Recalcitrant form of tennis elbow

[physiobob]

riding my bike and going to the gym.....long rides

Your comments above could lead to the cause of the problems. I am an avid road cyclist and remember the elbow issues when I first began the long rides (Often to much load on the arms due to poor bike setup and fatigue in the torso). Also the bike setup is very important .

As for the gym there are also a number of exercises that can cause pseudo tennis elbow. Especially barbell work and triceps pushdowns with a flat bar. Perhaps the most important consideration here though is the neck/upper trapezius area. This needs more investigation and a treatment approach. All of your activities impact on that area. Unfortunately gardening might make it all worse.

Seems you need a more thorough assessment. You should not be diagnosed with 'Tennis Elbow' without due cause. This is afterall a chronic condition i.e. it takes a long time to develop and even longer to become painful. Maybe another opinion is worth investigating

[RiderJen]

Thank you for your very thoughtful reply.

With respect to my bike set-up, I've had 2 fittings and I'm certain the bike fits me very well. I have never noticed any elbow or shoulder pain while riding. The shoulder pain began last September but I didn't notice it while riding until December -- even during a challenging metric century ride in November.The elbow never bothered me while riding. However ---- I had Kienbock's disease in my left wrist, which was treated with a silicon spacer put in in 1978. My right wrist has had similar symptoms (poor ROM, popping when the wrist is immobilized) and I've gotten conflicting reports on the x-ray/MRI results as to whether Kienbock's is there or not. All of that to say -- my wrists are not 100%.

Could this be pseudo Tennis Elbow even if the standard strength and ROM tests for it are positive? Are the symptoms exactly the same in either case? Pain is on the lateral epicondyle. Oh -- and this is a recent development in the past few weeks --- now it also hurts to press on the medial epicondyl, but the 'tennis elbow' pain is much MUCH worse. I feel like I'm falling apart.

I will give serious consideration to my neck and upper trapezius -- but how do I find someone who sees outside the box and looks at the whole picture? Finding the right doctor is starting to seem as likely as winning the lottery.