Tennis Elbow Advice from David Andry, Physical Therapist and Writer of RESONANT
While you likely know David "DB" Andry from the credits page of Vault's successful, suspenseful series RESONANT, you may have also seen some sage advice from him in the past, on how creators can avoid injury and how creators can use good posture while they're working.
Recently, Andry posted a Twitter thread on a common injury, tennis elbow, and he was kind enough to give Comic Book Yeti permission to host that advice here more permanently.
If you'd like to thank him, pre-order Volume 2 of Resonant (in stores Nov. 30th, 2021) the next time you're at your LCS!
Without further ado, here's his thread, all in one place, with links, minor edits and corrections from the editorial staff here at CBY:
So, we covered general ergonomics, injury prevention, and posture. Let's look at a specific injury and (in my opinion) the best way to treat it. "Tennis elbow," aka lateral epicondylitis.
This is pain on the outside part of your elbow. There is a little part of bone that sticks out called an "epicondyle," and the muscles that move your fingers and wrists back share a tendon that attaches here. Repetitive use of the hand, especially gripping, usually causes this.
(Side note: there are discussions in the orthopedic community now about classifying this as an "epicondylalgia," not an "-itis," but I'm not going to get in the weeds over this, just talk about what I've seen practically in real patients with treating this for the past 16 years) The hardest part of getting this better is that every time you make a fist, you are pulling on the area that is trying to heal. It's like punching a bruise over and over again. And people tend to "check it" to see if it still hurts. I had a patient literally make a fist in front of me 10 times in 30 seconds to show me it still hurt every time he made a fist. Don't do this. You can't continue to do painful activities and expect to heal. This is not a "sore muscle" that you can work through. Stop painful acts.
So what can you do? First, ice – a lot and aggressively. Ice massage is my preferred method for this. Rubbing an ice cube or ice frozen in a cup over the area until it goes NUMB. Not when it hurts, when it goes totally numb. Usually takes about 5 minutes. Do this at least 3 times a day.
Wear a counterforce brace. This "Band It" one is my favorite. Wear it about 2 fingers down the forearm from that bone, on the fat part of the muscles, and TIGHT! As tight as you can tolerate comfortably. All the time, whenever you're using your hand.
Lift and carry things with your palm up. Stretch that muscle with the elbow straight and the palm down, using the other hand to bend the wrist downward.
And most importantly, eccentric exercises. Hard to explain, but it's basically the lowering part of a strengthening exercise, not the raising and lowering. This little doohickey called a Flexbar is great for it and comes with instructions.
This YouTube video shows how to do it with a free weight:
There is also some pretty strong evidence that if you strengthen the rotator cuff, it can help this injury. I'll do a future post on shoulder impingement and rotator cuff strengthening. And just be patient with it. Tennis elbow can take a VERY long time to get better. When it does start to feel better, refer back to my previous posts on ergonomics, injury prevention, and posture (linked above) to prevent reoccurrence. #DBthePT