Tennis elbow can be a debilitating problem. The pain can so severe it
is tough to hold a cup of coffee, and suffers are frequently they might
drop their children if they pick them up. So what is tennis elbow, and
how can you fix it? The current technical term for tennis elbow is
lateral epicondylosis, which literally means, “condition of the outside
bump on the arm.” This doesn’t really tell you much, so what is
actually going on?
The problem is a muscular imbalance, where the body tries to
substitute with one muscle (several) for another which is weak. The
big culprits here are a wrist extensor muscle, extensor carpi radialis
longus (Aka ECRL, seen here in purple), which pulls the back of the
hand toward the forearm; and an elbow flexor, the brachiradialis (seen
outlined in purple.
is tough to hold a cup of coffee, and suffers are frequently they might
drop their children if they pick them up. So what is tennis elbow, and
how can you fix it? The current technical term for tennis elbow is
lateral epicondylosis, which literally means, “condition of the outside
bump on the arm.” This doesn’t really tell you much, so what is
actually going on?
The problem is a muscular imbalance, where the body tries to
substitute with one muscle (several) for another which is weak. The
big culprits here are a wrist extensor muscle, extensor carpi radialis
longus (Aka ECRL, seen here in purple), which pulls the back of the
hand toward the forearm; and an elbow flexor, the brachiradialis (seen
outlined in purple.
Weakness in these muscles means you will try to substitute other
muscles or the jobs of the brachioradialis and the ECRL. The
substitutes (which can vary quite a bit) are what hurt. They hurt
because they are doing work they're not designed for, and they start
to break down.
There is one more step in the problem, unfortunately, and this
step is what has made this problem difficult to heal. When the
substitute muscles start to break down, the body has a tough time
repairing them, usually because the joint stress (such as working with
your hands) which began the problem, hasn't gone away. When the
repair is attempted, the body for some reason decides to use
something with the consistency of jelly, instead of the steel cable, to
repair the muscle. This is known as a degenerative repair process.
In other parts of the body, an inflammatory process is used to repair
similar situations. As the pain gets worse, it can be treated with
cortisone injections, which contain a powerful anti-inflammatory. But
in tennis elbow, there is no inflammatory process, just the
degenerative repair process. As a result, cortisone injections here
tend to be ineffective.
So what does work? Active Release Technique (ART) is a
powerful hands-on treatment system which breaks up the
degenerative repair process and encourages the body to repair the
tendons correctly. It also corrects the muscular imbalance which
caused the problem in the first place. In our office, a small number of
stretching and strengthening exercises are also used after ART to
maintain the improvement in the muscular imbalance and prevent the
problem from recurring.
muscles or the jobs of the brachioradialis and the ECRL. The
substitutes (which can vary quite a bit) are what hurt. They hurt
because they are doing work they're not designed for, and they start
to break down.
There is one more step in the problem, unfortunately, and this
step is what has made this problem difficult to heal. When the
substitute muscles start to break down, the body has a tough time
repairing them, usually because the joint stress (such as working with
your hands) which began the problem, hasn't gone away. When the
repair is attempted, the body for some reason decides to use
something with the consistency of jelly, instead of the steel cable, to
repair the muscle. This is known as a degenerative repair process.
In other parts of the body, an inflammatory process is used to repair
similar situations. As the pain gets worse, it can be treated with
cortisone injections, which contain a powerful anti-inflammatory. But
in tennis elbow, there is no inflammatory process, just the
degenerative repair process. As a result, cortisone injections here
tend to be ineffective.
So what does work? Active Release Technique (ART) is a
powerful hands-on treatment system which breaks up the
degenerative repair process and encourages the body to repair the
tendons correctly. It also corrects the muscular imbalance which
caused the problem in the first place. In our office, a small number of
stretching and strengthening exercises are also used after ART to
maintain the improvement in the muscular imbalance and prevent the
problem from recurring.
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| Why won't my tennis elbow go away? |
| Copyright Steve Baroody, DC 2009 |