Protecting and Rehabilitating Your Elbows
Author: Blake Estape L.Ac.
For many one of the big draws of South Florida are the outdoor activities. Sunshine and blue skies make for a perfect golf day or a few hours on the tennis court. Good times, until that ominous ache starts in the elbow.
Sometimes the price we pay for a good game comes in the form of pain. Today I’m going to explore two conditions specifically; Tennis and Golfer’s elbow. Known in the medical world as lateral and medial epicondylitis respectively, they are similar in etiology but differ in location. Lateral epicondylitis is pain of the outside elbow, just behind the bony protrusion called the epicondyle. Medial epicondylitis is pain on the inside part of the elbow just outside of the fold, behind a similar bony notch.
Both of these are caused by inflammation of the tendons that connect to those bones, and both are usually caused by overuse of the muscles of the forearm. Jobs which require repetitive lifting or twisting of the arms can cause this, as well as sports such as the eponymous golf or tennis. Pain, tenderness, limitation of movement, and even tingling in the fingers can all be symptoms.
It’s a fairly common condition, especially in our part of the states. Nationally between 1 and 3% of the population is diagnosed with elbow pain yearly. The highest risk is between people 40 to 55 years old, gender does not appear to be a factor. While it can be self-limiting – lasting between 12 and 18 months without treatment – there are cases where it can persist and become chronic.
The purpose of this article is to introduce acupuncture and traditional Chinese medicine as an alternative or adjunct to treatment. As is so often the case, people may not be aware that acupuncture is an option, however studies have shown considerable pain attenuation and supportive care can be achieved with the addition of TCM.
To greatly simplify the treatment methodology, a traditional medicine practitioner endeavors to improve blood flow through the affected area. Stagnation is seen as the main culprit in pain and reestablishing movement is the path to recovery. Insertion of thin needles, herbs designed to increase move blood, and manual therapies like massage and gua sha/scraping are used - often in tandem - to achieve this end.
Unfortunately elbow pain is the result of repetitive strain and thus takes time to reverse. That’s why treatments should always involve examination of lifestyle. Eliminating aggravating factors and offering take-home therapies ensures progress continues outside of the treatment room.
To that end I’ve added a basic massage and exercise protocol below to keep the ball rolling if you’re in recovery, or to help with prevention. If you are suffering from elbow pain it is best to seek out professional care to ensure you have a treatment plan tailored to your specific condition. You can call my office at (786) 514-3942 for a free consultation or book with the button below.
Epicondylitis (Tennis and Golfer’s Elbow) Exercises:
1. Eccentric Wrist Flexion –
Sit with your forearm resting palm up on a table, with your wrist hanging over the edge. Slowly curl your fingers inward and with your opposite hand, help gently pull the wrist up while keeping your forearm flat on the table. Hold for five seconds then slowly roll the wrist back and release your fingers. Three sets of ten, twice a day. Add light weight like a water bottle or soda can once strength improves.
2. Eccentric Wrist Extension –
Rest your forearm palm down on a table with your wrist hanging over the edge. Gently curl your finger and lift your wrist until you can feel the forearm stretch, supporting the wrist with your free hand. Hold the stretch for five seconds then slowly roll your wrist back and release the fingers. Three sets of ten, twice a day. Add light weight like a water bottle or other items in a plastic bag.
3. Radial Wrist Deviation –
Allow your arm to hang by your side and clench your hand into a fist. Gently extend your wrist forward and backward, holding the stretch for five seconds. You can add weight once more stability is achieved. Two sets of ten, twice a day.
4. Forearm Pronation and Supination Strengthening –
Hold your arm in front of you at 90 degrees with your palm facing down. Rotate your hand palm up, then rotate back with slow controlled motions. Add weight once more stability is achieved. Two sets of ten rotations, twice daily.
5. Wrist Curl/ Reverse Wrist Curl –
Using a broom stick or other such item, extend your arms forward with your hands placed shoulder-width apart. Roll your wrist downward, holding the stretch for five seconds, then back with controlled movements. Flip your hands over so the palms are facing upward and curl your wrists backward. Hold for five seconds and release. Two sets of ten, twice daily.
References:
1. Johnson, G. W., Cadwallader, K., Scheffel, S. B., & Epperly, T. D. (2007, September 15). Treatment of Lateral Epicondylitis. American Family Physician. https://www.aafp.org/afp/2007/0915/p843.html.
2. Sims, S. E. G., Miller, K., Elfar, J. C., & Hammert, W. C. (2014, December). Non-surgical treatment of lateral epicondylitis: a systematic review of randomized controlled trials. Hand (New York, N.Y.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235906/.
