Tennis Elbow - Without Ever Playing Tennis!
By Dr. Steven Trembecki, D.C
Medically known as lateral epicondylitis, tennis elbow is the inflammation of the ouside of the elbow.
The muscles of the back of the forearm run from the wrist to the elbow, where they attach to the upper arm bone (the humerus). It is this tendon, and the surrounding outer layer of bone that become inflamed in tennis elbow. Any movement of the muscle, which puts stress on the tendon, will then cause the characteristic pain of tennis elbow.
Tension on these muscles can be caused by all sorts of activities such as typing, writing, lifting objects with the palm turned down, or using a screwdriver. Even though there is inflammation, there is rarely any swelling. Stiffness and pain in the elbow can usually occur after prolonged periods of rest.
How do you know if you have tennis elbow? Try lifting a book with your palm facing down to the floor. If it causes pain on the outside of the elbow, you probably have tennis elbow.
This condition is ultimately due to overuse of the wrist extensor muscles. These muscles attach to the humerus just above the elbow joint on the outside of the elbow. The muscles then continue down the back of the forearm. The tendons then travel across the back of the wrist and hand and connect onto the fingers. These muscles contract to help extend the wrist moving it toward the back of the hand.
Too much tension in the muscle group can also cause a decrease in the joint space in the elbow and actual inflammation of the joint. In time this can cause not just the typical pain from the epicondylitis, but also from the elbow joint itself.
Treatment normally consists of some lifestyle modification, plus anti-inflammatory and muscle relaxant medication. Physiotherapy such as TENS, ultrasound, laser therapy, and interferential current can also prove helpful.
Chiropractic techniques that work well with this condition include soft-tissue therapies such as active release technique, Graston, or cross-fiber friction massage. Chiropractic adjusting of the lateral elbow, including the proximal radial-ulnar joint and the radial-humeral joint, appear to be quite beneficial.
The aim of the chiropractic adjustment is to momentarily separate the joint surfaces in the elbow by just one to three millimeters. This takes the pressure off the joint, and eases the pain. It may be that some manipulation of the wrist can also help.
The theory is that since the muscles involved with this condition help to move the wrist, it should aid in the speed of recovery if the wrist motion is maintained. If the wrist tightens, the muscles need to work harder to move the wrist. This results in tightness in the wrist extensors which then exacerbates the condition.
The use of a tennis elbow band may also prove effective in decreasing symptoms. This works by forming an artificial origin for the muscle before it crosses the elbow. This allows a decrease in tension of the wrist extensor muscles as they cross the elbow which eases tension on the lateral epicondyle and decreases pressure on the elbow.
Also, though rest would be ideal, there may be times when lifting is needed to be done. In this case, one should only attempt to lift with the palm of the hand turned upward. This uses the wrist flexors more than the wrist extensors.
Two things that have been found to help is to limit salt intake to help reduce water resorption in the body and to supplement with Vitamin B6.
In closing, if you feel that you may have this ailment, the best course of action is to have it looked at by your medical doctor or chiropractor so that the best treatment plans can be started to assist in recovery.
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