Not too long ago we experienced a beautiful, warm, sunny day that gave me a glimpse of spring. When I woke up that day, I knew I had to get outside and take advantage of the day. So my brother and I got into the car and headed for the McMillen Tennis Center on Tillman Road. After about an hour of heavy hitting, my brother started to complain of outer elbow pain. I went over to look at it and sure enough, he had tennis elbow. He asked me if he needed to go see a doctor, to which I reminded him that he was looking at one.
This story is a representative of what occurs in our society. We think that if we have a problem, no matter what it is, we need to pay a visit to our primary care medical doctor first to get help with our ailments. This is true for many cases but it is not entirely necessary when it comes to musculoskeletal injuries such as tennis elbow. Majority of the time an M.D. is going to give you medication to mask the pain and inflammation caused by the injury, which does not treat the problem. When we don't feel pain, we tend to continue the activity that caused the pain.
Eventually you injure it more, take more pain pills than before, play again and so on. Do you see a trend here?
Some of you may be wondering where you should seek help. Well, you could go to a physical therapist but to do that you have to go to your PCP and get a referral first where you will more than likely have to pay two co-pays. The other option is to go see a chiropractor who can diagnose and treat the "problem" in one visit. A chiropractor does much more than "crack backs". Chiropractors are trained to work with the spine along with all aspects of the musculoskeletal system including the legs and arms. Tennis elbow falls under this theme.
Tennis elbow (lateral epicondylitis) is a muscle strain or minor tears of the extensor muscles (mainly the origin of the extensor carpi radialis longus and brevis) and tendons that attach to the outside of the elbow. Symptoms include pain with wrist extension and palpation (pressure) over the outside (lateral) part of the elbow. Signs consist of positive orthopaedic tests (Cozens and Mills) and palpation over the area. X-rays are usually unnecessary but if taken, calcium deposits may be found in the joint. Conditions to be considered or ruled out (differential diagnosis) include: arthritis, tendonitis, and trigger point referral. At first sign of any symptoms, put ice on the painful area to decrease inflammation and swelling and place an ace bandage over the area to relieve stress on the area. At this point you should see a professional if you choose to fix the problem and prevent persistent pain.
After completing the necessary first time paper work and going through the exam to correctly diagnose the problem, I would start out with some ice massage and some therapeutic ultrasound to the area. Then I would recommend that the patient take a homeopathic "pain and inflammation" remedy for the first treatment to help with the symptoms. The next visit, and those to follow if necessary, consist of ultrasound with heat &/or Anodyne® Therapy, soft tissue massage, trigger point therapy, myofascial release, and chiropractic manipulation therapy (the adjustment) to the elbow. Then I would take the patient to the rehab room for some physical therapy. I often recommend that the patient refrain from playing tennis until they are pain free and do some home stretches and exercises along with supplementation of a product called "Sport" containing glyconutrients for healing.
Thank you and have a healthy day.