Casting arm pain is a great topic that resonates with so many people! Seriously...it's the first thing I looked at when I got onto the Bass Fishing Forum this week. Because not only am I a hand therapist (the doctor diagnoses it and we fix it), but a hand therapist who lives to fish, and a fishing crazy hand therapist (specializing in elbow through hand injury and pain) who has had tennis elbow (it really sucks)....I would love to expand on the original Casting Arm Pain post. I have to shout out a big thank you to Crestliner2008 who started the original post.
Tennis elbow, or lateral epicondylitis in the medical world, is outer elbow and top of your forearm pain that comes from repetive motion, and is aggravated by repetitive motion. Specifically, the muscles that extend (straighten) your wrist and fingers arise from the bony prominance on the outside of your elbow (no, not your funnybone, think more up and outside). This is the area that becomes inflammed and painful when you have this condition. Once you have this tendonitis, evey rtime you extend your wrist or pick something up, those muscles are going to activate and pull from that sore spot.
I probably treat a hundred people a year with this problem, it's so common, but so hard to get rid of. Generally, it requires all of the tools in the tools box to fix it. So here are my top eight tools to cope with it....don't pick just one...just like you wouldn't pick just one lure to take with you on a fishing trip, and you wouldn't show up on the construction site with just a hammer....your are going to employ all eight tools, and treat yourself like the top athlete you are....
(1). Realize that this isn't going to go away overnight. Tendonitis takes at least 6-8 weeks to heal. So you need to rest. No...not on the weekend....but in-between.
(2) Use a wrist splint. Now why would you use a wrist splint if your elbow hurts you ask? Because the muscles that extend your wrist originate on the lateral part of your elbow. If you can keep your wrist from flexing, it stops the muscles from pulling from their elbow attatchment. If you can keep your wrist from extending, it also stops those muscles from pulling away from their attatchment. You want to get long brace long, with a metal bar, that you can get from CVS or Walmart. The longer the better. A cute little neoprene wrist wrap that doesn't get in your way is not gonna do it for you. Wear this wrist splint while sleeping, and wear it during the day when you can, so that your can REST your casting muscles after an outing at the bank or the boat. If you have a fantastic doctor or therapist who can show you haw to properly apply a band-it/aircast/tennis elbow strap...try it when fishing only. Mostly those straps compress the radial nerve in the forearm and cause more pain in 99% of folks. Our OP has an awesome doctor, apparently.
(2) Athletes love ice and heat. I love it, and painful elbows love it. Beer and recently caught fish also love it. After fishing, treat yourself like an athlete, and put some ice on that elbow to reduce pain and inflammation. You can use a bag of peas, a compress from the drugstore, or a bag of ice. Put it RIGHT on the painful spot, on the outside of the elbow. First it will feel obnoxiously cold, and you will want to take it off. But not yet. Then your skin will burn, and you will want to take it off... but not yet. Then your bone will start to ache. Still not time. After 6-8 minutes go by, the burning and the ache will be replaced by a blissful numbness. Now the ice feels good. Now it IS time to take it off. You're skin is pink and numb, and you have gotten enought ice. Do this twice a day, even if you are not fishing.
Many people ask about heat. Moist heat is great before stretching your elbow. It improves blood flow, improves elasticity of the soft tissue, and causes your body to release endorphins which reduce pain. When your elbow feels stiff and painful, go ahead and wrap a heating pad around it for ten minutes.
(3) Massage.....why do you think all those football players have athletic trainers massaging calves and hamstrings at halftime and what not? And how does it apply to the painful elbow? The fibrous origin of the exensor muscles (still talking about those one the outside of the elbow) have poor vascularization (blood flow) to begin with. When you have tendonitis, microtears occur in tissue at the elbow, and those tears fill with inelastic scar tissue. To heal, you need to improve blood flow, and that's where massage comes in. Find the most painful area....make a fist with your opposite hand...now dig your knucles into the painful spot and make a clockwise circle for 60 seconds. The more painful, the better. After 60 seconds, massage counterclockwise for 60 seconds. Now rub longitudinally, it the direction of the pain (and towards your pinkie) for 60 seconds. Then rub perpindicular to the painful area for 60 seconds. Shockingly, once you cease all this painful "massage", your arm feels much better. Go figure. But really...you will feel much looser. Do this before and after fishing, and at least twice a day when not fishing.
(4) Stretching. If you only do two stretches for your tennis elbow...do these.
First stretch....With palm up, straighten elbow, wrist and fingers. As if your are reaching way out for your cash at a fast food window, Grab your palm with opposite hand, and pull finger and wrist towards floor. Hold 10 seconds.
Second stretch...with palm down, extend elbow and make fist as if you are at the end of your Bruce Lee punch. Freeze there. Now grab your fist with the opposite hand, and flex your wrist (with fingers still closed) down towards floor. Hold 10 seconds.
Alternate stretches, repeating 10 times each. Do this before fishing, after fishing, and at least two other times EVERY day. Athletes don't play or practice before stretching, and neither should you. Besides, tight muscles just make you more injury prone, and our goal here is to get through the season.
(5) Avoid overhand grip. Ever. Whenever us human beings pick 90 % of stuff up, our palm faces towards the ground. That's anything from a wrench to a stapler to a briefcase to a grocery bag to a 2x4. The puts the WORST stress imaginable on the inflammed extensor muscles. The first step is to notice this natural habit (usually pain will alert you), and the second is to adjust your grip you either a sidways (neutral handshake position) or an underhand grip. Underhand grip is great bacause it transfers the load to your powerful biceps. finger flexors and wrist flexors. Do this for even light stuff. Those with tendonitis know that even lifting a coffee cup or squeezing a stapler cause debilitating pain. This one change in habit will take you a long way, and is another one of my favorite tools.
(6) Wait...more tools? Yes...these are for my special fishing friends, and not just for my patients.... Whenever I watch the pros fish....and yes, I TIVO that stuff for snowy days and the middle of sleepless nights....I am amazed at how effortless their graceful casts seem and how little their wrists move. It's because of this fact....the whole purpose of having a shoulder and and elbow is to position your arm in space for use (i.e. fishing). And work....which suports your fishing habit. If you can STRENGTHEN the muscles around your scapula, shoulder and elbow...your wrist will need to do less work. The cast will come from your whole arm...not just your wrist, and will take a lot of foreceful load off of your painful elbow. Consider then...the gym. But a caveat....never lift any weights or pull any cables with your palm facing down, if you have lateral elbow pain. Just do all the other ones.
7. Go shopping. THIS is your permission to buy expensive fishing gear. The lighter your baitcaster, spinning real, and rod....the less work your wrist has to do. And the longer you can keep fishing. The first thing I look at when purchasing a new reel is the weight. You really want to stay in the 5-6 oz range for your reels and baitcasting reals. It's amazing that a 8-9 oz reel (just a few ounces heavier) makes huge difference in terms of increased pain and decreased strength and accuracy when repetively casting with tennis elbow. And remember, catching monster bass on ultralight gear is a lot of fun, and takes a lot of skill! And it's kind to your elbow.
8. Wow...still more. Casting sidearm rather than overhead will reduce wrist load and will reduce pain. If you need to, switch places with your budy on the boat, or travel the otherway down the bank so that you don't knock your friend, huband, or wife in the head while casting with a side arm. Lures make a difference too. When you have acute tennis elbow...you don't "need" to cover a lot of water. You "need" to fish. A senko is great. It doesn't need extra weight. When fishing a senko, you are supposed to wait (ahem rest arm) after the cast...for oodles of time, and do a very restful senko type retrieve. Very tai chi zen like.... Patient fishermen probably do not have painful elbows. Frenetic, overhead, supercast retreiving fisherpeople with 3/4-1 oz weights on the end of their lines will probably get painful elbows, and will probably be reading this for any help they can by June.
Because my practice act prohibits me from dispensing information about medication, I can't recommend any....but here's what I tell my friends and colleagues. Personally, I have no ulcers, allergies, stomach issues, or tendencies to drink (too much.....), and I am SURE that my PCP would wholly approve on a short term basis IF I consulted him so, I love to take ONE Ibuprofen and ONE Alieve in the morning when my elbow is sore. Also, even though Glucosamine with MSM isn't shown do do squat in scientific reseach, not only does my dog seem to limp less, but my elbow also seems to hurt less when we both take it. My dog is only 70 in dog years, so she has an excuse. But I still do ALL my exercises. I think cortisone injections are crap. I have had two, The first helped 4 months. I thought it was a miracle till it wore off. The second didn't do anything.....it's what you do for yourself that will help manage the pain, your activities and keep you fishing.
And really, if this gets no better in 2 months, see your doctor. Ask him or her for a referral to an orthopedic doctor with a hand specialty, and ask for a referal for a Certified Hand Therapist...we'll help you out, You can always PM me for more info.
