Anyone have surgery for medial epicondylitis (golfer's elbow)?

Not a golfer, but I have golfer’s elbow real bad. Been doing conservative treatment (NSAIDS, ice, PT, oral and injectable steroids) for 2 years and surgery is looking imminent at this point. Dr. says 6-8 weeks likely before riding again OUTDOORS… and with that progress may be slow. Was looking to compare notes versus anyone that may have actually gone through with debridement surgery and how long it took to get back on the bike. Trying to figure out if I want to suffer through this year and have surgery after the season this year or bite the bullet and get it done now where I may salvage a large part of the year with lower/no pain levels? It is surprisingly painful to ride with this condition, as fixed arm positions really lead to elbow stiffness, even if elbows are not locked out.

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I had tennis elbow for almost a year. It was terrible. I started rehab and PT for a few months. That helped a little bit, but didn’t fix it. Then I had two rounds of Cortisone shots. They worked great for a few months, then they wore off. After that I had a PRP treatment. That finally fixed it. PRP isn’t covered by insurance and I paid for it out of pocket for about a grand. It took 3 months for the PRP to fully work and I did some more PT at the end, but that finally fixed it.

What PT are you doing?
Golfers elbow is a common complaint among rock climbers. I’ve found that eccentric exercises with progressively heavier and or longer hammers/1 sided dumbbells work well.

I had this and PT cured me. (I don’t play tennis or golf.) Basically, they did a lot of deep tissue work and then had me do a lot of very light weight exercises (lots of interval and external rotation stuff).

PT was lots of manual therapy (Graston and cross friction) and lots of eccentrics. From what I found those 2 things are standard of care these days for tendonosis issues. For me personally my pain actually increased over the course of 2 months in clinic PT. I complied 100% and followed on for 1-2 months afterwards before I reduced things as i felt i was getting worse. Only thing that has worked transiently has been cortisone injections. At first got months of total relief (2 injections) and injection 3 only gave me about 25% relief for a few weeks. Diminishing returns on injections can be an issue. That’s why at this point I am really considering surgery.

Sounds like you’ve already given eccentrics a good go. But amongst climbers the best-known and best-regarded summary is by an Australian specialist called Julian Saunders : Dodgy Elbows – Dr Julian Saunders

He claims :

One hundred percent of climbers who have attended my clinic for manual therapy and monitoring, in conjunction with the exercise program, have recovered. I have, at times, e-mailed the program to grovelling overseas climbers. Of these, about 60 percent recover

There are a few other bits in the article that may help you, specifically his comments about shoulder tightness and surgery. Good luck and I hope you get it sorted, I used to be pretty familiar with that ever-present elbow ache.

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I was just diagnosed with golfer’s elbow. Probably caused by the rehab PT of my hand and wrist. Short muscles and tendons being stretched back to normal. I do have arthritis. Question: do you and your doctor believe it was the PRP that allowed you to heal? Or was it might or might not type judgment?

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@TrekCentury It was 100% the PRP. PT helped some, and Cortisone only helped in the short-term. The doc didn’t rush to do PRP, but only after everything else failed.

He did note that some people need two PRP treatments. I only needed one, thankfully.

Not sure where you are in the world, but I saw Dr. Antonis in Alexandria VA.

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Thanks
I’m in Texas. If it does not get any better with some PT my orthopedic doctor will do it for about $400. I have all ready had 5 cortisone shots in that hand and really want to avoid anymore in that arm for a while.

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That’s a great price. It was just over $1000 here in Alexandria.

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Same for me. Very conservative doc who is also a professional friend. We exhausted other options and decided to give PRP a try.

The PRP injections plus daily exercises, plus not stressing the elbows allowed a return to normal in my case. I’ve continued to be careful about not adding extra stress to the elbows, but am able to ride road and mountain as much as I like, lift weights in the gym, row on the erg and take care of our yard.

Knowing what I know now, the months spent doing PT alone were not helpful and wish I’d gone to PRP months earlier.

OP : $400 is a relative bargain. $1000 per elbow is the more common rate. Even with good medical coverage, you’ll be out of pocket.

The PRP injections are not fun. The sensation is “interesting” as fluid is pumped into a space not designed to have fluid pumped into it. If you do try PRP, there might be some nausea or other reactions post-injection. I drove myself back and forth but must admit I’d have liked to have someone else drive me home.

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Does anyone think that cycling is contributing significantly to their medial epicondylitis pain? At first I kept telling myself “no” and my doc said I could continue to ride and did not modify my activity as such… Now when I ride my elbow gets VERY stiff very fast. I lose range of motion for full flexion and extension pretty quick. I don’t want to stop riding but can’t think it doesn’t contribute… Anyone’s doctor tell them to get off the bike?

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In my case yes, cycling contributed. Cycling was not the root cause, which was chainsawing trees and then manually splitting the resultant wood with wedges and a maul. But once established, the shock and vibration from mountain biking 4-5 days a week exacerbated the problem.

Once I realized what was going on, I stopped mtn biking but was able to road ride OK while healing. Nothing epic, but 60-90 min a day was OK.

Everyone will be different so my advice is to pay attention to the pain signals. If it hurts and you want to heal - back off. It’s better to heal and resume activities down the road than to prolong or prevent the healing and continue to have pain and miss out on your riding fun.

Not for me. I’m almost positive mine came from trying Olympic lifts at the gym. I went too heavy on some hang power cleans the tennis elbow started right after that.

When I had tennis elbow, cycling aggravated it. I wore an elbow compression sleeve for about a year when on the bike and it helped a bit. Once PRP did it’s job, I didn’t need the sleeve any longer and now I can ride for hours without any aggravation.

I don’t do Olympic lifts any longer. Just slow stuff (squats, overhead press, deadlifts, and bench). They’re all fine and don’t irritate my elbow.