Whats The Worst Case Scenario For Tennis Elbow
The worst cases cause severe pain and significant functional disability for years at a time. Fortunately, such extremes are rare, because they can become existential crises for a careers that depend on keyboarding. Many chronic injuries and pain problems can threaten careers to some degree, but this is an obnoxiously direct attack on your livelihood. People can and do change their lives to work around lateral epicondylalgia. Like carpal tunnel syndrome, some people simply give up trying to make a living with a keyboard and mouse. But there is hope, and most of those people probably shouldnt quit their jobs there are treatment options that, while hardly guaranteed to work, are worthwhile and often neglected.
If youre really serious about your racquet sports or golf, thats also a major issue.
Even at its worst, the pain is usually not extreme by the standards of some kinds of notoriously severe body pain. Although the pain severity rarely escalates to the level of general disability e.g. keeping you awake at night, interfering with activities that have nothing to do with using that arm its interference with work can change lives by forcing career changes, and that is serious indeed.
For most people, the condition is usually just an annoyance for a while. Its the minority of stubborn cases that make the condition notorious.
What If The Home Remedy For Elbow Tendonitis Does Not Work
What to do for tennis elbow often depends on who you talk to. Physical therapy is a great option to treat elbow tendonitis. There are different treatments for the various sources of elbow pain. Massage and stretching can improve the mobility of the tissue. Education is important in treating elbow pain. Physical Therapists use a variety of treatment options, including:
Elbow tendonitis pain can be reduced with laser treatment
- The Graston Technique.
The Graston method helps reduce elbow tendonitis pain
- Electrical Stimulation.
Related Article: Tennis Elbow Defined.
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Exercises To Help Tennis Elbow
There are many treatment options for tennis elbow, but the best place to start is with strengthening and stretching exercises. The following exercises focus on slow, deliberate motions.
Stress Ball Squeeze
Squeezing a stress ball can improve grip strength. Eventually, you can graduate to using a hand grip strengthener.
Step 1: Hold a stress ball, tennis ball, or rolled up sock in your hand.
Step 2: Make a fist around the ball and squeeze.
Step 3: Hold for about five seconds, and then relax your hand for five to ten seconds.
Repeat 8 to 12 times, then switch to holding the ball in your other hand and perform the squeezing exercise again.
Wrist Extension and Flexion Stretch
Wrist extensors and wrist flexors are groups of muscles that connect into the elbow and are often subject to overuse, which leads to pain and inflammation. This stretching exercise should be done before any physical activity involving your affected elbow. It can be done daily.
Step 1: Straighten your arm so that it’s perpendicular to the floor, bending your wrist back as if signalling stop with your hand.
Step 2: Use your other hand to gently pull your fingers back toward you until you feel a stretch on the inside of your forearm.
Step 3: Hold the stretch for 15 seconds.
You can repeat this five times, then perform the stretch on the other arm. Afterward, flip your arm over and complete the stretch with your fingertips facing down.
Forearm Supination & Pronation
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If Your Symptoms Are Work
- Discuss your options with your employer.
- Seek help from an occupational physiotherapist or other health care provider. They will work with you to find strategies or solutions that allow you to continue with your responsibilities at work without making the pain worse.
- There may be other tasks you could do while your elbow is resting or there may be changes that could be made to the way you work that could reduce the risk of it reoccurring.
- Alternate tasks with different demands on the wrist and forearm, if possible, and take regular breaks when you are working.
Whats The Difference Between Tennis Elbow And Golfers Elbow
Tennis elbow is a condition of the lateral epicondyle tendon, or outer part of the elbow. Golfers elbow is a condition of the medial epicondyle tendon, or inner part of the elbow. The medical term for golfers elbow is medial epicondylitis.
People with golfers elbow have inner elbow pain that radiates down the arm. They can also have finger numbness and tingling. Golfers can get tennis elbow, just as tennis players may get golfers elbow.
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Tennis Elbow Exercise Using A Theraband Flexbar
The FlexBar is a flexible, durable resistance device that can help you strengthen your forearm muscles.
It has been clinically researched and proven to reduce elbow pain by 81 percent. It increases strength in the tendons by 72 percent in tennis elbow patients.
Hold the FlexBar in your involved hand in full wrist extension.
Grab the other end of the FlexBar with your uninvolved hand with the palm facing out,
Twist the FlexBar with your uninvolved wrist while holding the involved wrist in extension.
Extend both elbows and bring both arms in front of you while maintaining the twist in the FlexBar, by holding the uninvolved wrist in full flexion and the involved wrist in full extension.
Slowly let the FlexBar untwist while moving the involved wrist into flexion.
How Is It Treated
You can start treating tennis elbow at home right away.
- Rest your arm, and avoid any activity that makes the pain worse.
- As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice as long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
- Take over-the-counter pain relievers such as ibuprofen or naproxen or acetaminophen if you need them. Or try an NSAID cream that you rub over the sore area. Be safe with medicines. Read and follow all instructions on the label.
- Wear a counterforce brace when you need to grasp or twist something. This is a strap worn around your forearm just below the elbow. It may ease the pressure on the tendon and spread force throughout your arm.
After the pain eases, your doctor or physiotherapist can teach you rehabilitation exercises to stretch and strengthen your tendon. Doing these exercises at home can help your tendon heal and can prevent further injury.
When you feel better, you can return to your activity, but take it easy for a while. Don’t start at the same level as before your injury. Build back to your previous level slowly, and stop if it hurts. To avoid damaging your tendon again:
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Perhaps Your Elbow Problems Started As A Fraying And Weakening Of The Ligaments
What if your elbow pain was more a problem of the elbow ligaments than the elbow tendons? Perhaps your elbow problems even started as a fraying and weakening of the elbow ligaments.
The elbow ligaments hold the bones in place with respect to each other, allowing for a strong, stable base for which the muscles can contract and move the joint. What if the loose ligaments caused the strain on the tendon by allowing excessive elbow instability? The tendons, trying to hold the muscle to the bone would be put under stress and begin fraying. Has anyone addressed the ligament problem?
Many times a patient will come into Caring Medical, curious about this talk of elbow ligament injury and its being a possible solution to their elbow problems. When we ask them, has anyone talked ligaments to you? A great deal of the time they report, NO.
This is unfortunate because the elbow ligaments provide structural stability to the elbow.
- The elbows radial collateral ligament supports the outside of the elbow. It holds the upper arm bone, the humerus, the forearm bone, and the radius. The ligament attaches at the lateral epicondyle of the humerus to the head of the radius.
- This ligaments main function is to prevent the elbow from suffering from excessive varus . What if this ligament is damaged? In its weakened state can it prevent hyper-extension? Can it help the tendons not be stressed?
What Physical Therapy Entails
There are several different things that a physical therapist does to help reduce the symptoms associated with tennis elbow. This includes:
- Education: Your PT will likely spend time discussing the movements and activities that can aggravate your condition and provide you with less-irritating modifications for your daily tasks. They can also help you select a wrist or elbow brace that can reduce the stresses placed on the degenerated tendon.
- Stretching: The goal of therapy is to stretch out the affected area and to build strength in the affected muscles. Your therapist will help select appropriate exercises that accomplish these goals and will progress them as they become easier. Manual therapy techniques, such as massage or light mobilizations to the elbow, may also be performed to help reduce pain and improve your arm function.
While modalities like ultrasound or electrical stimulation may also be used for pain relief, their benefits are still in question and they should not take priority over stretching and strengthening.
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Are Elbow Injections Effective
Different types of injection-based treatments are often suggested for tennis elbow or golfer’s elbow. According to the research on tennis elbow so far, most of them don’t live up to their promises. They can also have side effects. These are usually temporary, like pain at the injection site. Each injection is also associated with a low risk of inflammation or injury to the elbow. Most of these injections contain one of the following active ingredients:
So previous studies suggest that it’s a good idea to be very cautious when injection treatments are offered. Injections are usually only considered if the pain is especially bad, and nothing else helps.
Does Computer Use Cause Tennis Elbow
Is computing strenuous? Mousing and keyboarding might be a common way to overuse an elbow but its surprisingly unclear. I do suspect that computer elbow is a thing, just not a proven thing. If Im right, its likely a large source of lateral epicondylitis, because so many people use computers so much.
Although using a computer obviously isnt especially intense, it is highly repetitive, and ridiculously common. Hardcore computer users outnumber serious tennis players and carpenters and meat packers and so on at least a thousand to one. The weird part is just that no ones ever actually confirmed it with good hard data.
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Eight Weird Things About Tennis Elbow
There are eight odd things about tennis elbow, all of which will be explored below:
This is a surprisingly strange and understudied condition. Is there any science out there? Boyer et al asked in 1999. Numerous nonoperative modalities have been described for the treatment of lateral tennis elbow. Most are lacking in sound scientific rationale. Unfortunately, not much has changed.
Treatments Abound But What Works
Many treatments relieve the pain, but in most cases only temporarily. Sometimes the best approach is to simply give the elbow a rest.
Here are some strategies that may help you prevent further injury to the tendon, relieve pain and inflammation, and preserve or restore function.
Initial treatment. Cut back on movements and activities that cause pain in the affected elbow, forearm, and wrist. For additional pain relief, apply ice to the epicondyle for 15 to 20 minutes every four to six hours for the first day or so. Oral over-the-counter pain relievers may also help, but because of the risk of side effects, don’t take them for more than four weeks. Some people find that it helps to wear an orthotic around the forearm.
Intermediate steps. If symptoms persist, your clinician may recommend a corticosteroid injection. This often provides immediate relief, but don’t take that as a go-ahead to return to activities that aggravate tennis elbow. After the injection, you’ll be given a program to follow that includes rest, ice, and acetaminophen, followed by physical therapy. Repeated injections can cause tissue atrophy, so clinicians usually recommend no more than two to four, even in cases of chronic pain.
Other measures. Surgery is an option in rare cases when the symptoms have lasted more than a year despite rest and other efforts to relieve pain and restore function.
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Stretching Before And After Activity
Tennis elbow exercises and physical therapy can help with preventing and alleviating stiffness and shortening of the tendon. To complete these stretches, you should do them gently, with slow, deliberate, and controlled movements to always have pain awareness.
Stretching can help improve your flexibility and range of motion, which will help reduce pain with movement.
Research Questions The Tennis Elbow Diagnosis: As Orthopedic Surgeons We Are Besieged By Myths That Guide Our Treatment Of Lateral Epicondylitis Or Tennis Elbow
In 1999, doctors at the Department of Orthopaedic Surgery, Washington University School of Medicine warned about calling Tennis Elbow, a problem of inflammation in the Journal of Shoulder and Elbow Surgery:
- As orthopaedic surgeons, we are besieged by myths that guide our treatment of lateral epicondylitis, or tennis elbow. This extends from the term used to describe the condition to the nonoperative and operative treatments as well. The term epicondylitis suggests an inflammatory cause however, in all but 1 publication examining pathologic specimens of patients operated on for this condition, no evidence of acute or chronic inflammation is found. Numerous nonoperative modalities have been described for the treatment of lateral tennis elbow. Most are lacking in sound scientific rationale.
Twenty years later, in 2018 the confusion continues. So you go to your health care provider with a history of outside elbow pain. What type of treatments might you get? Anti-inflammatory, maybe a cortisone injection. In our opinion, as we will document below, these treatments will make your elbow worse.
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Recovering From Tennis Elbow
Of course, what you really want to know is when you can get back to your regular activities after having tennis elbow. That depends on your individual case and the extent of the damage to the tendon. People heal at different rates.
Whatever you do, don’t rush your recovery. If you start pushing yourself before your tennis elbow is healed, you could make the damage worse. You are ready to return to your former level of activity when:
- Gripping objects or bearing weight on your arm or elbow is no longer painful.
- Your injured elbow feels as strong as your other elbow.
- Your elbow is no longer swollen.
- You can flex and move the elbow without any trouble.
More Caring Medical Research
In the October 2009 issue of Practical Pain Management we presented a study on 36 patients with unresolved elbow pain who were treated with dextrose Prolotherapy at a quarterly clinic, which included a sub-group of 15 patients who were told by another practitioner that there was no other option for their pain. The patients average age was 53 years old. They reported an average of four years and one month of pain and saw 2.4 MDs before receiving Prolotherapy.
- Patients received an average of 4.3 Prolotherapy treatments per elbow.
- The average time of follow-up after their last Prolotherapy session was 31 months.
- Patients were asked to rate their pain and stiffness levels on a scale of 1 to 10, with 1 being no pain/stiffness and 10 being severe crippling pain/stiffness.
- The 36 patients had an average starting pain level of 5.1 and stiffness of 3.9.
- Their ending pain and stiffness levels were 1.6 and 1.4 respectively.
- Sixty-one percent had a starting pain level of 6 or greater, while only 11% had a starting pain level of three or less whereas, after Prolotherapy, only 5% had a pain level of 6 or greater and 94% had a pain level of three or less.
- One hundred percent of patients stated that the pain and stiffness in their elbows were better after Prolotherapy. Over 78% said the improvements in their pain and stiffness since their last Prolotherapy session have continued 100%.
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