start with at least 10 to 15 minutes of cardio to get your blood flowing and warm up your muscles – (better yet, make this a top priority of your workout, from 30 to 45 start in minutes.)

Do your ab/core/glutes and leg routine before upper body strength training to further warm up your entire body

Consider doing some gentle, light forearm specific exercises and stretches before doing upper body weight/resistance training.

I think the wrist deviation (both directions) is the best and safest exercise (post + video) - I would avoid the "wrist extension curl", at least until you get back to normal. They are the most immediate challenge to the muscles involved.

2 – Less is more: When you are injured, less is more. It's always much better to start with much less weight than usual -- even if it's not satisfying. (It's much better than "blow up" your tennis elbow and not be able to do anything for weeks, right?)

If you're used to doing 3 sets or more - wow! - Reduce to only 1 or 2, depending on how bad your elbows are. Just do one set of light - or one set of light and one set of medium, skip the heavy!

3 – Stop if it hurts! Obvious, right? When doing any upper body exercise or tennis elbow specific rehabilitation exercise, the most important rule of thumb is to not feel any significant pain while doing it.

(You don't know how you'll feel afterward—but at least if it screams at you while you're exercising, you can stop right away.)

4 - It's All Grips: Always keep in mind that all grips will challenge your tennis (and golfer) elbow muscles—almost all upper body exercises involve gripping.

Even if you're not doing forearm/wrist specific exercises, the muscles on both sides of your wrist and forearm are involved in your grip strength.

So rest between sets (or do a few extra sit-ups or planks for a few minutes) and gently and carefully stretch your wrist muscles in both directions.

5 - Barbell with. Dumbbells: There are also circles who believe that barbells are better than dumbbells for some reason. This is something to consider...

But I won't chime in here. Instead, I'll save it in another post about:

"Which sports should I avoid?"

Listen to your pain - what is it talking about?

"Listen to and respect your pain" has two extremes, either ignore it completely or stop everything until you are 100% pain free.

I have to reject both in favor of some sort of sweet spot in the middle.

Yes, on the one hand, it's important not to ignore the pain completely and keep working on it...  

But on the other hand, there's a kind of "baby injury" kind of thing that overprotects it and doesn't challenge it enough while it heals!

Symptoms of tennis elbow vary widely, from dull pain to intermittent bumping and moderate-intensity "tingling" to severe, sharp, "knife-like" burning pain.

The problem is that we tend to assume that the more severe the pain, the more severe the injury - which is usually true, but in this case, it doesn't have to be.

Sometimes mild patients have a lot of pain, conversely, some tennis elbow patients with more severe, advanced tendinopathy don't suffer as much, all of which is taken into account.

It's still important not to ignore pain, but it's also important not to overreact to it.

A sudden burst of tingling from time to time doesn't necessarily indicate that you've re-injured or aggravated it -- especially when the pain logically appears to be "disproportionate" to what you were doing when you felt it.

In other words, if you get a throbbing pain when taking milk from the fridge, you probably have nothing to worry about — even if it acts a little b!#chy for the rest of the day!

However, if you're trying to lift as much weight as you normally do in the gym, regardless of your injury, (risky!) and suddenly hurt as hell in the middle of your set, that's more likely to mean re-injury/aggravation s damage.

Likewise, when doing any type of upper body strengthening exercise, the most important rule of thumb is to not feel any significant pain while doing it. (There may be some tightness or a very slight burning sensation.)

If the pain is worse the next day, it may mean that you have exercised too much, although this is not necessarily the case. It might just be a little heavier and it will get over it.

There is a lot of trial and error in the tendon healing process, "two steps forward - one step back", and we are born with the need to be at peace.

Tennis Elbow: Frequently Asked Questions

Should I wear a suspender or a suspender when lifting weights?

Maybe. I don't recommend wearing any kind of rigid or even semi-rigid brace around the entire elbow as it might be too restrictive

Weightlifting belts and belt braces that wrap around the wrist, such as the ZSZBACE brace that wraps around the upper forearm muscles (but not the elbows) may make sense temporarily.

As long as you only use them when exercising, not while resting or performing low-intensity repetitive tasks like typing.

Here's my article and video on why braces, straps, and brackets are not a good idea in the long run.

Should you ice after?

Generally, my answer is "no"

Unless you feel like you're doing too much, your elbow will be aggravated by movement and much more painful.

In this case, a few minutes of ice can calm it down and make it feel better.

If it does break out on you then you probably did aggravate the injury and you may be experiencing an "acute attack" and if you further injure your tendon, it makes sense to use ice on the spot.

Especially if there is swelling. (RICE Protocol for Acute Injury and Clear Signs of Time - Rest, Ice, etc.) In this case, you may have it several times a day for 2-3 days.

However, most flare-ups of pain aren't the result of a severe acute injury and don't have any swelling, so ice isn't necessarily helpful (other than pain relief).