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Straight Talk About Injuries

Elbow Epicondylitis (Tennis Elbow & Little League or Golfers Elbow)

Tennis Elbow, Little League Elbow, Golfers Elbow; we all know what these mean, or do we? Known technically as Epicondylitis, all of these popular problems refer to the same thing. Tennis elbow is lateral Epicondylitis (affecting structures on the lateral side of the elbow), Little League or Golfers elbow is medial Epicondylitis (affecting structures on the medial side of the elbow). The humerus (the bone of the upper arm) has two prominent projections down near the elbow, these projections are known as epicondyles. Each of these small epicondyles has a large number of muscles attached to them. Many of the muscles that extend the wrist and fingers originate at the lateral epicondyle, while many of the muscles that flex the wrist and fingers originate at the medial epicondyle. The muscles that extend the wrist and fingers share one tendon, the common extensor tendon, which attaches all these muscles to the lateral epicondyle, while the muscles that flex the wrist and fingers share another single tendon, the common flexor tendon, attaching them to the medial epicondyle. It is these single tendons, and their resulting attachment to the epicondyles, which generally constitute the weak links. As a result, if the flexor or extensor muscle groups become overworked, either all at once or over time, the common tendons and their attachment to the epicondyle are the most likely sites for problems. Symptoms usually include pain at the elbow and muscle weakness of the affected group, which gets worse when the muscles are used and feels better during inactivity. Fortunately, whether you call it medial, lateral, tennis or golfers it doesn't much matter, Epicondylitis is Epicondylitis and the treatments are the same.

As with most musculo-skeletal inflammatory conditions, there are three general rules of thumb to follow when dealing with Epicondylitis; rest, ice and anti-inflammatory medications. Rest always seems to be the most difficult part of the equation. Fortunately, you don't need to put your arm in a cast to rest the muscles involved. Tennis elbow, in tennis players, is often caused by a poorly timed backhand. Correcting your form can correct the tennis elbow. In much the same way, by altering the way you perform the activity causing your pain, you can correct the problem. This may take a little creativity on your part, but look at the activities that cause you the most discomfort and think of a different way you can do it. If that reduces the discomfort, then you have chosen wisely.

To help provide some rest, an Epicondylitis strap can be very useful. The strap puts pressure on the muscle mass just below the epicondyle. This may seem like an overly simple solution, but can be tremendously effective at significantly reducing the discomfort of Epicondylitis. While many different manufacturers produce Epicondylitis straps, they are all based on the same principle. The strap rests on the muscles below the epicondyle. When the muscles are used, they push against the strap causing the strap to absorb some of the force that would otherwise have been transmitted to the epicondyle. Less force being transmitted to the epicondyle results in less aggravation, resulting in less pain. The Sports Medicine Shop has several excellent Epicondylitis straps to choose from. Visit the shop's web site upper extremity section for pictures, descriptions and prices.

Athletic trainer's go to school for four years to learn that if something swells, put ice on it. (I'm a certified athletic trainer, so I can say that. In good humor of course.) Ice is so simple a treatment, people forget that it is also a tremendously useful tool. While ice doesn't reduce the inflammation that's already there, it will prevent more from accumulating. While the inflammatory response is necessary for healing and the body is excellent at getting it geared up, it's not so good at stopping it or getting rid of it once it's there. Ice prevents the inflammation from getting too out of hand. Wrap the elbow in ice for twenty to thirty minutes every two hours, or as close to that as you can get. Even once or twice a day for half an hour is better than nothing, and will provide some excellent benefits. If ice is too inconvenient, get a gel cold pack, not the instant kind. There is a common misconception that the gel ice packs are not as cold as ice. The truth is just the opposite. Since gel doesn't freeze solid until extremely low temperatures, it is able to absorb more cold energy and get colder than ice, which is able to reach only 32 degrees. However, since the gel packs get so cold, you need to remember to put a small cloth between the pack and your skin, or you may find yourself with a nasty ice burn. A pillowcase is an excellent cover for the gel ice packs.

Anti-inflammatory medications may be helpful, but should be taken under the direction of a physician. Talk to your physician about the possible benefits these medications could provide.

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