How an Osteopath might be able to help your Elbow pain
Have you heard of Golfer or Tennis elbow? Do you have elbow pain but don’t play either? Elbow pain can be extremely painful and debilitating, the 2 most common musculoskeletal conditions to affect the elbow are commonly referred to as ‘Tennis elbow’ and ‘Golfer’s elbow’ however the majority of our patients who present with elbow pain surprisingly don’t play either.
Tennis elbow, or lateral elbow tendinopathy affects the tendons on the outside of the elbow and is caused by overuse & repetitive loading of the wrist extensor muscles (on their attachment sites to the elbow). Golfer’s elbow or medial elbow tendinopathy and is caused by overuse & repetitive loading of the wrist flexor muscles. Golfer’s elbow is much less common than Tennis elbow, with Golfer’s elbow only 9-20% off all tendinopathies of the elbow.
We know that tendon pain (tendinopathy) is not due to inflammation but rather degeneration and disorganization of the tendon usually due to a change in load…ie more gardening, computer work, or home duties, you don’t have to play the sports or lift super heavy weights. Small changes in load repetitively can create the same issue.
Risk factors
It most commonly presents in men and women between the ages of 35-60
Smoking and other systemic factors such as obesity and diabetes.
Manual workers (repetitive movements of the wrist)
Tennis players (40% will be affected at some point in their ‘career’)
Sports such as golf, baseball, weight lifting and rowing,
Signs and symptoms:
Decrease function of the elbow and surrounding muscles
Tenderness over the outside of the elbow (tennis) or inside (golfers)
Pain on gripping or general everyday things, ie opening jars and mouse/computer work
Tennis elbow – Pain on wrist extension (action of acceleration on motor bike, the wrist is slightly extended on typing on your keyboard )
Golfers elbow – pain on wrist flexion (opposite of above)
Osteopathy and Elbow pain
Our osteopaths will perform a complete assessment and determine a diagnosis of your pain. While the diagnosis of elbow pain is generally straightforward, management needs to be tailored to each patient.
Osteopathic techniques including soft tissues, joint articulation, muscle stretching and mobilization may be used to help reduce muscle tension of the elbow, wrist and forearm
Chat about some small modifications you can make to your daily routine to avoid aggravating the symptoms
Tendinopathy’s DO NOT IMPROVE WITH REST.
To decrease tendon pain, you need to modify the load going through the area.
Exercise has the most evidence for treatment of tendon pain. These tendons are angry, we need to use them correctly. A tailored exercise plan will slowly help the tendon regenerate and repair.
Tends generally respond slowly to treatment and it can be very frustrating.. Patience is important, exercises should be correct and progressed appropriately.
References:
– https://www.jospt.org/doi/full/10.2519/jospt.2015.5841
-https://www.raynersmale.com/blog/2017/2/10/lateral-epicondylalgia-pathophysiology-assessment
– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990766/
– Amin NH, Kumar NS, Schickendantz MS. Medial epicondylitis: evaluation and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2015 Jun 1;23(6):348-55.
