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CONDITION OF THE MONTH
JANUARY 2008: Elbow Pain
 

Many have heard the terms "tennis elbow" or "golfer's elbow", but you don't have to be an avid golfer or tennis player to have elbow pain. People who do computer work, typists, dentists, baseball players, chefs, plumbers, mechanics, carpenters, librarians, pianists, cashiers, and knitters often develop elbow problems. This is usually caused by repetitive motion over a period of time (over use) such as continuous typing or hammering. Although the pain usually has a gradual onset, it can also be a result of a sudden trauma or sports injury. Tennis elbow is known as lateral epicondylitis. Golfer's elbow is known as medial epicondylitis. See diagram below:

 

Lateral epicondylitis is a condition in which the muscles responsible for extending the wrist, hand and fingers get damaged. The pain is the result of the muscle tendon attached to the outside elbow developing micro-tears, inflammation, tightness, and/or adhesions. 

Medial epicondylitis is a condition in which the muscles responsible for flexing the wrist, hand and fingers get damaged. The pain is the result of the muscle tendon attached to the inside elbow developing micro-tears, inflammation, tightness, and/or adhesions.

We often treat patients with lateral or medial epicondylitis. After the medical history, examination and orthopedic testing we determine which muscles are involved. If we suspect a more serious problem we may X-ray the elbow or order an MRI. The most common problem we find with epicondylitis is muscular adhesions. This is a condition in which the over use of the muscle results in the individual muscle fibers sticking together forming knots. This weakens the muscle and causes the tendon of the muscle to tighten or even slightly tear at the elbow. Other symptoms may include decreased grip strength, morning stiffness, and radiating pain to the wrist or shoulder.

The treatment includes administering myofascial release, electrical muscle stimulation, Low Level Laser Therapy and ice packs. We use Active Release Technique© for the myofascial release. It's a hands-on technique to find and separate the muscle fibers that are sticking together. It's called Active Release Technique© because the muscle is in motion during the treatment. We have found it to be a very effective treatment in relieving pain caused from epicondylitis. You may have heard of cold laser. It is also known as Low Level Laser Therapy (LLLT) and is used to decrease inflammatory conditions. The laser works on a cellular level using invisible infrared light. The laser decreases inflammation and increases cellular activity to aid in tissue healing. We advise the patient to ice the elbow for 20 minutes at a time, rest, and wear an elbow brace upon activity. We give specific recommendations on how to make changes to improve healing. We also promote stretching and strengthening exercises when the patient is about 50-75 percent better. For more information on Active Release Technique© visit www.activerelease.com.

 
 
 
 
 
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