Ah, the sun is shining, and the temperature is rising. The summer is getting longer, hotter and more humid every year. Summer activities that we enjoy tend to involve running, throwing things and catching things in the sand. Volleyball and frisbee to name a few.
Having painted the picture, I would now like to mention to you a fairly common condition called epicondylitis, more commonly known as “golfer’s elbow” and “tennis elbow.”
(Many of you would know that the suffix ‘itis’ means inflammation, so epicondylitis means an inflamed epicondyle.)
An epicondyle is a protruded portion on your elbow. It is on the outer side and also the inner side of your elbow. Many of the muscles in the forearm are connected in a specific manner to this structure. The muscles that involve extension of your wrist (like the position when you start playing the piano) are connected to the outer — lateral — epicondyle, whereas the muscles that involve flexion (when you are making a fist) are connected to the inner — medial epicondyle.
Repeated and straining flexion or extension of the wrist leads to overexertion of the muscles, which naturally gives stress to the starting position of those muscles — which are the epicondyles. A direct blow or pressure to the epicondyle may also be a cause.
But it is not only tennis and golf players that have elbow pain. People involved in frisbee, ball throwing, pitching, badminton, or volleyball, also may have pain in their elbows. After all, it’s how the wrist and the elbow are involved in the activity, not the activity itself that is important. In this column I will talk about a more common “tennis” elbow.
You know that you may have this condition when you feel tenderness with simple pressure applied to the lateral portion of the elbow. Repeated activities that are similar to doing a backhand stroke, holding a racquet may be one of the causes. Pain during this activity may be diagnostic. In the clinic, we can take an X-ray to see if there is collection of fluid or a tear of muscle/tendon in this region.
In moderate to severe cases, you will need medical assistance for healing. Physical therapy and heat therapy is of the greatest help. If fluid collection and inflammation in the region is evident, a steroid injection may be an option. A nonsteroidal anti-inflammatory drug would lessen the inflammation and reduce the pain if acute.
I often see patients who have “completely” healed, going back to their daily routine, only to come back with the same condition on the same arm. Once developed, there is a greater possibility of a recurrence, and prevention is of equal if not greater importance to the condition.
If there is the slightest pain during exercise, lessen the amount of time spent on the activity. Better yet, rest. When you cannot rest, an arm band can be applied during the activity reducing stress to the epicondyle.
Strengthening of the muscles in the forearm, for instance using weights and elastic bands is helpful. It reduces the likelihood of an injury and stabilizes the joints at the elbow. Stretching the muscles and tendons alleviates irritation of the tendon.
Soft tissue release and massage can help reduce muscular tightness and the tension on the tendons. Apply friction in a simple manner, up and down the area of tenderness.
ⓒ Jeju Weekly 2009 (http://www.jejuweekly.com)
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