Fly Fishing Induced Tendonitis

It’s time to come clean. I’ve barely fished since September. During hunting season it wasn’t a big deal. Now that spring is here it is. At times I step back and am able to put it all in perspective. Other times it consumes me. Tendonitis, tennis elbow, lateral epicondylitis, or whatever you want to call it, has become part of my everyday life.

Two days of throwing streamers with an eight weight, in winds gusting over forty, caused the elbow to flair up last April. A few weeks of rest and this might have been a non issue. Instead I fished hard through the spring and summer. By August I couldn’t lift a coffee cup. By the time I sought help the doc said he’d rarely seen someone let it get this bad. Cicadias, golden trout, and steelhead had all clouded my judgement.

A steroid shot in September provided respite but ultimately failed to have lasting effects or allow for the window of healing we had hoped. In December I sought a second opinion from another specialist. Before resorting to surgery I settled on a regimen of physical therapy, anti-inflamatories and no fishing. After three months I’m just starting to see the smallest signs of progress. I can now pull my laptop out of my shoulder bag without pain shooting down my arm. But it’s a far cry from fishing all day. Today I’m cautiously optimistic. Some days it’s hard to imagine getting back to normal.

Tendonitis is a tough injury to heal and there is no easy treatment, it takes time. As one specialist told me “in a year most people get better wether they rub dirt on it or have surgery”. I’m considering September as when my year began. Now I’m at a point where the injury is chronic. Things like ice and rest alone aren’t going to cut it. Through exercises including eccentrics and cross fiber friction, I am now purposefully stressing the tendons in a controlled manner, forcing my tendons to adapt, strengthen and ultimately heal.  It takes six to eight weeks for tendons and muscles to adapt. As I come into my sixth week I’m seeing subtle progress.

If the physical therapy fails to get the desired response, the options get a little more grim. Some folks have had good luck with plasma injections, although the science around it is not robust. They cost about $600-$1000, which most insurance companies won’t pay for, but they are non invasive. Surgery is another option. The research shows that about eighty percent of people have positive results, but according to one orthopedist “that’s terrible compared to most surgery’s I do”.

For now I remain optimistic about the path I’m on. Long term I’ve identified a couple of changes to my casting stroke and grip that will also help, not only with tendonitis, but my form and accuracy in general. In the meantime, I need to remain diligent with my exercises and refrain from fishing right handed.

16 Comments on “Fly Fishing Induced Tendonitis

  1. A chronic problem for me. I’ve found that: stretching the tendon and icing it really, really helps. I tried all other things, but those were the only two that ameliorated the pain after about 10 months.

    • So sorry to hear that you struggle with it too. At least Steven can know that he’s in good company.

  2. Hi, I’m just now getting back to normal after almost a year of rest, treatment and physiotherapy on a nasty case of tendinitis in my elbow. For a long time I could barely lift a pint glass! What seemed to work best for me was “shockwave” therapy in combination with eccentric strengthening exercises. I also found “active release therapy” very helpful. I did acupuncture and prolotherapy too. Find a physiotherapist who does has the “shockwave” equipment and training. GOOD LUCK!

  3. Come by the house and I will loan, and show you how to use, a simple item that that did more for me in three days than three weeks of rest. As you can well understand, we in the blacksmithing community deal with this community wide. 349-5066 is my cell, check that i’m in.

  4. It might not be tendinitis. My wife developed a very sore elbow after years of double hauling a 9wt. for steelhead (pre-spey), and than a 10wt. for saltwater fishing. When the elbow didn’t respond to the usual heat/cold and rest, she had an orthopedic surgeon take x-rays which showed arthritic calcium build-up which caused inflammation of the joint from casting. She had a surgical clean-out and felt great for a few years until the calcium came back from the same amount of casting (she likes to fish, what can I say). After a second clean-out we gave up the salt and steelhead, and now she only has summer months with 5wt.

    Sorry for the length, but the surgeon said she had done significant tissue damage forcing it, and he wouldn’t go in again due to possible nerve ramifications. He replaces shoulders (me) and elbows so we trust his judgement. If the home remedies don’t work, don’t force it and go have it examined.

  5. It might not be tendinitis. My wife developed a very sore elbow after years of double hauling a 9wt. for steelhead (pre-spey), and then a 10wt. for saltwater fishing. When the elbow didn’t respond to the usual heat/cold and rest, she had an orthopedic surgeon take x-rays which showed arthritic calcium build-up which caused inflammation of the joint from casting. She had a surgical clean-out and felt great for a few years until the calcium came back from the same amount of casting (she likes to fish, what can I say). After a second clean-out we gave up the salt and steelhead, and now she only has summer months with 5wt.

    Sorry for the length, but the surgeon said she had done significant tissue damage forcing it, and he wouldn’t go in again due to possible nerve ramifications. He replaces shoulders (me) and elbows so we trust his judgement. If the home remedies don’t work, don’t force it and go have it examined.

  6. Steven

    As I have recently acquired tendonitis from too much hand sanding while refinishing kitchen cabinets this winter…

    I showed this post to my wife- “Here – look-see this is bothering other fisherman too.”

    Her comment- “At least now you have a support group”

    and then… “start casting left handed”

    so thanks for sharing- it’s good to know we aren’t suffering alone- but surely not all understand that our casting arm is a basic part of who we are- and that it casts a shadow on going out and doing what we love. And yep – I just might have to follow her suggestion and learn to cast left handed- cause I just can’t imagine not throwing streamers for a while.

    Appreciate the suggestions of others too.

    Good luck!

  7. Very interesting read. Last year was the first year that I really fished hard from spring to the end of fall here in the north east. I did a lot of ocean fishing and by the end of May I had completely ruined my elbow. It took me a little while to figure out what it was but after resting it this winter it has felt significantly better. I decided to take up two hand fishing (spey if you will) The force and pressures on my elbow are a fraction of what they were with the single handed rod. Hopefully this will help on my end.

  8. ultra sound waves and ultra violet blue light waves works for me to repair the sleeve your tendons slide thru.

  9. What was fishing left handed like?
    I have had tendonitis in my wrist and ankles, and swear by rest as a cure. I can use my mouse in my left hand, but have never had to switch rod-hands.

    • Sometimes you just have to say Uncle. One time in Belize we had hit the first bait influx of the season…five or so hours of medium tarpon (40 lb.), large snook, and large mangrove snapper on every cast. The wife’s elbow was so sore from the previous week’s casting that I would cast and she would retrieve and fight a fish on every other cast.

      Then, a few years later, I had a slam in Mexico (tarpon, permit, bonefish) and gave the guide our last day off (the lodge guests just didn’t get it) because my shoulder hurt so much. The fish will always be there….just keeping on having fun.

    • Awkward at first but easier to pick up than starting to fish from scratch. A year of complete dedication and I might be able to call myself ambidextrous, to date I can nymph and throw streamers decently, but throwing dries with precision is still difficult.

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