ELBOW CONDITIONS
- Tennis Elbow
- Golfers Elbow
- Tendonosis (under construction)
- Olecranon Bursitis - elbow bursitis (under construction)
Definitions
Golfer's Elbow - Golfer's Elbow characterized by the inflammation of the flexor tendons at their attatchment sites (medial epicondyle).
Medial Epicondyle - The bony prominence felt on the inside of the elbow, serves as an attachment site for the flexor tendons.
Extensor - A muscle that extends a part.
Flexor - A muscle that brings two bones closer together, causing flexion of the part or a decreased angle of the joint.
Humerus - Upper bone of the arm from the elbow to the shoulder joint.
Tendon - Fibrous connective tissue serving for the attachment of muscles to bones and other parts.
Tendonitis - Inflammation of a tendon.
Tendonosis - Condition of the tendon.
Ulna - The inner and larger bone of the forearm, between the wrist and the elbow, on the side opposite that of the thumb.
Tennis Elbow Outside of Elbow - The onset of pain, on the outside (lateral) of the elbow is usually gradual with tenderness felt on or below the joints bony prominence. Movements such as gripping, lifting and carrying can be troublesome. |
Golfers Elbow Inside of Elbow - The cause of golfer's elbow is similar to tennis elbow, the difference: pain and tenderness are felt on the inside (medial) of the elbow, on or around the joint's bony prominence. |
Bursitis Back of Elbow - Bursitis is usually due to excessive leaning on the joint or a direct blow or fall onto the tip of the elbow. Many times a lump can be seen and the elbow is painful at the back of the joint. |
Tennis Elbow is also
known as lateral epicondylitis (inflammation of the lateral epicondyle)even
though inflammation is not always present, a point we'll discuss later
on. A common source of pain is damage to one or more of the
extensor tendons, within the group of the common extensor tendon (see diagram
above).
Although the name may refer to a tennis related injury, tennis players
are not the only ones suffering. Any activity or sport,
whether it be recreational or work related, can cause this injury. Repetitive
stress and strain of the extensors can cause micro tears to
form in the tendons. The result is restriction of movement, inflammation
and pain. Even if the original injury heals, these areas are weak
and prone to tear again, which may lead to hemorrhaging and the formation
of rough, granulated tissue and calcium deposits in the surrounding
tissues. In an acute injury, inflammation forms when the body releases
collagen into the injured area. The pressure that results from this process
can cut off blood flow and pinch the radial nerve , a major nerves
that supplies the muscles of the forearm and hand. Tingling
and numbness can be felt in the forearm and hand and many people complain
that their hands are continually cold.
A fundamental factor in Tennis Elbow injuries are tight, inflexible muscles, and fascial restrictions. Muscle connect to tendons which then attach to bone. When a muscle contracts, it shortens, pulling on the tendons at both ends. Fascia is a connective tissue seen throughout the body. Muscles and surrounding tissues are meant to glide freely on top of one another. When they are restricted, the joint they supply won't have it's optimal range of motion. When muscles are tight they are already putting load on the tendon from a resting position!
Of interest is how the grip mechanism plays a vital role in both tennis and golfer's elbow. When gripping an object we are contracting the flexors of the hand and slightly stretching the extensors. Then we ask our muscles to extend or flex the hand at the wrist. You can imagine why a tendon would tear when
a.) the muscles are tight putting load on the tendon
b.) the tendons tighten when gripping
c.) the tendons are then ask to stretch past their extreme when extending the wrist
Think of the tendon/bone attachment as the "weakest link", most injuries
occur in that area.
Conventional treatment for tennis elbow may include non-steroidal anti-inflammatory drugs (NSAIDS). As previously mentioned, inflammation is not always present. That may sound strange because the suffix "itis" pertains to inflammation. Tissue can receive tears that are not traumatic enough to cause the vascular disruption necessary for an inflammatory response, in that case a more appropriate suffix would be "osis", meaning condition of (tendonOSIS). So why give anti-inflammatory medication when inflammation isn't present? Good question. Unfortunately, tennis elbow is often mistreated and misdiagnosed. These conditions can linger on for several months, even years, if not properly treated.
Conditions that are acute and involve inflammation are typically "easy" to treat and patients recover in a relatively short period of time (4-6 weeks), where as non-inflammatory conditions tend to take longer (3-12 months).
Facts About Tennis Elbow
- Tennis players actually account for less then 5% of reported cases
- Half of all tennis players will suffer from this condition at some point
- Each year, approximately one person in every 25 will seek medical help for a "sports" injury, but not all of those injuries are sustained while playing sports. Any repetitive physical activity even walking, can injure muscles and joints
- Sports injuries are most commonly caused by poor training methods,
structural abnormalities, weakness in muscles, tendons, ligaments, and
unsafe exercising environments.
Golfer's Elbow is also known as medial epicondylitis (inflammation
of the medial epicondyle) even though inflammation is
not always present, a point we'll discuss later on. A common source
of pain is damage to one or more of the flexor tendons, of the common flexor
tendon (see diagram above).
One must realize that Golfer's Elbow is not strictly a golf related injury.
Any activity or sport, whether it be recreational or work related, can
cause this injury. Repetitive stress and strain of the flexors can cause
micro tears to form in the tendons. The result is restriction of movement,
inflammation and pain. Even if the original injury heals, these areas
are weak and prone to tear again, which may lead to hemorrhaging and the
formation of rough, granulated tissue and calcium deposits in the
surrounding tissues. In an acute injury, inflammation forms when the body
releases collagen into the injured area. The pressure that results from
this process can cut off blood flow and pinch the radial nerve
, one of the major nerves that supply the muscles of
the forearm and hand. Tingling and numbness can be felt in the forearm
and hand and many people complain that their hands are continually cold.
A fundamental factor in elbow injuries are tight, inflexible muscles, and fascial restrictions. Muscle connect to tendons which then attach to bone. When a muscle contracts, it shortens, pulling on the tendons at both ends. Fascia is a connective tissue seen throughout the body. Muscles and surrounding tissues are meant to glide freely on top of one another. When they are restricted, the joint they supply won't have it's optimal range of motion. When muscles are tight they are already putting load on the tendon from a resting position!
Of interest is how the grip mechanism plays a vital role in both tennis and golfer's elbow. When gripping an object we are contracting the flexors of the hand and slightly stretching the extensors. Then we ask our muscles to extend or flex the hand at the wrist. You can imagine why a tendon would tear when
a.) the muscles are tight putting load on the tendon
b.) the tendons tighten when gripping
c.) the tendons are then ask to stretch past their extreme when flexing the wrist
Think of the tendon/bone attachment as the "weakest link", most injuries
occur in that area.
Conventional treatment for Golfer's Elbow may include non-steroidal anti-inflammatory drugs (NSAIDS). As previously mentioned, inflammation is not always present. That may sound strange because the suffix "itis" pertains to inflammation. Tissue can receive tears that are not traumatic enough to cause the vascular disruption necessary for an inflammatory response, in that case a more appropriate suffix would be "osis", meaning condition of (tendonOSIS). So why give anti-inflammatory medication when inflammation isn't present? Good question. Unfortunately, tennis elbow is often mistreated and misdiagnosed. These conditions can linger on for several months, even years, if not properly treated.
Conditions that are acute and involve inflammation are typically
"easy" to treat and patients recover in a relatively short period of time
(4-6 weeks), where as non-inflammatory conditions tend to take longer
(3-12 months).
Unexplained elbow pain may be as a result of crystal deposits which may form in the elbow joints as a result of conditions such as: gout and arthritis, or as a side effect from drugs or other medications. These individuals have a high density of impurity in their blood (may be caused improper digestion of uric acid). Over time the accumulation of such impurities can crystallize and form deposits in the elbow joint. Deposits then block the circulation to the attached tendons, which in turn causes pain and loss of elasticity in the tendons.
Golfers Facts
- Each year, approximately one person in every 25 will seek
medical help for a "sports" injury, but not all of those injuries are
sustained while playing sports. Any repetitive physical activity even
walking, can injure muscles and joints
- Sports injuries are most commonly caused by poor training methods,
structural abnormalities, weakness in muscles, tendons, ligaments, and
unsafe exercising environments.
- According to Statistics Canada about 2.3 million Canadian adults suffer
from repetitive-strain injuries, and almost one-third of them live with
chronic pain.
- Cumulative trauma disorders due to performance of repetitive tasks account for more than 50% of occupational illnesses in the United States and Great Britain (1992).
Additional Links of Interest