Tennis Elbow?

Has anyone had tennis elbow? My wife finally went to have her elbow checked out, it has been bothering her for a couple months. Consequently she has been afraid to go out kayaking, for fear it will get worse. So she’s been diagnosed and the treatment it to stay off her elbow. Has anyone tried kayaking with this condition, does paddling make it worse?

been there…

– Last Updated: Jun-24-08 10:24 AM EST –

I have bad elbows - any kind of repetitive motion makes them hurt and it's worse on the right than the left. For example, painting the inside of our home is a killer for me.

When I started kayaking, I got the pain that I fully expected and I though seriously about not taking up kayaking as a hobby.

But I found that the cure was to make sure that I'm using my big "trunk" muscles and rotating my upper body through the stroke rather than trying to pull through the stroke with my arms and elbows.

It worked - in that area, :-), I'm almost pain free. I'm sure some of the others can offer a more eloquent explanation but hopefully, you got the gist of my comments.

I am prone to tennis elbow but it can
be prevented fairly easily.Paddling has never caused it or made it worse, but if you paddle with it, it hurts.What really brings it on for me is a manual scewdriver type motion.

things that help:

Avoid the motion that creates it.

NSAIDS. Aleve works best for me.

ICE at the first sign of it.

A tennis elbow band.

A Better Forward Stroke
During a trip in the Apostle Islands a couple years ago, the afternoon before a big day involving some high miles, I developed a sharp pain in my elbow. As I grumbled to my buddy about it, another member of our party overheard me and recommended I employ more of a ‘chicken wing’ stroke, raising my elbows to a point level with the paddle shaft and maintaining a 90-degree bend in them throughout the stroke.

This of course required that I rotate my torso a LOT more, as k7baixo recommends, but it almost entirely alleviated the pain.

So imagine my surprise a few weeks ago when I took a “Forward Stroke” clinic with Brent Reitz and he extolled the virtues of his ‘chicken wing’ stroke! Turned out my paddling friend had seen Brent’s video and learned the stroke from that.

Although no replacement for a full day spent on the water with an international-level competitive paddler, with video critiques of your stroke, this article is a good summary of Brent’s technique:

When you use the typical ‘arm paddler’ stroke, with your elbows tucked in near your waist and your arms doing all the work, the leverage is simply too much for the relatively small tendons and muscles of the elbows, wrists, and shoulders, which are forced to provide power through torsion. Instead, learn to paddle using lots of rotation from your TORSO and hips, which are loaded with very large muscle groups, allowing your elbows to only provide paddle orientation.

In fact, a valuable learning exercise is to practice locking your elbows and shoulders at 90 degrees and paddling ONLY with your torso. It’s admittedly a bit extreme, but is a good way to start teaching those stronger torso muscles to start pulling their load, and giving your joints a break.

Look for Brent’s class somewhere near you, or check out his DVD:

Good Luck!


A Couple Of Things…
…that can help tennis elbow:

I’ve had several go-rounds of varying intensity over the years, and have found that I can usually paddle with it - if I’m careful about things.

First, I use a tennis elbow strap whenever I feel the slightest twinge - tennis elbow isn’t an injury you can “work your way through” - and I keep using it for several weeks after the initial flareup has ceased. The best one I’ve used by far is called a Band-It; I keep one in our emergency ditch bag so it’s always with us on the water. A good strap, properly positioned and tensioned, helps protect the actual injury site by making the shortened muscle take much of the strain, instead of it being borne by the tendon where it connects muscle to the bone…

Ibuprofen helps, as do other anti-inflammatories.

Cold packs help relieve pain. I alternate them with heat packs at times, which seems to help with healing.

Steroid shots in the elbow sure aren’t pleasant, but the effect of the one I had during the first acute attack was magical - look, Ma, no pain - but there’s a limit to how often it can be done. Best kept as a last resort, IMO…

I have also had good results over time using exercise to help build up the forearm muscles - when they’re stronger, they are more elastic and can absorb more of the ‘workload’, saving strain on the damaged tendon. A squeeze ball works. I made up my own device, using foam pipe insulation wrapped around a wooden dowel - it lets me ‘wrap and roll’ the fingers down around it while tightening the grip…

Rest - when the pain’s severe, I use the arm as little as possible. As much as I love to be out on the water, I’ll pass on going out for a spin when the elbow is bad - better a day ashore than weeks ashore…

Finally, patience - it can take up to a year to fully heal tennis elbow. Be protective of it after the acute attack subsides - find the things that trigger it (e.g., for me, using screwdrivers can start it up very quickly) and avoid these activities if you can. I use the band and restart the medication at the first sign of discomfort.

Gripping paddle too tightly

– Last Updated: Jun-24-08 11:45 AM EST –

If you don't use good torso rotation and grip the paddle too tightly you can have issues. I also found moving to an unfeathered paddle helped. You can try using a compression strap while paddling.

The important thing to remember is that no two people have exactly the same physiologic make up, meaning their muscle mass, bone length, strength and flexibility are different, so where tendons are the linkers that hold all the components together under stress, what is fine for one person can cause big issues for another person. I've had severe tendonitis from bicycling and running. The best solution was physical therapy from someone well trained in sports injuries.

I have tennis elbow (from my high school tennis days) as well as tendonitis on my wrists. For standard paddling, as long as I use good form, my elbow is fine. Also a greenland paddle really helps me as its much easier on the body. When I’m playboating (whitewater) a lot, it sometimes rears its ugly head but a bent shaft playboating paddle has helped me a bit (for the wrists) and I’m a big fan of Aleve as well.


– Last Updated: Jun-24-08 1:57 PM EST –

Did they take X-rays or just do the usual move your arm around and press on various place exam? For years the Airforce said I had tennis elbow, finally after years of painful cortisone shots, the VA x-rayed my elbow, turns out I have a Bone spur. They haven’t done anything to fix it yet, but truth be told its not really hurting me right now either.

Good points
Every instructor I’ve ever paddled with has stressed the importance of keeping a loose grip on the paddle shaft, even opening the hand entirely during the push phase of the stroke with each alternating hand. This gives those muscles and tendons a chance to relax between strokes.

I’ve also been using seadart’s suggestion of an elastic wrap on my elbows; not because I need them to alleviate pain, but to train myself to keep my elbows bent at about 90 degrees and use torso rotation instead.

Depending on exactly where the pain stems from, your wife may have either tennis elbow or the lesser-known golfer’s elbow. Here are some good exercises to treat the latter:

Good Luck!


No X ray

– Last Updated: Jun-24-08 1:10 PM EST –

They didn't do an x-ray, just a physical exam, range of motion stuff I guess. She can't have xrays right now.

Thanks for the feedback. She got a tennis elbow band. Perhaps in a week or two we can head back out on the water for a short paddle. We'll see . . . Might have to head out without her for awhile.

Dealing with it right now
Great post - the timing couldn’t be better.

I had cortisone shots last week and have an appointment to go back this Thursday for a re-evaluation. It was sooo bad that I could not even pick up a coffee cup without pain!

All of the earlier posts are pretty much accurate:

  1. Ibuprofen or other anti-inflammatory (Cortisone shots if the condition is severe)

  2. ice three times a day

  3. rest. Don’t aggravate the arm.

  4. forearm band

  5. X-rays are useless - it is a tendon thing.

number 5
X-rays are useless - it is a tendon thing unless the tendons are rubbing on a bone spur, or pulling a fracture apart. I had all the usual symptoms, the coffee cup thing was agonizing!

reverse you aging
tennis elbow and other tendonitis issues, will magically disappear!


Trigger point therapy
I abused my elbow doing cartwheels last fall, and doc diagnosed the classic tennis elbow, said the only options were anti-inflammatories, cortisone shots, or surgery. I didn’t like any of those options, and I stumbled onto trigger point therapy and gave it a try. It’s simple massage - cheap and easy, certainly worth a try. Look up “The Trigger Point Therapy Workbook” on Amazon. There is a section on tennis elbow that describes what it is and how to fix it. Worked for me, and the pain relief was immediate. It was not a tendon issue, it was a muscle issue. The trigger points above and below the elbow pull the muscles so tight around the joint that they feel like wires, and that’s why the docs think they are tendons. The elbow is where the pain is but not where the real problem is. When the trigger points are released the wires get their circulation back and swell up into muscles again, relieving the pain. For me it worked exactly as the book described.