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TENNIS ELBOW

What is it?

(Keywords: tennis elbow, tennis elbow, tennis elbow exercises, thoracic outlet syndrome )

In tennis elbow , the muscles of the outer part of the elbow have been presumed to be the primary site of the problem. However, it is well known that this condition can be extremely resistant to conventional treatment, the primary cause of the condition often not being repetitive use of the arm but a chiropractic subluxation in the neck.





Strike out "itis" and write "osis". Read more about why further down the page.

Cortisone

Thus it comes as no surprise that researchers report in the Journal of Hand Surgery (2008;33) that:

Corticosteroid injection did not affectthe apparently self-limited course of lateral elbow pain.

Given the known potential dangers of corticosteroid injections on tendon strength it makes no sense to follow a course of treatment that may at best be described as non-scientific, and at worst as potentially dangerous.

If a subluxation is the cause of the pain in your arm, then no amount of cortisone injections, or physical treatment of the elbow will cure the condition.



Chiropractic tennis elbow can only be properly addressed by first treating of the subluxations in the spine that are irritating the spinal nerves serving the elbow muscles.

Inflammatory changes have been noted in the acute stages but are absent after a few months which is why steroid injections have no benefit, and in fact have a significant chance of causing infection and tendon rupture.

Hence this condition is no longer caused lateral epicondylITIS, but epicondylOSIS. There is no 'itis' or inflammation.


Exaggerated Chiropractic Rhetoric???

Read what Dr Jennifer Chu, M.D. emeritus professor of Physical Medicine and Rehabilitation, School of Medicine, University of Pennsylvania has to say:

Neck pain - elbow pain - extensor carpi radialis longus

Commonly neck pain is due to C5, C6 cervical nerve root irritation. This can produce pain and spasm in the extensor carpi radialis longus muscle which crosses the elbow and therefore pain in the elbow can also be felt by the patient.

Extensor carpi radialis longus receives C5 and C6 nerve root fibers through the radial nerve. Together with the brachioradialis and the extensor carpi radialis brevis, it is one of the three muscles that is known as the wad of three.

  1. Brachioradialis

  2. Extensor carpi radialis longus

  3. Extensor carpi radialis brevis

These three muscles can give significant pain in the elbow commonly known as tennis elbow.

It originates from the outer aspect (lateral) of the lower one third of the arm bone (humerus), and inserts into the base of the second knuckle (metacarpal bone) on the back of the hand.Its action is to bring the wrist up as in making a fist. It can also deviate the hand away from the midline of the body.

Neck pain - elbow pain - extensor carpi radialis brevis

Neck pain secondary to C5, C6 nerve cervical root irritation can cause pain and spasm in the extensor carpi radialis brevis muscle causing elbow pain.

This is one of the three muscles known as the wad of three and together with the triceps, causes the common condition known as tennis elbow.

It arises from the arm bone just above the elbow joint in the region called the outer (lateral) epicondyle and inserts into the base of the third knuckle (metacarpal) bone. It lifts the wrist and also deviates the hand away from the trunk.


EXAMS AND TESTS

The diagnosis is made by clinical symptoms (pain in the elbow, and often pain or stiffness in the neck and shoulder), four frequently used orthopaedic tests, and often there will be pain or tenderness when the tendon is gently pressed near where it attaches to the upper arm bone, on the outside of the elbow.

These elbow tests are based on

  • contraction of the muscles (as in shaking hands, and extending the wrist and the third finger upwards against resistance), and

  • stretching of these tendons.

  • Simple home test: With the elbow straight, place the tip of your middle finger against your thumb. Now, does flicking the middle finger, as though firing off a paper pellet cause pain in the elbow?

    SYMPTOMS

    • Pain and tenderness of the muscles the outer part of elbow.

    • Possible pain and stiffness in the neck, upper back and shoulder.

    • Gripping and movements of the wrist hurt, especially wrist extension as in lifting a heavy kettle, and twisting movements as in using a screwdriver and even simple activities such as lifting up a glass of beer or throwing a ball.

    • Extreme tenderness to touch.

    Without proper treatment tennis elbow is likely to become chronic and very difficult to eradicate. Nip it in the bud! There are few conditions I love more to treat. Mostly, so easy. Occasionally, a bugger!

    TREATMENT

    1. The first goal is to free up any subluxations in the neck, if any are present. This is what makes chiropractors the pre-eminent therapists of this debilitating condition. Nerve tension tests may be positive in the acute phase.
    2. A second goal of treatment is to relieve pain and swelling, if present. Treatment of choice is alternating ice and heat. An ice block directly on the painful muscles in a hot shower is an ideal way. First cold, then warmth. More cold.
    3. Cross friction of the muscles may be useful, but should be limited to a few strokes. Personally I prefer to do it along the length of the muscle. It may be extremely painful and increase the inflammation if done too enthusiastically. Dry needling also may be helpful.
    4. Regular stretching of the tendons TENNIS ELBOW EXERCISES

    5. Progressive strengthening exercises to rehabilitate the muscles are essential part of the regimen of treating chiropractic tennis elbow. If you love baking, kneading bread is excellent exercise for the forearm muscles. For more, click here. HONEY BREAD ...

    6. Rest is also necessary in the acute phase. No tennis, shaking hands with the left hand, and no lifting of beer mugs!

    7. Strapping may help.

    Steriods, anti-inflammatories and heat treatment should be avoided. Surgery is rarely necessary. There is no conclusive evidence that ultrasound assists in the treatment of tennis elbow.

    Love to read? Bernard Preston tells of a an unnerving experience after curing a glider pilot of Tennis Elbow. Double or quits? The Enemy Within ...







    Return from TENNIS ELBOW to our CHIROPRACTIC CONDITIONS frequently treated in our clinics ...

    Return from TENNIS ELBOW to our CHIROPRACTIC HELP home page ...

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    TENNIS ELBOW

    Did you find this page useful? Then perhaps forward Tennis Elbow to a suffering friend.


    BRACHIAL PLEXUS

    Arm Pain

    SHOULDER


    "The brachial plexus is a network of nerves that originates from the spinal cord and controls muscle movements and sensation in the shoulder, arm and hand."

    Mayo Clinic

    Inter Scalene Triangle



    Shoulder anatomy ...



    Frozen shoulder ...

    "My thumb, forefinger and middle finger went weak after cuff surgery."

    "Hello,I take it you've been back to the surgeon.

    It's probably temporary inflammation of the median nerve, but of course could be worse... I'm afraid I don't think chiropractic has anything to offer at this stage.

    Once everything has healed up, if you don't get the strength back, or your fingers remain numb and tingly, then I'd consult a local chiro to see if there is also a problem in your neck or the first rib.

    Dr B"

    Letter from reader looking for advice.



    Rotator cuff syndrome - try Chiropractic first!



    Rotator Cuff strengthening



    Thoracic Outlet syndrome

    ELBOW



    Tennis elbow



    Tennis elbow exercises

    WRIST



    Carpal tunnel syndrome



    Carpal tunnel exercises



    Carpal tunnel case file