Bilateral Elbow Pain Question, holding a child and working out

by Gary
(Wantagh NY 11793)

Hi, I began noticing pain in both my elbows about 4 weeks ago.

It hurt the most while holding my 1 year old son, (arms bent "cradling" him toward my chest).

I'm an avid weight trainer, and I've been training very hard lately doing daily pushups after every workout, and incorporating different movements like "punching dumbells" (just what it says it is, punching motion while holding 10 lb weights).

I can only guess that I'm doing something to iritate my elbows in the gym since it hurts in both of them. I feel it right on the elbow itself and in the typical tennis elbow area.

I came across your site on Sunday and have been doing the iceing and hammer time. I also stopped lifting for 2 weeks before I saw your site to "rest" my arms.

After 3 days my elbows felt MUCH better! Thank you!.

Now here's my question, I went back to the gym to do some light training because I felt so good, nothing hurt at all during my workout, (was very happy!) But then hours later my elbows started to hurt again, felt it while driving the car.

Should I stop training altogether until I complete the 7 day cycle or can I continue to lightly train while continuing the ice and hammertime?

I can't tell exactly what excercises are doing the damage because it doesn't hurt when I'm lifting!

Thank you so much, Gary


Joshua Answers:

Hi Gary.

Maybe a specific exercise is hurting you.

More likely, you've been active a long time and you've been slowly developing a Tendonitis dynamic, or a Pain Causing Dynamic, depending on how you want to think about it.

Things get tight, you likely don't stretch enough, and then the structure is just waiting to hurt, and something as simple has holding a child for a while can strain it enough to push you
over the edge.

In answer to your question, it's not really cut and dry.

You could take the 7 days off the workout and invest that time in self care, which would be a great option, only because you wouldn't be doing anything to cause irritation to the dynamic.

Rest isn't beneficial, removing irritating factors is. It's an important distinction.

You could do light or hard workouts. Just take into account any irritation you are adding in. Which means you will want to ice more to counter that extra irritation.

More irritation = more icing to counter.

I'm not necessarily a fan of working out or not while icing to get out of pain.

It's just a matter of the ratio between how much pain you're in, how much you need to ice to reverse the pain levels, and how much extra you need to ice to counter working out.

That's the complicated answer.

If you want a simple answer, or just like being told what to do :), here's the short answer:

Take the week off form working out and ice like crazy.

Consider it interval training, giving your body recuperative rest, such that when you start working out again it will be a shock to the body and will increase your gains.

That was kind of long winded. Make sense?

More questions, more answers.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Sep 17, 2009
PART 2 - continue the conversation - Bilateral Elbow Pain Question, holding a child and working out
by: gary

Hi Joshua, it's me again, I just wanted to follow up on my question: by not working out for a week, (thus not irritating the injured area) and continuing to ice & hammer, my elbows will feel better, but is actual healing going on? tissue repair?

And is it really safe to work out again or am I just gonna keep on injuring the area over and over again? Tennis elbow seems to be a very common problem, but I read the internet posts and so many people cant seem to get rid of it, I'm so scared that if I do what I love to do (work out) I'm gonna be in constant pain.

Thanks for your time.



Joshua Comments:

1. Yes, actual healing is going on.

2. The problem is more one of inflammation and tightness than actual injury.

3a. You likely do have some wear and tear 'injury'. Heals fast, but inflammation and tightness don't necessarily go away.

3b. The problem with scar tissue that lays down to heal is that it lays down in all directions, which is less structurally strong. So you do some push ups and one or two -tiny- fibers shear off, and BAM the nervous system jumps in and tries to protect you from injury.

4. Constantly.

5. Fear is the mind killer. :)

6. Just because 'they' haven't found and used the right tools, doesn't mean they don't exist or that there is no fix.

There's a correct tool for every job. Some tools are better than others.

Some people have pain more from actual injury, some people have the same pain more from inflammation and tightness. It's a bit more of an art than a science, but it's just as predictable as science.

7. Unfortunately, there is no 100% fix, in the sense that once this pain is gone, it will never come back. Realistically, you'll need to do some maintenance and self care to keep pain away over the course of your life.

You will learn it, you'll get efficient with it, and you'll figure out exactly what it takes to keep your structures healthy and happy.

Oct 02, 2009
PART 3 - Hi Joshua, More questions - Bilateral Elbow Pain Question, holding a child and working out
by: Gary

Hi Joshua, I just purchased your tennis elbow DVD.

My original daily pain had definitely gotten better,and I pretty much have eliminated all exercises that seem to have been irritating my elbows.

The original pain still comes back when I lift something a certain way, or hold the kids too long.

I've also noticed that I will have some tingling or irritation on the inside of the elbow (which I didn't notice before) as well as some slight tingling of the pinky.

Now does this mean its getting worse or is there some restructuring going on in there?

Also, I went to see my Dr, and she said she had tennis elbow, and her orthopedic had her put on icy hot gel with a sock over it for a few weeks and it got better, ever heard of this?

One more question, my Dr also said that if the icing is working for me to continue, but tennis elbow takes a very long time to heal (like over a month) as long as I continue not to irritate it again. True?

She also mentioned that if it doesn't get better,there is a possiblity I may have an entrapped nerve, whats your opinion on that?

Thanks so much



Oct 04, 2009
PART 4 - Bilateral Elbow Pain Question, holding a child and working out
by: The Tendonitis Expert

Joshua Answers:

Hey Gary.

In reverse order.

1. Entrapped nerve.

What does that mean exactly? (That's a rhetorical questions. I know what it means, and the doctor knows what it means, but we think it means different things.)

You have some tingling. Yep. Nerve is getting squeezed by tight muscle/connective tissue.

'Entrapped' is a term that means 'uh oh, you better have surgery!'.

I'm not a fan. In my world, if one's pain doesn't go away, that just means that either A. You haven't done enough of the right stuff, or B. Haven't yet found the source of the problem.

You've gotten results, great. Now it's a matter of fine tuning what exactly you are doing, and where exactly you are doing it.

My opinion of entrappment is that you can un-entrap it with some stretching and self massage. Maybe you'll have to blunder through it some since you aren't yet a master of working on your body, but it's safer than surgery by far.

2. Healing Time

A month is certainly doable.

Here's my issue with waiting it out and hoping the pain goes away.

-Sometimes- just rest and time will heal you.

In my experience, what almost always happens is that you rest, the pain goes away...until you do some activity with your arms again at which point the pain comes right back. Because the source of the problem wasn't dealt with.

Sometimes it's just Inflammation. Sometimes it's too tight muscles and connective tissue. Sometimes it's wear and tear damage and scar tissue.

It's usually a combination of all three.

3. Sock on elbow

It makes sense that if you rest, and keep something that brings new blood to the area that that could do a lot of good. Certainly worth a shot.

If that reverses one's specific pain dynamic, great! If it only affects 1 of the above 3 factors......

4. Tingling and such.

Does that mean it's getting worse? I don't know, I'd have to ask some questions, and that would lead to fine tuning what you're doing.
But I doubt that that means it's getting worse.

I think that answers your questions...for more specific answers we'll need to get into fine tuning.

Let me know if you want to do that, I'll ask you some questions so I can get an accurate picture of where you're at now compared to what self care you have done, and we'll go from there.

Oct 04, 2009
PART 5 - fine tune - Bilateral Elbow Pain Question, holding a child and working out
by: Gary

Hey Joshua, I would love to go over some fine tuning, let me know what you need. One more question, My Dr. gave me a prescription for physical therapy to use if I feel I need it, whats your opinion on physical therapy for elbow pain?


Joshua Comments:

RE: Physical therapy for Tendonitis.

It's a crap shoot Gary. It'll either work, or it won't. From what I've seen, it's just not that effective. Again, I'm biased, I mostly work with people that have tried everything else and it hasn't worked.

If it's paid for, go for it. They'll likely have you do some stretching and strengthening. That may be just the key. If it's not, they'll still have you do it.

They'll likely have you do ultrasound too. It'll be a good learning experience for you.

So, for fine tuning. Tell me how and what exactly you've done since you go the DVD, your experience with that, your results with that, and where exactly you are at now.

You said 'tingling'. Say more about that. How, what, where, when.

Did you just buy the DVD in October? So you haven't even gotten it yet?

Oct 07, 2009
PART 6 - whats been happening - Bilateral Elbow Pain Question, holding a child and working out
by: Gary

Here's whats been happening: My pain really started to feel better, but I continued to lift weights, was ok after some days, in pain on other days, I'm sure I kept aggravating it, so I'm now gonna stop lifting for a month (Dr. suggestion to see what happens)

Now the thing is, I dont even think the pain is totally tennis elbow, I feel it much lower on the elbow than where you show on the dvd, and I started feeling it on the inside of the arm near the ulner nerve area, and started getting very slight tingling in the pinkie no real pattern throughout the day.

Now, when I started ice massaging, I think I may have been too rough around the ulner area, so I may have aggravated it some also.

My Dr. thinks I may have more of a medial epicondilitis, than true tennis elbow, or maybe my inflammation just spread. (can it do that?)

Ive stopped lifting, and continue to ice dip every night, I'm very concerned that I'm heading toward "entrapped nerve" like i told you.

Also, if I've got "golfers elbow" would I still do the stretches on the dvd?

Thanks Joshua

Oct 08, 2009
PART 6 - Bilateral Elbow Pain Question, holding a child and working out
by: The Tendonitis Expert

Joshua Comments:

1. Entrapped nerve. There's nothing special about an entrapped nerve. It sounds bad, but really it just means that muscles and connective tissue are tight and constricting the nerve.

Doctors like it because it can be made to sound like a medical problem and they can do surgery on it.

A good massage therapist, or even you stumbling your way through it, can loosen things up and get the nerve sliding again, no surgery, no injury, no scar tissue resulting, etc.

Granted, I'm biased.:)

2. You could stop lifting, no problem. Or, you cold do light lifting. Whatever you do, keep moving. Be a monkey. All directions, all angles, just moving around. That's kind of vague, I know, but.

3. Medial epicondylitis, or lateral, it's basically the same thing but in a different location. This Tendonitis dynamic essentially consists of tight muscles and tight connective tissue.

There are other factors at play, of course, but they just add to the tightening.

Everybody is different, so the tightness can focus at the elbow, or farther down the structure. Wherever it's at, you have to get it. And even though there's generally a main spot, everything in the area is affected to some degree or other too. Pain and/or injury does not happen in isolation.

4. Yes, inflammation spreads. Which means, the chemicals released by inflammation can flood/spread to surround tissues. The Icing -should- flush it out and keep it out if you do it enough, or at least, overwhelm the strength of the infammation response with the effect of enough self care.

Which leads to the topic of fine tuning.....

1. How much better would you say you are now, as opposed to when you started.

2. How close to exactly did you follow the Healthy Elbow Protocol from the DVD, or are you doing activities from the website?

Let's compare results to actions and go from there.

Oct 08, 2009
PART 7 - I'm back! - Bilateral Elbow Pain Question, holding a child and working out
by: Gary

Well, I think that the original sharp pain in the elbow is somewhat lessened, but the ulnar area "tinglings " kinda come and go.

Originally I only got the sharp pain when I picked something up a certain way, now they feel kinda achy throughout the day.

I haven't been moving them as much as usual (thinking I'm aggravating the condition), do you think my lessening of movement is making them achy?

I followed the website protocol to the "T".

Now I had a "eureka" moment today, discovering what I think caused this pain on me : I teach Phys-ed had to take a yoga class for 4 months, i had to hold a particular pose for over a minute each time I went, now picture this: on my back, flip legs over head arms supporting my low back, with elbows and forearms flat to floor, all my lower body weight is supported by my elbows.

I'm basically looking at my thighs at this point. I got in the pose today to stretch out, and felt everything In my arms right where I hurt. Now I'm sure I had some aggravation from my weight lifting, but Im sure this started it. Could a "compression " injury happen from something like this, and do you think it could be a lot of damage or would it still be inflammation?


Joshua Comments:

Hey Gary. Sorry for the delay responding.

1. Yes, that stretch position could certainly put a lot of strain on. I doubt it's a compression injury per se, though I can see it causing irritation and inflammation.

2. I doubt less activity made things achey, -unless- things are still so tight that you're not getting blood to the muscles, which makes them ischemic and painful. That's why movement often helps things feel better.

3. I think you need to keep doing Ice Dipping, and make sure you get it up as far over the elbow as you can.

4. I think you need to starting going a lot deeper and pushing the edge with activity #3. If I felt your arm I bet I'd feel the deep structure around the elbow as VERY dense and constricted and tight (thus full of pain enhancing chemical, and not working very optimally).

Your tissue is healthier now, so even if it still has pain, it's time to push it and start really opening up all the constricted structures in your forearm, working towards the palm side too.

Make sense?

Oct 18, 2009
PART 8 - more info - Bilateral Elbow Pain Question, holding a child and working out
by: Gary

Hey Joshua, My Dr. gave me a nerve induction test, results were on left arm, mild nerve entrapment on ulnar area, rt arm has mild entrapment on medial nerve. Tennis elbow on rt, golfers elbow on left.

My Dr. says since both were mild that's good news, I should make a full recovery if I continue to ice(told her what im doing) she also wants me to continue on motrin for a month to help reduce swelling around the nerve(Im not big on medication, whats your opinion on limited use for this situation?)

Overall I think the pain is reducing, but if I strain it in any way it comes back(Ive got little kids, sometimes strain is unavoidable).

I'm gonna stop lifting(which I don't wanna do, but I gotta try anything to make this really go away)

Also, I have a friend who got really great results with prolotherapy.

My Dr. thinks that in my case, an increase of inflammation will further annoy the nerve even if it helps with the healing of tendons etc.

Whats your opinion on prolotherapy?


Joshua Comments:

My opinion on a month of Motrin for Tendonitis is: Not worth the effort or potential Ibuprofen side effects.

While long term use of Ibuprofen is potentially dangerous (Leaky Gut From Ibuprofen), short term use probably isn't a problem.

Still, in my experience on myself and from others, Motrin is good for temporary pain reduction, but doesn't counter the Tendonitis dynamic in any functional, or more importantly, effective way.

My opinion on prolotherapy: Overall I like it. If a ligament or tendon is damaged or even stretched (once ligament is stretched, it stays stretched), prolotherapy is a good option to help it.

An irritant is injected into the tendon/ligament, and the body responds by building the structure back stronger, basically.

Will this help you? Only if you have actual tendon damage.

I suspect that the cause of your pain is more tightness related than damage related.

I've seen good results, and no results (my mom regularly get's shots into her thumb joints. The key word being 'regularly' which to me means 'not a fix').

Now back to tightness. I repeat everything from #4 in the last post. I think that is the main deal.

Have you been doing that? Tell me your experience of/with it.

It's worth a shot (pun intended)

Oct 19, 2009
PART 9 - hey - Bilateral Elbow Pain Question, holding a child and working out
by: Gary

Ive been doing the ice dipping 2 hrs every night up to mid biceps. On the weekends Ive been doing two dip sessions, morning & night.

I know the ice is helping, it feels better when Im done, My concern is that I'm doing it for over 4 weeks already, yes the pain has lessened, but its still there.

I've now stopped lifting weights completely, maybe without irritating it it will heal better? What else should I do or should I just be patient?


Joshua Comments:

Patience is good, but you should be having more results.

1. Have you been doing this as I suggested earlier? "I think you need to starting going a lot deeper and pushing the edge with activity #3. If I felt your arm I bet I'd feel the deep structure around the elbow as VERY dense and constricted and tight (full of pain enhancing chemical, and not working very optimally)."

2. Taken Magnesium for Tendonitis and gone to the Magnesium Dosage page?

3. Increased your protein intake?

4. Might be time to try 100-300mg (safe and documented effective dosage of Vitamin B6.

It turns out that Inflammation Causes Vitamin B6 deficiency. The link goes to the only page I've made on that so far. Substitute your stuff for 'Carpal Tunnel'.

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