One of the most common injuries that fencers get is commonly called “fencer’s elbow”, or tendinitis if we’re being technical.
A tender, painful spike of sensation that hangs in the dull curve of the elbow joint is how people usually experience it. Like a pinch that can progress into a fiery, throbbing ache. Without the right kind of support and precautions, it’ll only get worse.
It’s the same thing as tennis elbow or golfer’s elbow, except of course that those come from holding a tennis racket or a golf club. In fact, any repetitive motion or long-term action that uses the arm can cause the same thing. It could happen to hairdressers or plumbers, to carpenters or artists – anyone who uses their arm over and over again in the same motion. The medical term for it is lateral epicondylitis.
What is tendinitis?
Fencer’s elbow isn’t typically a sudden injury like a sprain or a bruise, rather it’s something that develops over time. The injury happens in the weapon arm, and it comes from the strain of holding the weapon for an extended period of time. Even if it feels like it’s happened in one fell swoop, it’s more that it hits a tipping point and becomes unbearable.
Tendons are the pieces of fibrous flesh that connect a muscle to a bone or some other structure, as opposed to ligaments that connect a bone to another bone. Every muscle in your body that moves you has a tendon. The way that our muscles work is to pull on a bone (or some other structure, like your eyeball), which then moves that bone or structure and the rest of the body that’s attached to it. Tendinitis can happen at any number of joints in the body, in theory anywhere that there’s a muscle moving. Swimmers get it in their shoulders, and jumpers get it in their knees.
In the case of fencer’s elbow, it’s the muscles of the lower arm that connect to the humerus, or the bone in the top of the arm. That tendon, the one that connects the lower arm muscles to the bulge of bone in the elbow, is what gets angry and inflamed with tendinitis.
The pain tends to be felt on the outside of the elbow, and it’s distinctive. It starts off as a dull ache that gets worse over time. The flesh around the the knob of the elbow will start to feel hot, achy, and tender to the touch. As the tendinitis gets worse, the pain won’t always stay in the elbow. I can start to radiate all the way down to the wrist, making the muscles of the lower arm painful.
Along with the pain, there can be weakness in the arm with tendinitis. It might be hard to do things like hold a cup of coffee, turn a doorknob, and of course, hold a fencing sword. Aside from the distinct pain of tendonitis, the sudden collapse of the arm is a hallmark of the condition. It’s almost like the arm stops working – it goes suddenly limp when tendinitis flares up.
The problem will continue to get worse if it’s not treated, though treatment can be very simple early in the tendinitis experience. Tendinitis can come and go, but it does tend to get progressively worse over time. Once you’ve developed fencer’s elbow, it is more likely to return. That’s why prevention and treatment are so important.
Staying ahead of this fencing injury
There are lots of ways to stay ahead of this fencing injury, and most of them are also good for either your overall health or your fencing skill.
It all starts with form. Improving the form of your fencing arm is the first step and the best way to prevent tendinitis. The right form will build your muscles without putting so much strain on the tendon. A good fencing coach will be able to look at your fencing arm and give you tweaks that will guide your form in the right direction and away from tendinitis.
Fencers should avoid any kind of twisting in the arm, and they should also avoid putting extra strain on the lower arm. Oftentimes, fencers try to compensate for bad form in the core or slow speed in the legs by extending the arm too much, pulling on the lower arm and straining the tendon there at the elbow.
Though tendinitis gets its hold at the elbow joint, developing the muscles in the lower and upper arm can also support prevention of this injury. Cross-training can help to prevent fencer’s elbow. When the muscles are strong, the tendons don’t have to do so much work and are less likely to get inflamed.
In the last decade, I’ve seen it more often in adults than in young people and kids in general. This is despite the fact that younger fencers tend to go harder and longer than adults. I attribute this to a different training regime that youth fencers and adults are doing, with school-aged fencers focusing a lot on cross-training, supervised fencing and private lessons with form correction, and on a lot of different exercises, while adults are mostly fence after a short warm-up, neglecting to develop the muscle support system that helps to prevent the injury in the first place.
Treating & addressing tendinitis in fencers
If you feel anything but a passing pain when training in fencing, you should go to your doctor as soon as possible. Though fencing coaches and fencing clubs might have a lot of experience with the normal ailments that come with this sport, nothing is a substitute for a medical opinion.
We’ve recently seen a few cases of severe tendinitis among our adult fencers, and it’s honestly one of the tougher fencing injuries to deal with. Tendinitis gets settled in and takes hold, and it’s difficult to stop the cycle of injuring the area.
There are a few ways to combat this, some of them are preventative and things that you can do at home, others are more medical and require the doctor’s care. The doctor’s interventions will always be more invasive. The worse cases of tendonitis are treated with botox injections or surgery. The goal is to prevent that kind of drastic measure through other therapeutic and preventative measures. Note that physical therapy is a midlevel defense, and also that the right interventions can often reverse fencer’s elbow.
Here are some practical tactics to combat fencer’s elbow based on my own experience.
1 – TheraBand Flexbar
One of the most positive preventative and restorative treatments we’ve seen for fencer’s elbow is the TheraBand Flexbar. It’s the top way to help this problem, and you can do it with just one low-cost tool and at home. Physical therapists offer this as an at home way for people to remedy tendinitis.
The TheraBand Flexbar is a dry rubber cylinder that comes in different weights. For fencer’s elbow, you hold the Flexbar with both hands and twist it back and forth slowly. There are tons of YouTube videos about how to do this, and of course you would want to talk to your doctor or physical therapist about it.
One thing that it’s important to note about this treatment is that it’s a long game treatment. Don’t expect to feel results in a couple of days. Instead, plan to do this daily for a couple of weeks or even months before you see consistent results. The great news is that it’s a long-term solution!
This is something that I have personal experience with when I developed a severe form of tendonitis. I did it like five to six times a day for ten to fifteen minutes each to remedy my acute fencer’s elbow. Took me about 3 weeks. I’ve recently recommended it to one of our adult fencers and it’s worked wonders.
It’s better to do this often and with shorter sessions than with longer sessions and more infrequently. It’s all about consistency and building the muscles up over time to ease the strain on the tendon.
2 – Calm the inflammation
The problem with lateral epicondylitis is that inflammation in the tendon. Luckily we’ve got three major tools to calm it down in the moment that will help prevent fencer’s elbow from getting worse. Here are three.
Rest is an essential component of settling down the inflammation in the arm. Wearing a sling or a brace will keep the elbow still and stop the area from getting more inflamed. There are specific elbow braces that are made just for this condition – look for something for tennis elbow and it will do the trick. You don’t have to wear it all the time, but it can help if the area is getting aggravated when you’re not fencing. If you find yourself accidentally tweaking the elbow when you aren’t fencing, then a brace can be hugely helpful.
At the first sensation of a problem, the slightest twinge, it’s good to go ahead and get some ice on the elbow to slow down the inflammation. This will calm it down immediately. Heat can soothe the ache as well, but ice addresses the problem head on.
Depending on your need and your doctor’s recommendation, an anti-inflammatory medication like ibuprofen can also help. It will directly calm the inflammation.
Fencing elbow takeaways
The hardest thing is the treatment – one of the best ways to treat tendinitis is to change the movement that you’re doing. If you’re in fencing, there’s very little latitude to change it. Fencers tend to be passionate about the sport, and taking a break to recover from fencer’s elbow often feels like an impossibility. Talk to your coach and your doctor. See what can be done earlier on before the problem becomes to be a real one. The possibility of reinjury is high as well. This is why it’s so important to make changes as soon as you feel a twinge.
Preventative exercises are an absolute must for fencers, especially adult fencers. This is one of the most common and most debilitating injuries that we see in fencing, and it can very much be prevented. No one wants to slow down their fencing because of a painful injury! Not even one with a common name that is highly treatable.
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When placing the elbow brace, be particular with the therapeutic protuberance. Elbow frozen gel packs applied immediately after practice help – as does medicinal scotch or gin. 😉 Holding the mid-forearm and rotating it in your hand also provides relief.