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I Forge Iron

Blacksmith Elbow


rockstar.esq

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I've had blacksmith's elbow for two years now and in that time I've learned a few things that might help others.  Before I go on, I want to stress that I am not trying to provide medical advice.  If you've got a problem, please see a qualified doctor.

With all that said, here are a few things that took a a lot of pain, and a very long time to figure out.

Blacksmith elbow tendon problems can be diagnosed with an ultrasound, provided you have access to a facility that has an elbow imaging specialist.  However, I saw several doctors, physical therapists, and even a surgeon who wanted to operate without any imaging to confirm or diagnose my problem whatsoever.

There are three root causes (that I know of) for this condition.  Scarification, torn/perforated tendon, and stretched/thinned tendon.  When researching treatment options, very little is presented in terms of resolving a particular root cause.  It wasn't until I sought a second surgeon's opinion that I learned that some treatments excel for some conditions and don't work as well in others.  This may explain why people have such inconsistent results with any given treatment option.

It's my completely unqualified opinion that some popular treatment options made my condition worse.  At a bare minimum, it wasn't worth the pain and the lost time waiting to see if an inappropriate treatment would improve my situation.  One thing that nobody tells you is that each treatment option is a two to three month commitment.  You're expected to wait at least two to three months to see if you recover before you can try something else. Nobody wants to "escalate" the treatment until simpler remedies fail.  The unsaid thing here, was that imaging could have been done at any point along that line to rule out the time-consuming and painful treatments that definitely wouldn't have worked.  

 

 

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I think the point was specifically that some medical professionals were quick to suggest "solutions" that were either not helpful or actually made the situation worse.  There was no suggestion of self-diagnosis, experimentation, or treatment. 

What I took away from it was if at all possible have ultrasound imaging done by and then evaluated by a qualified medical professional to decrease the likelihood of ineffective treatments or those that may even aggravate the condition.

I had tennis elbow for about 2 years, although I know the origin of my condition and it had nothing to do with blacksmithing.  Regardless, I did go to an orthopedic specialist and ended up getting a cortisone shot in one elbow.  That provided some relief for about 3 months and then the pain returned.  Ultimately there were some techniques that worked for me to decrease the severity of my symptoms and I took it easy on my arms for quite a while to give them time to heal properly. 

Now I'm back to as normal as I get, but like Rockstar and you have suggested, the appropriate medical professionals are the ones to consult.  Rockstar's tale was just cautionary about accepting surgery as the solution before getting imaging done that can provide more insight to the condition IMHO.

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Slag,  I sure didn't mean to imply that I was advocating trial and error in lieu of following a physicians advice.  I very literally followed every physicians advice from start to finish, except for the first surgeon who was wanted to book surgery without imaging, or even examining my elbow.  I discussed it with my General Practitioner and followed his recommendation to seek a second opinion.

I'm not trying to give medical advice at all.  I'm simply relating the (layperson) lessons I learned along the way to figuring out what was wrong with my elbow.  The direct pay cost for the specialist ultrasound was very literally half of what a local clinic charged me for a cortisone shot.  Speaking of that, all the surgeons I've seen were adamant that two shots of cortisone is the limit before they start doing harm. 

 

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Mr. R. Star,

I was not implying anything. I am sorry that I gave you and anyone else that impression.

You were right to get another opinion when the Quack Doctor suggested surgery without any image taking.

I don't know where you are situated so I could not have recommended knowledgeable doctor.

Surgery is usually the last option that should be taken. Because after surgery all other choices are precluded. Surgery is the last straw.

The reason that cortisone injections are used very sparingly is that more than two or three,  causes  joint damage. (these days irreversable damage in 5 years stem cell technology should regenerate that joint tissue.)

I am glad that you figured out your problem, on your own,  and  discovered the best mode of exercise by yourself.

Have a great weekend and regards,

SLAG.

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I have elbow problems as well. Very painful at times. I just put up with it, but I guess I will need to take some positive action sooner or later. Wish I could use the other arm for a while but that's not an option. I'm dangerous left handed.

I hope Rockstar finds a treatment that helps his condition and perhaps he will let us know.

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Just recently I've been having some pretty bad pain in my left elbow due to some heavy lifting and fenangling other than forge work. Only really hurts with strain in certain directions.  Thankfully I'm a righty but its been rough at my day job and such. It's been up and down for 3 weeks and I'm hoping it will ease away on its own with trying to take it easy on it. Thanks for the cautionary tale. Another tool in the box of knowledge if I need to get it looked at. 

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Ultrasound imaging when coupled with softwear similar to that used I’m an MRI has been used to diagnose lower limb isues in race horses for about a decade. I am glad to see the technology slowly making its way into human medicine. 

Rockstar, keep us in the loop. Particularly the recommendations of the OT for preventing reacurance.

 

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Slag, no harm done, glad we're on the same page!

Ausfire, were I to go through this again, I wouldn't have delayed seeing the doctor right off.  Most of the doctors have commented that tendons don't get as much blood flow as other body parts so healing takes longer.  It's my layperson understanding that injuring it again during recovery is what sets up the chronic condition.  In my case, it took less and less to injure it again.  

Daswulf, I definitely have that weakness in one range of motion that you described.  Palm down hurts more than palm up.  As it progressed, I've lost grip strength and dexterity.  When it's really bad, my ring finger stings.  

I figure it's worth sharing that I wore the elbow brace thing more or less from the beginning of symptoms.  At first, it seemed to help a lot.  On the long term, I now see that it didn't prevent me from re-injuring myself.  With the strap on and "warmed up" the elbow didn't hurt much at all.  Once I stopped for the day, it was a whole different story.  

Cortisone worked much the same way.  It concealed the pain to where I thought I was all better.  Right around the three month mark, the first shot wore off and it hurt way more than before.  My first doctor didn't instruct me to avoid hammering for three months.  She said after two weeks, I could ease back into it, which is exactly what I did.  I have no proof that waiting three months would have cured my condition.  I can say that it never gets better on it's own, and it always gets worse after I push it.  It's awfully difficult to go two years without encountering situations where you don't have a choice but to push it.  

 

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This is what sports medicine is for. Doctors specialize for good reason and soft tissue is it's own field. The surgeon who was called in to rebuild my elbow when I took the header off a tilt deck trailer is a specialist, Osteo . . . (something) and he isn't the only one in his office who examined the various scans on my arm and elbow or was present during the 5 surgeries performed to put it back together. 

Once the bone and gross damaged reached a point in healing he referred me to a specialist in soft tissue, a step above sport's medicine specialist. He sent me with a thick file of what and how therapy should be performed for the best results when I started seeing a therapist here in Wasilla.

My left elbow doesn't look like a regular elbow, it doesn't straighten all the way and there's a slight off angle overall. But it works just fine and the only pain I suffer is if I bump that elbow, there's no meat over or around the bone and the screws really SMART if you bump into them. 

Specialists! If you have problems above a general practitioner's pay grade fine a specialist.

That's as far as my medical advice goes. Oh OKAY I can't resist the old fart to the youngsters thing. Don't take chances when you're young, the things you can just shake off or work through WILL come back to haunt you later in life.

Frosty The Lucky.

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  • 3 weeks later...

Frosty, you aren't kidding about injuries when you're young coming back to haunt you. 30 years of skateboarding destroyed my joints. Some days I have to use a cane and haven't been able to sleep in a bed in years. I don't think it would have made a difference if someone told me that this was going to happen though. I do wish I would have done a better job following the advice of the doctors while I was recovering from the many injuries I did sustain.  I would skate with casts on or cut them off early. When you're young you seem invincible. With age comes wisdom.

Pnut (Mike)

 

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I personally wish I'd taken better care of my hearing back when I was a professional woodworker. My tinnitus is intermittent, but annoying as all get-out.

And let us not forget the sage wisdom of Will Rogers: "If I had known I was going to live this long, I would have taken better care of my teeth."

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I use DMSO dimethyl sulfoxide although if used improperly it can carry surface contamination from your skins surface into your blood stream. It is an amazing natural chemical when used properly on joint or muscle pain ! DISCLAIMER : I am not responsible nor have I created or profit from it’s usage read about this before using it!!!!!!!!!!!! 

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Quote:

DMSO :This is a schedule 6 poison according to the Australian Government Poisons Manual, and as such not allowed to be recommended for internal or external use in humans or animals.  This is not a schedule 2 therapeutic good.

There's always someone who will spoil things!

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Ausfire,

Australia is the only country that I am aware of that banned DMSO. It might have happened because an number of quack manufacturers claimed that it had benefits in combating cancer. 

It does NOT.

Australian regulatory scientists were, also,  worried about neurotoxicity. But their counterparts, in other countries have not found evidence that made them suspicious. The  F.D.A. has had a running battle with some makers that were using it in combination with some ineffective cancer "drugs".

It actually interferes with the anti-cancer activity of the organo-platinum  anti-cancer agents. (examples are cisplatin, carboplatin, oxalo-platin, etc.)

U.S. scientists have determined that DMSO is less toxic than ethyl alcohol, (ethanol).

It is being used for to treat brain tissue swelling after traumatic brain injury. It' also used to treat horses for similar problems.

Occasionally reports of untoward, effects have been reported with its use.

Therefore it should be used with knowledge and care. 

DMSO actually goes through the skin into the blood system. It can carry other chemicals with it.

So gloves should be used. I know that neoprene, butyl rubber, and thick latex gloves are advised. Avoid nitrile gloves as they quickly break down.

I have misgivings addressing this subject as it far removed from the main subject matter of this site. And I questioned posting this response.

But here it is,   and I wait the powers that be to inform to not do so in the future.

SLAG.

DMSO can form explosive compounds with many laboratory chemicals. So look up the possible hazards before compounding it with any 'drugs' . (or storing it with other reagents).

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Thank you for the information I Truly appreciate it Ausfire. I have no doubt of it’s levels of danger hence the disclaimer. It is a wonderful topical analgesic for joint and tissue pain relief if used properly! 1 death occurred due to misuse [political content removed].

That being said it can and is purchased and used otc all over the us but doctors here can be reprimanded for even responding positively about the use of it. I’ve asked my long time trusted Physician!

Thank you again. 

Edited by Mod34
Political content deleted
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Joey, the information came from Slag, not me.

Mr Slag, I don't think you will be censured for your comments. They are pertinent to the topic of treating Blacksmith's Elbow, as per the original post. And it is certainly something many of us are interested in. I had two very heavy work days last weekend (our annual Pioneer Days) with demos all day. Had to pull up at one stage with right elbow pain. A day off today has helped.

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Sorry Aus!

I know people who are  NOT allergic to sulfa based drugs who have used it for years without negative side effects. And I’ve known many people who are now in the ground due to alternative pain medication. Sorry it’s a little personal, if I’ve been out of line I apologize.

And I hope you resolve your elbow pain!

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