Best way to mitigate tennis elbow on a gravel ride?
 

I've got a 45 mile gravel race coming up next week, and my tennis elbow is playing up. After about 10 miles of a training ride last week it seemed pretty locked up with a lot of stiffness and pain when I tried to move it. I'm using a drop bar bike but mostly stay on the hoods.

I figure I need some kind of support but I can't tell if a full elbow brace or one of the smaller straps that go under the elbow are the better way.

Does anyone have any advice or recommendations?

Is it medial or lateral? I know it’s something like golf vs tennis but people mix the two up all the time.

Strengthening exercises with a hammer seem really effective. You can look those up on climbing forums.

For the race, elbow sleeves seem ok. Same with ibuprofen.

I had this in my early 20’s when I was riding only road bikes a ton and also rock climbing a ton. It went away in time. Riding position and strength/flexibility seem to help. Time off, in my experience doesn’t help at all.

I've noticed that I've been getting pain in my elbow during/after a ride. I'm thinking of swapping my drop bars for flat bars. I know I'll be losing the aerodynamic advantage of riding in a hunched over position but I think the comfort of an upright position would be worth it.

Improve your joint stability through it’s full range of motion by exercising with a gyro exercise ball. Keep it spinning with your wrist, using it’s range of motion, as you move your elbow and shoulder joints through their range.

should see improvements in two weeks. the goal being to more evenly than your regular activities may allow, strengthen all the muscles that surround and stabilize the joint. Else-wise things don't always track right. This leads to overuse injury with inflammation/swelling, pain and stiffness, possible nerve irritation/impingement.

I initially thought it was golf since I had that a few years ago after lifting rocks and this came on after lifting rocks (you'd think I'd learn...), but the symptoms seemed to fit more with tennis and the muscle on the outside. The motion seems fine, and the strength is mostly still there but at some angles there's a lot of pain and some there's a total loss of power, generally involving clenching my fist towards a full arm extension. Like I can do 2 pull ups (I'm ~220lb and not in great shape, 2's pretty good) without issue, but lifting my laptop off a high shelf is hard.

I haven't tried resting it up because I've got kids :)

I'll try and do some movement exercises, and have picked up an elbow brace / strap set to see how I get on with that.

I have both muscle/ligament pain on the inside of my right elbow, and pretty signiicant arthritic pain caused by old radial head breaks on the outside of both elbows, but especially the right. Some of my interventions might help you in the short term, some in the longer term.

I have decided that Sram "double tap" shifting is much better for my right elbow especially than Shimano. It's kind of subtle, but the Sram down shifting (to a lower gear/ larger sprocket) in back is more of a wrist and finger motion than moving/sweeping the brake lever to do the same with Shimano. The Shimano - for me - requires more elbow rotation and exacerbates the right elbow pain.

My newest AXS Etap bike is even better for that. I told my skeptical self years ago that if electronic shifting would help this pain, I'd be all in, even though I'm totally happy with the performance and other aspects of modern mechanical. It's not enough of a difference to update my other two Sram mechanical bikes, and I'll always keep a mechanical bike for the ease of repair and replacement on the road (we travel with our RV for months at a time).

Braking from the hoods can also irritate my right elbow. I found that for longer and/or harder braking, I go into the drops and squeeze the lever from there and this is probably the biggest help for my issues. Again, with the new AXS hydraulic disc brakes, that helps a bit too. But not a huge amount compared to good rim brakes and I often have to resort to braking from the drops with the hydro discs too.

Finally, I've gravitated more and more to padding of gloves and handlebar tape. I have cushy handlebar tape with gel inserts on the tops. I also have a Shock Stop stem on my gravel bike. Those things also help.

It all adds up. It's still a pain, and some days are worse than others, but I never have to quit a ride. Of all those things, I think the Sram shifting and braking from the drops helps the most, with the Etap and hydro discs to a lesser extent. I really gravitate to braking from the drops on a bad day.

An experienced physical therapist once told me to wrap a thick five-inch rubber band around my fingertips and open the fingers outward against the resistance.
It took about a month of doing the at my desk, during my commutes, and while watching TV at night to see my tennis elbow subside.
I got mine from doing yardwork. It lasted more than six months, before finally doing something about it.
Give it a whirl. About the cheapest solution ever devised.

… and ice it frequently. I had a bout of it a few months ago and finally got it to go away with the ice. If/when you’re just sitting around ice it for 10-15 min.

Dan

I have mild “tennis elbow” and have had good luck getting short-term relief from the bands you wrap around your forearm just below the elbow. This gets me through doing activities, but isn’t a long term solution. It could be enough to get you through your race next week while you pursue a longer term solution. I’m going to try some of the exercises recommended above.

Unlikely that switching to a flat bar is the answer. You will have many fewer hand positions and having your elbow in the same position all the time is not likely to help. Try moving around on the bars more during your rides, and look at all the other good suggestions in this thread.

When I had the wider 42 cm drops on my bike, I was feeling a little annoyance right above my elbow. I changed to 38 cm drop bars and haven't had that issue show up again.

I don't get elbow pain when riding my gravel/commuter bike which is a mountain bike with flat bars. But I won't ride a flat bar bike without bar ends so I can change my hand positions. I've got a set of bar ends on order which should show up next week.

My other reasons for changing the handlebars is that my bike is around 30 years old and the bars are not very comfortable when riding on the hoods. Certainly not like more modern bikes. And I'm not a big fan of the down tube shifters which I find hard to shift while pedaling, and sometimes have to feel around to find while riding.

ICE and rest was the answer for me. Also AGE makes a difference. If you haven't checked your T levels, or blood sugar levels i would check those out. If you have low T, it takes forever to heal. Plus if your blood is slow due to blood sugar, you won't heal either. Ah, the joys of getting old.

Maybe it is an age thing, I'm a lot closer to registering for the veterans category for events than I'd like (38).

Maybe a bike fit is in order, I haven't bought any new parts in over a week!

the Mayo Clinic has some interesting info

if you want a decent sleeve I've been happy with these. be sure to measure your elbow before ordering

Thermoskin Elastic Elbow Support, Beige, X-Large

Elbow Brace Compression Sleeve (1 Pair) - Instant Arm Support Elbow Sleeves for Tendonitis, Arthritis, Bursitis, Golfers & Tennis Elbow Brace, Treatment, Workouts, Weightlifting, Pain Relief, Recovery

the "Crucial" brand item is a little more comfortable
the "Thermoskin" brand is a little more snug & not as long, but I still like it
I like having more than one so I always have a clean one handy.
I gently hand wash in the sink
the "Copperfit" brand stitching started to fall apart. those are comfortable but they are black & don't provide much compression

Poor healing from injury, due to malnourishment from digestive problems, and inflammation in joints from food sensitivities due to leaky gut, were a thing for me for a decade or more. Had a torn meniscus that did not heal. I developed trigger finger, T.O.S, carpal and cubital tunnel issues, arthritic pain all over. Among many other health complications

I found I had celiac disease. Stopped eating wheat and all of those things healed up and stopped bothering me. I gave up thirty foods that I had built antibodies to, in order to reduce the immune attacks on my joints, where incompletely digested proteins become deposited and are attacked as invaders.

…consider this if you just don’t seem to heal no matter the therapy tried.

Well don't just go by what I did and related earlier. You need to evaluate whether the current bars width seem like they may play a part in your annoyance. Things like, do they put your arms in a position where they brace you to well for side to side sway and take up all the road and riding forces instead of sharing some of those with the rest of your body. Or do they put your upper and lower arm at a odd twist to each other. And other things like that.

I'm not sure if the position is the problem, as the bike has been comfortable enough before. I think it's more related to having my arm in a single position for a longer duration and the vibration, but I'll experiment with different positions and try to keep changing it up.

Vibration is a killer for my arthritis so I use gel pads under the tape and anti vibration gloves which are much much better than cycling gloves:https://www.amazon.com/Cestus-Vibrat...%2C175&sr=1-28

Bar weights can quell vibration. These bars are much wider than I prefer or are an appropriate fit, and seem to resonate more because of it. Until I get them changed, I added these bar end weights from my supermoto, to reduce the vibrations when I take to a path or rough surface. Seems to work well there. No doubt it would too if long ride vibrations are even part of what is wearing at you.
https://cimg0.ibsrv.net/gimg/bikefor...2527760577.jpg

I'm like Iride01, only different. For me, narrower bars can result in pain on the lateral point of the elbow joint (looking at arms outstretched with palms down). Wider bars help, but too wide can result in pain on the opposite side of the elbow. Both are manageable/preventable if I concentrate on 1) not gripping bars too tightly; 2) varying hand position periodically, including different grips in the same position; and 3) not bearing too much weight on my hands. All of these are basically just having good form on the bike. When I get sloppy/lazy, that's when I start to get pains.

That's just me, of course, there are others who have different issues, but it's something to think about.

For getting through an extended activity, like a 2+ hour ride, I like the full -arm (wrist -to-bicep) compression sleeves. You may find that subconsciously, you're favoring a slightly different than usual position, to relieve the irritation/injury and putting more load on other parts of your arm over time.
I like the 'graduated' sleeves; the ones with extra seams or overlays, over the plain, 'tube sock' style; they seem to give more directed support during athletic activity.

Cortisone shot.

You know you can set your drop bar so the top will be in the same place as a flat bar, right?