Solution for Tennis Elbow!

The NY Times just ran a short piece on a new treatment for tennis elbow: PhysEd: A New Treatment for Tennis Elbow .

...researchers from the Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital in New York City announced last month that they’ve developed an effective and supremely cheap treatment for chronic tennis elbow. Huddling a while back to brainstorm about inexpensive methods for combating the injury, the scientists glanced around their offices and noticed a homely, low-tech rubber bar, about 8 inches long, which, at the time, was being used for general physical therapy programs. The researchers wondered whether the ribbed, pliable bars, available for less than $20, might be re-purposed to treat tennis elbow. The answer, it soon become clear, was a resounding yes.

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in the past two or three years, doctors and researchers have begun focusing on a particular kind of exercise that has shown promise against other achy tendons, especially the Achilles. The program involves eccentric exercises, which aren’t oddball moves but those in which the muscle lengthens as it tenses. Think of a biceps curl. When you raise the dumbbell, your bicep shortens and tightens. That’s a concentric contraction. When you lower the weight, the muscle lengthens, straining against the force of the weight. That’s eccentric.
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“There’s a growing body of research showing that eccentric exercises are quite effective in treating Achilles tendonosis” and other tendon problems, Tyler says.

One of those studies was a well-designed 2007 experiment centered on tennis elbow. Conducted in Belgium, it found that eccentric exercises provided considerable relief. But the exercises had to be performed on expensive machines under medical supervision during repeated office visits. “We looked at those results and thought, there has to be an easier, more cost-effective way,” Tyler says.

Which is how they arrived at the rubber bar technique. He and his colleagues realized that a single, unhurried exercise using a tensile bar that looks like an oversized licorice stick could create an eccentric contraction all along the forearm. In the exercise, a person holds the bar upright at his or her side using the hand connected to the sore elbow, then grasps it near the top with the good hand. The top hand twists as the bar is brought around in front of the body and positioned perpendicular to the ground; the sore hand then takes over, slowly untwisting the bar by flexing the wrist. “Afterward, you should be sore,” Tyler says. “That’s how we know it’s effective.”

Eccentric contractions require the muscle to work against a force, in this case the coiled bar. “You can load a tendon so much more eccentrically” than with concentric exercises, Tyler says. “So we think the process may be remodeling the tendon.” Ultrasound studies by other researchers, including the group in Belgium, have shown that damaged tendons typically become less thick, indicating they are less damaged, after a course of strenuous eccentric exercise.

Tyler reported his findings at the July annual meeting of the American Orthopedic Society for Sports Medicine and has been deluged ever since with requests from doctors, physical therapists and patients for more information about how to perform the exercise and where to buy the bar. (Called the Thera-Band Flexbar, it’s available on Amazon.com; the manufacturer donated products for the study, but didn’t otherwise fund it; Tyler is not affiliated with the company.) “It’s not a difficult exercise but it is unique, so I would advise people to be taught by a physical therapist, if possible,” Tyler says. If not, proceed on your own — after, of course, an examination by a doctor; elbow pain can have many causes, not just tennis elbow. “In my opinion, you’re not going to hurt yourself,” Tyler continues, although you should be prepared for a commitment. His patients did three sets of fifteen repetitions every day. Beginners should start with three sets of five repetitions, adding more as the repetitions get easier, Tyler says.

The article has an instructional video, also available on YouTube Isolated eccentrics with flexbar:

I ordered a flexbar at Amazon.  $17.17 + shipping.  Given the tendonitis I've worked around for years, it seems like a bargain.

Can we get some CrossFitters or other trainers to apply this idea of "isolated eccentrics" to other tendons?

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