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Buck Hedges

What to do about tendonitis?

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This seemed the most appropriate place to put this.

 

I've been battling tendinitis in both elbows since October. It doesn't help that I run a delivery route for a day job, and constantly have to lift and carry all day. On top of hunting for a better job, I followed the doctor's advice and tried to rest my arms as much as I could (barring about 3 hours of hammering in December when I simply couldn't stand it anymore!)

 

While my left arm (my hammering arm) is getting better, my right still hurts like a...well, we're not supposed to use that kind of language here, but I'm sure you get the idea.

 

I've got braces from the doctor, I've worn out 2 on my right arm and one on my left. But it still seems to be taking a long time to get over it. While the braces apparently alter the way my muscles pull, I can't hold tools with them since they come up over the palms of my hands. Besides being HIGHLY annoying to wear, I feel like I have penguin flippers for arms.

 

Any suggestions, help, or home-grown remedies?

Edited by Buck Hedges

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I've got braces from the doctor, I've worn out 2 on my right arm and one on my left. But it still seems to be taking a long time to get over it.

 

Any suggestions, help, or home-grown remedies?

 

I have had a few different forms of tendonitis including tennis elbow, achilles tendonitis, and while not strictly tendonitis, still suffer from plantar fasciitis. Follow the doctors orders, and let it rest and heal. I used to run a lot, and started to suffer from achilles tendonitis. I figured that I would just run more sporadically and it would heal like that. Nope. It just got worse. I had to not run for something like 4 or 5 months to let it completely heal. It sucks yes, but if you continue to exacerbate it, it will never get better, home remedies or not.

Edited by Wes Detrick
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I really don't mean any offense by this next statement...

Often tendonitis happens when the tendons are stressed, and they get stressed because they are weak.

 

I say this because I had to find my own way out of the spiral of pain and bad tendons... I only found one work out that worked for me ( I know that you think it's the last thing you need right now). I don't like to plug stuff but the book Convict Conditioning helped me greatly. The first exercises you do for each muscle group focus on getting your tendons and ligaments strong. Those seem easy... and they are if you don't follow form and just blast through them to get them done.

 

So take this as my two cents... it worked for me... it works!

You can get it through Dragon's Door publishing, and I am not a paid spokesman!

 

In the mean while, rest, hydrate, and Tigerbalm!

 

-Gabriel

Edited by grpaavola

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Rest, ice, time, and your choice of anti-inflammatory. I'm fighting tendonitis in both elbows right now, sigh. It's a long road and no quick fix,

 

Geoff

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I am among the many who has dealt with this. When I first started I went all out trying to forge weld and draw out large billets by hand. The end result was tendonitis. I had to stop forging for about 9 months. So in that time I built my hydraulic press. Now hand forging is down to a minimum. Like the other guys said, take care of your arm and let it heal. If you really have to, practice with your other arm. So basically what I'm saying is, if you don't have a press or a power hammer maybe you should get one or the other.

Edited by Matt Todd

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I decided a press was cheaper than ANOTHER surgery (not quite, with insurance, but close).

kc

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I have gone through several bouts of tendon problems (including a partly torn tendon ... no fun that) the keys I have found is to 1 know your limits, STOP doing what ever is causing the problem. 2 mild strength training helps as long as you have recovered.

 

I find tendon problems have stages stage 1 mild ache during the day, lot of pain in evenings or after doing more damage ... this is generally a sign you are hurting your self, could be from doing to much , using to large a hammer, bad form, to tight a grip on hammer, what ever, this stage is a warning , stop what ever is causing the problem, ice and rest now... stage 2 is when the pain is more or less consent , analgesics make it just possible to work numbness in extremity's begins, this stage the only hope is to do nothing with the affected joint for as long as it takes to heal, then a slow recuperation with strength training to prevent a recurrence, stage 3 debilitation pain, inactivity offers no lessening of the pain numbness and tingling. this stage is bad in my experience this is very bad, this is a sign that the tendon sheaths have been damaged, the only thing that fixed this stage for me was surgery,, and the very very long recovery.

MP

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Thanks for all the good advice. On the bright side, my left arm is getting better (still a little pain in the elbow), but the right one still aches. I rest them as much as I can (I have a delivery job, and until I find another one, it's all I've got).

 

Didn't think about the Tiger Balm. Someone in our dojo will have some, I'm sure. I'll see if I can find "Convict Conditioning" on Amazon, since our neck of the woods is void of anything but used book stores.

 

Thanks again!

 

Buck

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I gave myself tennis elbow a couple of years ago, (Playing tennis no less) and it took about a year to get back to normal. It would slowly get better, and then it would seem like I would tweak it somehow and get set back a few weeks in the healing process. I don't have to do much physical work in my job, so I would guess you'll have an even longer row to hoe.

 

About a year ago I decided to try making pattern-welded steel, but don't have any means other than hand hammering. I found that I needed an 8-lb hammer to draw out my welded stacks, but quickly re-injured my elbow. This is when I started paying more attention to hammer technique.

 

I had a hard time picking up on the subtitles of hammer technique, even while watching others. (I'm a bit slow that way) However, what I finally realized that worked for me is that unlike martial arts, don't try to hit through the target. (Yeah, it's obvious when I type it)

 

I find that if I act as if I am letting go of the hammer as it hits the steel, and catch it on the rebound, I can hammer all day without injury. Obviously, I am not actually "Throwing" my hammer and "Catching" it, but that it my mental model. I suspect this is what others refer to as snapping their wrist, but I didn't get it when I was told that way.

 

My apologies if you know this already, but when you mentioned a dojo, the punching through your target thing came to mind. In hindsight, it was silly to approach blacksmithing that way. All it did was cause me to absorb a lot of impact.

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I have read that it is not uncommon for the tong holding hand to cause more problems than the hammering hand. Usually due to gripping to hard due to poorly fitting tongs and vibration. I'm sure I read it on this forum. I actually think it was a hammering tutorial Alan Longmire posted a while back. I'll see if I can find it and link it. I hope you find relief soon. I had a similar problem with my hand last year and it set me back a few months. Rest was the only thing that helped.

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Havn't posted for awhile.I have been dealing with a lateral epicondylits ( tennis elbow) since May. It sucks. And I am areal Doc. The cure is rest it. Ice. And wrist splints , just like if it were carpal tunnel syndrome. The tendons get inflammed from bad technique or just too much work or any combination of the two. Range of motion, gentle tendon stretching and lots of time(months).Then when better work on strengthening .And also learn better technique, because what you were doing caused the problem. The forge has been cold since May , also not safe to grind , no hand strength. Did I mention that this sucks.

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I few years ago did a video on safe hammer technique I just up loaded it to youtube

I hope you will find it helpfull.

MP

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That video should be required watching for all aspiring smiths! I'm pinning this thread for that reason. B)

 

The only thing I can add to that demo is to avoid the broken-wing swing. That is, keep your elbow close to your side, don't let it fly out away from your body.

 

It's also important to have the anvil at the proper height for YOU. That is the height at which your hammer face is naturally parallel to the anvil face at the bottom of the swing with the most common size stock you work on the anvil. Too low isn't as bad as too high. Too low strains your lower back; too high strains your tendons badly and makes it hard to get a smooth surface on the work because you simply can't get the hammer face flat without abnormal wrist motion.

 

I learned all this the hard way too. :(

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Solidly mounted anvils help alot too.

If an anvil rings when you strike steel on it's surface it's sucking energy and making you work harder, if the steel is hot, you should hear a thud, no ringing.

It makes more than a small difference.

 

Hammers to light blow out elbows...as much as hammers to heavy.

Hammer should have enough weight to do the work by being dropped and guided down to the work piece, if you are powering all the way down to the anvil, you are using too much energy and should go up a bit in hammer weight.

Many people "short stroke" and use a lot of power to push the hammer down, better to raise the hammer higher, give it a little boost to start downward motion, but then let gravity do the work, you only need to guide the hammer to it's target.

This will save you an enourmous amount of energy and take a huge amount of the stress out of the motion.

Blacksmith tendonitus is happening from tendons and muscles becoming springs in constant high tension from powering up and down non stop, through the entire stroke. This is extremely wastefull of energy and will burn your elbow up very quickly.

 

If you are getting tendonitus for real from hammering, you must stop, period, and heal.

If it is minor maybe 4-6 weeks. If major, maybe years. If the burn in your forearm and pain lasts into the following day you have done damage, take a break. There is no quick cure or blacksmith medicine that will repair the damage other than time and rest.

 

Our arms are designed to lift and pull primarily, pulling down from above not so much. Pushing the hammer all the way down to the anvil with every stroke will wear the elbow very fast.

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I should add one of the reasons I dissapeared from the sword world all those years ago was the near total destruction of my right elbow, forearm, and shoulder, from overstress forging. It took ten years roughly to be able to comfortably pick up the hammer and do meaningfull work again.

I did not stop when I knew I should have, kept going to make one particular demanding customer happy.

I was a stupid, stupid man.

 

A lot of the damage is permanent and non-repairable. I'm not able to forge a sword blade now in one session, i can forge bevels on a 8 or ten inch piece in one go but that is about it. I have to be extremely anal about technique now just to get through, and there is still some pain and burn and I have to be very careful. My right shoulder is a wreck and requires constant attention to keep from injuring it.

My right wrist is weak and also needs quite a bit of care to keep an i jury from showing up.

 

One sword, in a rush, one day of breaking my own rules and pushing to hard, ignoring the pain, was a decade long forced break from the only thing I have ever loved to do besides play guitar...which I also can't do now.

 

So. Listen to folks who have some time on the hammer, and don't try to tough your way through stuff. If it hurts, YOU AIN't DOIN IT RIGHT.

If the anvil rings, it ain't tied down right. If it is not tied down solid at all like I see alot, well, youre a dumbass. Good luck with that.

If you are reefin the hammer down every blow just to move some metal, your hammer is too small, your steel may not be hot enough.

If you are getting tired lifting the hammer, it's too big, you may have gone to far that way...it can take a while to find a happy medium, and it can change from month to month depending on how much you forge.

If you are icing our using heat to relieve pain or get through a session, you are in danger, you need to stop.

 

And it can take a while to build the muscles and conditioning for extensive forging sessions.

Go slow, don't rush it.

 

Seriously, it ain't worth it.

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Man that's harsh .but I fear true.

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The cure is rest it. Ice. And wrist splints , just like if it were carpal tunnel syndrome. The tendons get inflammed from bad technique or just too much work or any combination of the two. Range of motion, gentle tendon stretching and lots of time(months).Then when better work on strengthening .And also learn better technique, because what you were doing caused the problem. The forge has been cold since May , also not safe to grind , no hand strength. Did I mention that this sucks.

 

So far I've worn out two sets of wrist splints. I rest it on the weekends, but I'm a medical courier by necessity. I lift and carry, or push in a hand truck, lots of totes every day, and some are fairly heavy. I haven't tried ice. I can tell I've lost a lot of strength in my hands and forearms. My left arm is 99% better, but the right one is giving me fits. It will hurt in one spot, then another. Then both, then another. The one bright side is that this happened at work, rather than in the smithy.

 

Matthew, I downloaded the video for future reference. My anvil doesn't ring when I hit it. It's on 2 big rounds of elm, spiked into place with railroad spikes, and has a chunk of tow chain wrapped around it.

 

As near as I can measure it the "knuckles ot the anvil height" test, it's the right height.

 

R.H., there was a lot of good information on proper technique in your post, and I really appreciate it. I'm definitely going to take a look at my technique when I'm able to do something again.

 

Thank you all for the help, and the advice. It was...sorely...needed. :)

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Buck, I sure feel for ya.

Main thing is to listen to the pain when forging and stop of it hurts. Don't bull through it, like I did, it was one of the bigger mistakes of my life.

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I should clarify also, ice and heat in alternate sessions can help alot, just don't use it as a way to keep going. Icing in particular can relieve a lot of the pain and inflamarion but the temptation is to keep going once it feels a bit better, and that is a mistake.

Heat and ice is for recovery time.

 

A lot of very firm massaging with a rounded object, i use a two inch dowel with a rounded end, right into the sore spots, can be downright distastefull, but it'll help. As firm as you can stand, don't muscle against it, stay relaxed, but it'll help.

An increase in potassium, calcium, and magnesium intake can help as well. Alfalfa taken as a supplement can be nearly miraculous as well.

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Buck, on the knuckle-height thing, I find that to be too high for me. The way to test for proper anvil height is to hold your hammer with the face flat on the anvil face. Your arm should be totally relaxed, with a slight (15-20 degree) bend at the elbow and your wrist should be totally straight. If the hammer handle is 90 degrees to the anvil face or tilted slightly up towards your hand when you check this, it's the right height. If the head end is higher than the other end of the handle (that is, if your wrist is cocked towards your thumb), the anvil is too high and you will get hurt if you're not extremely careful.

 

That's for a hammer with a 90-degree handle. Cutler's hammers, doghead, and Japanese style hammers have the handle set at a slight angle. This is deliberate. It keeps your elbow and wrist at the proper angle with the weight-forward long head. If you do the height test above with one of these hammers, when the face is flat on the anvil your elbow and wrist will still be in the correct position. Ergonomics! Filemaker's hammers even have the face at a steep angle to the head and handle, up to 45 degrees. They are meant to be used sitting down with the weight of the hammer doing all the work, yet still keeping the face parallel to the work.

 

The old-timers who had to use hand tools because that's all there was knew how to use them to best advantage, and the people who made the tools knew how to shape the grips for best use. Grab an antique handsaw and it's like shaking hands with a friend. Grab a new one made in China and it's like grabbing a sharp-edged board. This leads me to my next gentle rant: make sure your hammer handle fits your hand. I am not a small guy, but many factory handles are too fat for my taste. If your handle is fat enough that you have to actively grip to hang on to it, that's going to hurt you too. I reshape my handles' cross section at the grip to a round-cornered rectangle or octagon about an inch to 1.25 inches in the long axis and about 3/4 inch in the short axis. This lets me hold it with no effort at all. It just sort of floats in the handshake position. That's also why I can't abide fiberglass handles with rubber grips, they can't be reshaped to fit the user and I suspect they transfer more vibration to the hand and arm.

 

I use a tennis elbow strap rather than a splint. I'd rather not use anything, but like I said, I learned all this the hard way and now I don't have a choice but to wear it if I'm going to be forging a lot in one day and want to be able to use my arm the next week or two afterwards.

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I guess I found this thread a little late in the game. Not because I'm hurting but because all of you have in the past, or currently are!

My background is in Physical Therapy and I cringe when I hear people with tendonitis of any sort or even worse injuries, especially when it's this lot.

 

Long story short. There is no magic to this, there is no cure all, and there are no quick fixes. Without proper technique, set up, and care, you will hurt yourself. This profession/hobby is a physical one, and if you don't care for yourself and pay attention to the aches and pains, it will result in the complaints I am seeing here.

Tendonitis of any sort is considered a chronic injury, meaning it takes a long time to develop, and a long time to heal. This also means, that if you are hurting when working, STOP. You will make it worse.

 

Pay attention to your body, how you are working, and if possible avoid the pain, even the motions that cause the pain. Everyone knows the joke, "Doctor, it hurts when I do this." Well then, don't do that!" the doctor replies. It sounds stupid but the logic still applies. Pain is the bodies way of saying something is currently wrong, not something will eventually go wrong. Listen to the pain, you're body is smarter than you think.

 

I apologize for the essay but tendonitis is preventable, and it starts with education and respecting your body. If you have tendonitis, it's likely your own fault and you really need to reevaluate how you are working. Whether it's your hammer weight, handle shape, height of the anvil, day job, amount of hammering, technique, or even the total amount of work you are doing, I think that everyone should take a moment to think about how their set up is right now. I promise you that you will find a way to improve.

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