My wife has come down with a case of Medial Epicondylitis (Golfer’s Elbow) from swimming. The physio has needled her a bunch and given her eccentric strengthening exercises. She wears a brace during the day which seems to help a lot.
Any attempt to return to swimming makes it flare up though.
Has anybody had this before? Any ideas what kind of stroke deficiencies might be causing this? Any thoughts on stretching & strengthening?
She was just starting to build her long swim for IMC and wants to get back on track before it gets serious.
Thanks.
Now that the buzz from IMAZ has died down, maybe somebody who has had this has something to share?
She’s narrowed it down to something in her breathing on one side. So far, the solution has been not to breathe, which, uh, isn’t very sustainable.
Question is the pain truely on the medial epicondyle and muscle/tendon related or is the pain in the notch between the medial epicondyle and olecranon (elbow bone) if it’s in the notch her nerve may be flared up as opposed to the tendon. I have trouble wrapping my brain around medial epicondilitis from swimming even with a really good wrist down catch. Does it hurt with resisted wrist flexion etc… or only swimming?
Does she enter thumb or pinky first on her hand entry? This could be purely a stroke mechanics issue and the nerve is flared up as opposed to tendon. She may be internally rotating shoulder and caving in thumb first on entry. That used to happen to me all the time during high swim volume and it took me a while to self diagnose. I was getting pretty sharp medial elbow pain but could tell it was more nerve type pain versus soft tissue. It helps that i’m in PT for a living. I have found that entering more pinky first or neutral which is what we should be doing to be almost immediate relief. Just a thought.
Hmmm…good things to think about. Her elbow does hurt with resisted wrist flexion, but that’s not something that is aggravated very much by daily activities. It’s the swimming (actually the breathing) that really sets it off.
As far as I remember, her hand does enter thumb first, so we’ll take a look at that in the pool tonight. Thanks for the tip.
Is there a treatment difference depending on whether it is a nerve issue or a tendon issue? The PT did prescribe a “nerve stretch” which I’d never heard of before.
The nerve glide exercise may help. The pain I had only accured while swimming and then would be fired up that day. 1 or 2 days out of the pool and it would be fine. It only came on at about 3k of swimming, if my workout was shorter it usually didn’t hurt. I incidentally figured out the solution after my friend started to correct my entry. I corrected my entry and it never came back so I figured out I must have been somehow aggravating my medial nerve and that was the source. Funny my friend is a PT as well and just a better swimmer offering help. We were just purely working on my swim mechanics not addressing my elbow issue. The lack of elbow discomfort that followed was just an added bonus. That was pretty sharp pain as I recall, enough to shut my session down a few times.
So starting with her entry may be a good place to start. One should not be caving in thumb first on entry anyways. It’s overly internally rotating the shoulder which can also lead to shoulder issues as well. See if it helps.