Tennis elbow

[LMS]

Hi everyone, (new here) I was wondering if it was possible for someone to recouperate (sp) from severe tennis elbow without intervention?

Back in August (4 months ago) I did 3 screen printing jobs back to back and then some signs in a 36hr period. It put loads of stress on the joints needless to say, and my one elbow has been in pain ever since (everything else: wrists, other elbow, etc improved with rest). After 2 months of no improvements I went to see my doctor but was seen by an intern instead who basically said it was tennis elbow, stop all work, put ice on it & go to physio.

From what I've read, unless you stop all motions that irritate the elbow, not cortisone shots, physio or ice will help. I've read that there's a study where they take the white platelets from your blood & inject it in the site that has proven to be the most successful so far.

I just had a hip arthroscopy done 2 weeks ago and for the first time since the day I hurt myself, I was completely pain free... well because of the lovely meds they gave me for my hip of course. So for 1 week, it was nice but I'm in no way shape or form interested in becoming an addict in order to be pain free again.

An aquaintance agreed that the best way to recover was to stop the movements that put stress on my elbow (that was his experience & it took a year to recover) but unfortunatly that's not possible. My husband & I operate our own business and I have a part time job at a therapeutic riding centre (instructor). I can limit & delegate some of the actions, but I still have to do a lot.

I haven't gone to physio yet as it's fairly expensive here & I'll be in physio for my hip begining next week (have already spent a bundle on it last year, so money is an object)

Does anyone have any advice?

[Zaynah]

hi

i'm a physiotherapist from South Africa.

Tennis elbow, aka elbow lateral tendinitis is inflammation of the tendons where they insert at the elbow on the outside. The tendons come from the muslces that extend over your wrists and fingers. Tennis elbow causes pain at the outside of the elbow and some tenderness in the muslces running from that area over your forearm, wrist and fingers on the back of the hand. The problem is from overuse, as these muslces contract, they cause friction pulling at the insertion site on the bone, causing irritation and swelling... aka inflammation. If the inflammation continues, this becomes a chronic situation (>3months)... then it is called tendinopathy. Now the insertion of the muscles-tendon on the bone becomes degenerative (breaking down) and stiff (reducing elastic nature), causing small tears in the muscles and tendons. it can even lead to avulsion, where the tendons detach/tear off their insertion site on the bone.

So to make sure you have tennis elbow, you must be properly diagnosed! If you press on the outside part of your elbow and work yourself around that area, do you have any sore tender spots? Now pull your wrist backwards and extend your fingers. Hold this and now with your other hand try to push the wrist and fingers ont he back of the hand back down. So you are applying resistance against the back of your hand, and trying to keep your wrist pulled up backwards and your fingers straight. if this hurts it suggests the muslce-tendons doing this movement is involved, and they cause the tennis elbow. It may also be sore if you twist your forearm or wrist like screwing in screws or turning a door knob.

For treatment, first protection. You can buy a tennis elbow strap at pharmacies and sport shops. Its a strap that you place around the upper part of your forearm just below your elbow. A physio can also tape this area with strapping. This presses the musle-tendons that attach on the bone down, decreasing the pull of the muscles on the bone, thus reducing the inflammation-irritation. After work or usage of your forearm or hand, apply some ice to the area for 10-15minutes. this reduces bloodflow and swelling, combatting the inflammation. You may also take anti-inflammatory medication after work to combat the inflammation... It's silly to suggest stop working, as this is not practical and realistic! We must rather try and prevent injury with aids and advice. Try to refrain from twisting and wrist flicking movements with your wrist and forearm (twisting doorknobs, DIY screwing, typing etc.) outside of your job. Our aim here is to prevent the longstanding chronic tendinopathy (degeneration of the tendon-bone).

Hope this works...

[LMS]

If the inflammation continues, this becomes a chronic situation (>3months)... then it is called tendinopathy. Now the insertion of the muscles-tendon on the bone becomes degenerative (breaking down) and stiff (reducing elastic nature), causing small tears in the muscles and tendons. it can even lead to avulsion, where the tendons detach/tear off their insertion site on the bone.

Oh no! So I guess I'm not doing myself any favours by not seeing a physio therapist?

So to make sure you have tennis elbow, you must be properly diagnosed! If you press on the outside part of your elbow and work yourself around that area, do you have any sore tender spots?
Yes

Now pull your wrist backwards and extend your fingers. Hold this and now with your other hand try to push the wrist and fingers ont he back of the hand back down. So you are applying resistance against the back of your hand, and trying to keep your wrist pulled up backwards and your fingers straight. if this hurts
Yes
it suggests the muslce-tendons doing this movement is involved, and they cause the tennis elbow.
That's what the intern mentioned too.

It may also be sore if you twist your forearm or wrist like screwing in screws or turning a door knob.
Yes very much!

For treatment, first protection. You can buy a tennis elbow strap at pharmacies and sport shops.
I wanted to but the intern said it was useless in his opinion.

After work or usage of your forearm or hand, apply some ice to the area for 10-15minutes.
Thank you this is most helpful! The intern only said to apply ice, he didn't specify when or how often.

It's silly to suggest stop working, as this is not practical and realistic! We must rather try and prevent injury with aids and advice.
My thoughts also.

Try to refrain from twisting and wrist flicking movements with your wrist and forearm (twisting doorknobs, DIY screwing, typing etc.) outside of your job. Our aim here is to prevent the longstanding chronic tendinopathy (degeneration of the tendon-bone).

Hope this works...

Yes, thank you so much, you were very helpful!

The moment that I could no longer have use of my left side (yes my job does required a lot of wrist movement and awkward grabing & lifting), I refrained from doing them unless it was very minimal movement or an absolute necessity. I do my best to use my right side instead wich is very awkward & slower.

He advised that I should at least get myself a tennis ball or stress ball & squeeze it several times a day to keep the area from getting worse. Is he correct?

I will go ahead & continue to try & find an elbow support. Is this worn all the time then?

At this point in the game, should I bother asking to see my regular doctor & re address this? Or just go ahead & see the physio therapist?

Thanks again.

[Zaynah]

So now that you know you've got tennis elbow, you can treat it properly and prevent chronic symptoms.

Squeezing a ball is a good idea, as this works the muslces at the palm side of your forearm, called the flexors. So this exercise strengthens the opposite muscles and relieves the strain on the extensors that are problematic in your case.

Here is a good online guide of the ice-protection phase and phase 2 exercises you can start doing by yourself or while your seeing a physio (discuss this with him/her):
http://www.tennis-elbow-treatments.c...w_exercise.php

Best thing will be to go to a physio. She/He will show you some excercises to help minimize strain on those muslce-tendons that are injured and to strenghten your joints. She/He will show you some stretches you can do to lengthen those muscles etc. You will also be shown how and when to wear your strap/brace (basically when you will be using the wrist for work or sports involving those muscles to work). She/He will also use some machines on you, called Laser or Ultrasound etc that stimulate bloodflow and helps the healing process along. A Sports Physiotherapist / Physical Therapist will be your best bet, as the person will have delt with similar patients before.

Good luck!

[LMS]

Thanks for your advice. Unfortunatly I haven't been able to get a band or go to physio (tapped out & still going to physio for my hip) but because my hip was painful as well, my doctor put me back on the NSAID Cox-2, Meloxicam (generic of Mobicox). It's helped reduce the pain but I now have high blood pressure. My hip surgeon told me to get off of it asap.

Anyhoo, just thought I'd post an update.

[Zaynah]

sorry to hear that you have hipertension now, as this complicates the use of medicaton to help with pain and inflammation. if you can't take anti-inflammatory meds (NSAIDS), the ice with rest (when you can) after 'over-using' those muslces, is the next best thing. remember that ice and rest is for the inflammatory phase which happens just after overuse or an injury, for the first 5 days... then when the inflammation goes down and you are left with feeling stiff and sore in the area around the elbow or when using the hand (about day 5-10), you can apply a hotpack for 10-20minutes in the area and with some oil or cream gently massage in circular motions over all the stiff-sore areas. This will increase the bloodsupply to the area, relaxing the muscles and helping to flush toxins away and increase the healing.

Good luck.