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Is tennis elbow just about an inflamed tendon?

May 16, 2011 By 2 Comments

Occasionally, a patient reminds you not just of what osteopathy can do to reduce pain and improve health, but what is truly distinctive about its outlook and approach.

power lifter

Weight Lifter (this is not Liz!)

Liz (not her real name) is a successful personal trainer with a distinguished sports career in kick-boxing and competitive weightlifting at a national level.

Three years ago, she sustained an elbow injury whilst training. She initially tried to power her way through the pain, but rapidly found that the slightest stress – even carrying a mugful of tea – caused sharp, debilitating pain.

Her GP referred her to a local orthopaedic unit which rapidly confirmed his diagnosis of lateral epicondylitis, more commonly known as tennis elbow. She was initially referred for physiotherapy, followed by acupuncture. When this initial approach failed to deliver results, she was then given two successive steroid injections, equally unsuccessfully. The next step involved an arthroscopy and “extensor tendon release” surgery, and finally an injection of platelet enriched plasma into the tendon – none of which provided durable relief from the pain and handicap.

In desperation, Liz decided to consult the local osteopath in Uxbridge, located in her main gym club. The young woman I met was complaining of crippling shoulder as well as elbow pain; she was on a prescribed combination of strong drugs (Neurofen Plus, Tramadol and Diazepam) that had no lasting effect; and above all, she was angry and depressed at feeling so crippled and making no progress towards a recovery she viewed as vital if she was to pursue her fitness career.

My clinical examination confirmed all the soft tissue features typically associated with tennis elbow, but careful palpation of the elbow joint provided another critical clue: the articulation between the radial head and the humerus was slightly subluxed (i.e. “out of alignment”), generating structural soft-tissue stress that would remain unaltered until the joint was realigned.

From the instant the radio-humeral joint was reset, Liz’s relief was palpable. It required a few more sessions to rehabilitate the chronically strained related tissues in the shoulder, neck and mid-back; but essentially, Liz had not looked back, is making steady and increasingly rapid progress towards full recovery – and is gradually resuming weight-training.

Osteopathy’s view of this case is that body structure and function are permanently interrelated. If Liz’s elbow tendon was chronically injured and inflamed, was another related anatomical mal-alignment inhibiting the healing process? Addressing that question provided the key to solving Liz’s “intractable” elbow pain.

If you are suffering from tennis elbow or any other repetitive strain injury, do not hesitate to contact us for help or advice.  We are an osteopaths in Ealing and also in Uxbridge.

Filed Under: RSI, Sports Injury

How to treat a common Repetitive Strain Injury: the "Tennis Elbow"

September 10, 2009 By Leave a Comment

Tennis elbow – a.k.a. lateral epicondylitis – is one of the most common overuse injuries.

It is usually associated with repetitive finger/wrist movements such as in typing, using a mouse on a computer, wielding a hammer or a racket, or using a screwdriver.

It commonly affects a wide range of office and manual workers: typists, computer operators, carpenters and plumbers, cashiers etc and… yes, racket athletes.

Although there may be no swelling or redness, the condition manifests with pain on the outside of the elbow or in the forearm, worse when gripping a handle or lifting a weight. When it is particularly bad, it may even prevent the sufferer from working.

To the extent that the elbow is an integral part of the upper body at work, tennis elbow is often related to poor working posture, and may be accompanied by wrist, shoulder and/or neck pain as the condition becomes entrenched.

Initially, treatment of tennis elbow involves:

  • Resting the joint until the pain subsides, and limiting any aggravating movements of the wrist, elbow or shoulder;
  • Applying an ice pack to the elbow for a few minutes at regular intervals to reduce the inflammation
  • Light massage therapy of the forearm, and gentle easy movement of the wrist, elbow, shoulder and neck / mid back;
  • Increased water intake (not tea or coffee) to facilitate tissue repair.

If the condition has been present for 2-3 months or over, treatment is more involved and diverse:

  • More intensive mobilisation of the elbow, but also upper back, neck and other upper limb joints;
  • More extensive massage of the elbow and forearm muscles;
  • Contact hydrotherapy (application of hot/cold water) to encourage local blood supply and tissue repair;
  • Home and workplace exercises emphasising stretching of the wrist muscles and movements of the upper limb and neck;
  • Adapting the work station, e.g. bringing the mouse closer to the keyboard, using wrist rests, using larger, shock absorbing handles on work tools.

If you think you are suffering from tennis elbow, please call us on 01895 20 00 50 to discuss your symptoms and seek further advice. Our clinic is located on Uxbridge high street. Bridge to Health also arranges drop-in employee health checks on site at local businesses and organisations as part of its Corporate Services offer, providing busy workers an opportunity to discuss and take action on health issues that might otherwise go unchecked. Do contact us if we can help!

Filed Under: Posture, RSI Tagged With: , ,

Treating and preventing repetitive strain injury

June 9, 2008 By Leave a Comment

Several of our patients are being treated for Repetitive Strain Injury (RSI for short) – most frequently tennis elbow and achilles tendonitis – and other patients often ask us about what lies behind RSI. Today’s post aims to provide some basic answers to these queries.

What is Repetitive Strain Injury?

Repetitive Stain Injury is an “umbrella diagnosis” that accounts for a wide range of musculoskeletal pain disorders as a result of overuse of the body. This is most often experienced in the arm due to occupational strain.

(Musculoskeletal = bones / muscles / tendons)

The pain is usually a sharp stabbing pain which initially comes on once the aggravating cause has ceased, however this may then go on to flair-up more often. There are many conditions that fall under this term such as Tennis elbow, Carpal tunnel, Thoracic outlet syndrome, Tendonitis and many more.

What is the cause?

When a movement or action is repeated over and over, the tissues of the body become overused and begin to break down. This leads to a build-up of inflammation as the body tries to repair the damage. Typical triggers are sporting injuries where an action is constantly repeated, for example running, swimming, serving a tennis ball can all trigger these conditions. Also, hobbies such as playing the guitar, fly-fishing, you name it! However, the most common cause of RSI in the modern age is overuse due to occupational strain and the biggest culprit of all is the computer keyboard – especially laptop computers.

How to fix/cure RSI

The most important element of the healing process is rest to allow the body to heal the tissue; however the dilemma faced by most patients is how to recover from an injury such as this when the causative factor is the one which puts food on the table. Other treatment methods are cryotherapy (using ice/cold water to help heal sprains) to reduce the inflammation and manual therapy such as osteopathy, physiotherapy and acupuncture.

Others methods involve applying a joint splint or forearm compression bandages to alleviate the pressure on the muscle insertion point.

How can I prevent Repetitive Strain Injury?

For many office-bound people, inevitably the bulk of the day is spent on a laptop but this needn’t be a guarantee that you will be affected by RSI.

  • Seek advice on correct setup of your workstation, both at work and at home;
  • Take regular breaks throughout the day, even if some are just 2 minute breaks, to stretch the arms, shoulders and back;
  • Maintain good hydration at all time: you should be aiming for 1.5 to 2 litres of water each day. Tea and coffee are diuretics which lead to an increased expulsion of water from the body, leading to dehydration;
  • Ensure a well balanced natural diet which avoids refined and processed foods and includes plenty of fruit and vegetable intake, as it is vital for promoting tissue health;
  • Maintain good posture, this is important at all times but especially when at your desk as long periods in a poor position (typically slumped) will lead to poor circulation and nerve conduction and increase the risk of developing RSI;
  • Ensure regular exercise, which is essential for muscle health, 30 minutes of walking a day is a great boost for circulation and will improve overall health in many ways;
  • Seek good manual therapy, as it is a great way to keep muscles and joint moving correctly; a regular Osteopathic maintenance treatment will help.

If you have the symptons of RSI, don’t put off doing something about it. Bridge to Health Osteopathic Healthcare is based in Uxbridge, West London where we specialise in workplace based musculoskeletal complaints – visit our website at www.bridgetohealth.co.uk.

Filed Under: Muscle sprain, Osteopathy, RSI, Running, Sports Injury Tagged With: , , ,