Tendinopathy in Jiu Jitsu: How to treat elbow pain
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Elbow pain is fairly common among jiu jitsu athletes, due to excessive gi gripping or repetitive elbow strains from elbow locks. Often jiu jitsu athletes are too stubborn to stop or reduce their activity so this can become a chronic injury that lingers.
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Tendinopathy in general is difficult to manage once it becomes chronic. In early stages, acute / reactive tendinopathy, reducing aggravating activities is enough to manage symptoms. In the later stages there is degenerative changes to the tendon which make just stopping the activity insufficient to deal with pain.
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Strategies for dealing with elbow tendinopathy-
Acute / forearm tendinopathy:
1️⃣Rest.
2️⃣Isometrics: Isometrics are a great way to reduce pain and load the tendon without putting too much stress on the irritated structures.
3️⃣Minimize techniques that are reliant on grips: sweeps, passes, chokes.
✳️Keep in mind heavy barbell or dumbell training may put a significant load on these same muscles as well.
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Degenerative tendinopathy:
1️⃣Load management. At this point resting, massage or stretching will not be enough to reverse the changes to the tendon. ✅When dealing with degenerative tendinopathy you need to start to strengthen the tendon. .
Slow wrist extensions: 4 seconds in each direction. To increase the demand you can alter your elbow position or increase resistance.
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You may have an increase of symptoms (up to 3/10 on the subjective pain scale) following the loading process but if you return to baseline within 24 hours you can repeat. If your baseline symptoms are worse after 24 hours you need to reduce your load. .
When dealing with suspected tendinopathy I would recommend seeing a healthcare professional to effectively diagnose and rule out other potential factors for elbow pain. In addition to proper assessment of the injury a healthcare professional will also be able to help you properly load, to avoid under/over loading, so that you can achieve sufficient tendon adaption and strengthening.
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Reference:
Coombes, B. K., Bisset, L., & Vicenzino, B. (2015). Management of lateral elbow tendinopathy: one size does not fit all