On this episode of the #AskMikeReinold present we discuss treating Tennis Elbow, which is a troubling damage to cope with. However we’ll go over what you might want to know to deal with lateral epicondylitis. To view extra episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.
#AskMikeReinold Episode 239: Suggestions for Treating Tennis Elbow
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Present Notes
Transcript
Eric:
All proper. Now we have Paul from Switzerland. Do you’ve gotten any recommendations on treating tennis elbow? I usually see this kind of damage, however it all the time appears to take longer to get higher than different accidents.
Mike Reinold:
Superior. Nice query, Paul. Thanks, Eric. Wonderful studying. Good job. Now we have the most effective college students, they’ll learn so effectively. That is widespread, proper guys? I really feel like there’s just a few issues that we cope with that individuals wrestle with. I like what Paul stated right here. It’s like, I see this damage a bunch, however it appears to take longer to get higher than others. Tennis elbow appears to be a kind of little odd ones. Lateral epicondylitis, proper? It appears to be a kind of odd ones that simply take awhile. Possibly it’s due to the chronicity of it. Possibly it’s somewhat bit extra beat up, so it takes somewhat bit longer, however let’s discuss this. The query for me is about what are our suggestions, not let’s undergo an enormous in depth protocol. What are our suggestions? Dave, you need to begin? What’s a few of your suggestions for tennis elbow and possibly we’ll simply hold going across the room and simply go and tip by tip and attempt to knock this out.
Dave Tilley:
Yeah. I’ve a few these sufferers now which can be sort of struggling and I feel, sadly, typically they don’t actually notice how lots of issues contribute to the problem and typically it’s sort of not of their consciousness that lots of completely different grip actions in all probability occur. The couple that I’ve now, for instance, began after doing a pull-up program, making an attempt to get a giant set of pull up or one thing like that, but in addition had been lifeless lifting very heavy. Additionally, had been doing lots of cut up squats and step-ups holding dumbbells they usually had been additionally enjoying golf on the weekends. He was actually like, I don’t know the place this got here from, simply sooner or later out of the blue, however you look again at his workload program and since quarantine, he was like, yeah, I used to be doing pull-ups and lifeless lifting and cut up squats after which I used to be making an attempt to golf when the golf course is open and realized how all of these issues are very grip intensive. He was like, oh, I didn’t even notice that.
Dave Tilley:
He took time away from his pull-ups. He thought that was the one factor that induced it, however he was nonetheless {golfing}. He was nonetheless doing different stuff and he’s additionally obtained a younger child, so he’s holding her and all that sort of stuff. I feel as soon as he was extra conscious of that, he was in a position to modify round it. It’s arduous although as a result of these stuff you want your arms with to do stuff. [inaudible 00:04:22] each day life, however simply educating him in regards to the quantity of gripping, I feel was actually vital for him, but in addition he was actually going all on the handbook remedy, mushy tissue care route for some time and what we wanted to show him. I used to be like, these items want load. The load is just too excessive, however no loading will not be going that can assist you. I feel we all know from analysis or making an attempt to really scale back some load induced adjustments. You really do should do some workouts to assist that construct up. He was sort of using the curler coaster of no loading as a result of it damage, to full loading to attempt to check the waters.
Dave Tilley:
That will be my recommendation. Simply have a very good subjective speak first earlier than you begin diving into workouts.
Mike Reinold:
Yeah. It appears like what he did, he tried to layer some handbook remedy, some feel-good stuff, which might be a part of an excellent therapy development, however he tried to layer that on prime of probably not adjusting workloads. To make use of a dramatic instance, my finger hurts as a result of I hold hitting it with a hammer. Properly, if I hold hitting it with a hammer, however then I’m going see Dave to therapeutic massage it, in all probability not going to do something. Theoretically, proper? Generally it’s a must to make the analogy that apparent for individuals or use no matter imaginative and prescient that works finest for you, however I feel that’s an excellent instance of that.
Mike Reinold:
I feel tip primary there, is that treating with out actually assessing their workload, I feel goes to actually result in some points. I feel lots of people in all probability that occurs to fairly a bit is we simply go proper into therapies and never sufficient of making an attempt to actually dig in deep on what occurred with their workload. In Dave’s instance, that was lots of issues he was doing, for instance, however it would possibly’ve simply been that one factor that threw him over the sting. You bought to actually sort of determine that out.
Mike Reinold:
Good. Good tip. All proper. Who’s up subsequent? Tip quantity two. Who desires to take it? I’m going accountable this on the delay of Zoom and never anyone being hesitant. I like this. It’s good. Let’s see. I’m going to go Pope. I feel I noticed Pope elevate his hand first. What’s tip quantity two for tennis elbow?
Dan Pope:
Yeah. Clearly there’s lots of them, I’m going to attempt to not take a bunch of them, however I feel the massive factor is you need to be sure you have an excellent prognosis. When individuals have ache on the aspect of the elbow, the plain factor we’re eager about is a tennis elbow, however you is perhaps coping with some humeral radial joint pathology. You is perhaps coping with say a radial nerve concern. Should you’re not getting any progress in any respect, you would possibly simply be barking up the improper tree, had the improper prognosis going into it. At the least for me, I didn’t know a ton about these pathologies till I took a particular course for it and now I’m simply extra eager to eager about different issues if one thing’s not proving.
Mike Reinold:
That is smart. Good tip quantity two, proper? Even when it had been barely off, if we’re treating the improper factor, then we could also be spinning our wheels somewhat bit or at the least a number of the issues we do is probably not working and we could also be lacking the boat on one thing. I like that. That’s a very good one. Get good at your differential prognosis of lateral elbow ache. I like that. Lisa, what do you suppose?
Lisa Russell:
Properly, piggybacking off what each Dan and Dave stated, elbow ache for, I’m actually in my rowing bubble at this one, however it’s really one thing I’m actually anticipating lots of people are going to have a depraved arduous time with this spring as a result of individuals haven’t been in boats and never having that very same gripping mechanism after which particularly to get somewhat rowing technical, however particularly in a much bigger boat the place you’re feathering the oar otherwise you’re shifting your wrists in timing with gripping. Sometimes within the spring tennis elbow and forearm tendinitis are enormous anyway and then you definately go from lacking virtually a whole yr in boats for some packages, I feel it’s really going to be fairly important, however lots of rowers who find yourself with that downside, it’s actually extra that their method is defective.
Lisa Russell:
I are inclined to, once more, what Dan and Dave had been speaking about, I sort of are inclined to look again at like, okay, why is your elbow getting overloaded as a result of it shouldn’t be. Possibly including in some extra gripping workouts exterior of rowing, however on the similar time it’s normally a break within the elbow that’s overloading it extra and never placing the load of their again or their shoulders and various things that’ll change that loading, fairly than simply massaging your forearm.
Mike Reinold:
That’s nice. I really picked up on two good suggestions proper there. Dave talked about simply layering on and overloading. Lisa has a very good instance of not constructing your workload capability up in instances. Not constructing sufficient power workload base earlier than you simply go loopy into no matter actions you’re doing. Possibly even placing that along with Dave’s instance, proper? Possibly if Dave’s affected person didn’t simply leap proper into that pull-up program and he’s eased in somewhat bit extra, possibly that might have been higher. That’s one other good one. Possibly it’s not simply the general amount, however possibly it was the ramp up development for that. I like that. Two, the opposite one is method. I feel that’s a very good one, Lisa. Lots of people simply, they’re doing issues awkwardly.
Mike Reinold:
I do know in tennis, most tennis individuals, we’re not tennis specialists right here, however I feel it’s like golf the place lots of tennis gamers don’t get lateral epicondylitis. It’s normally those that aren’t good at tennis they usually’re flipping their wrists an excessive amount of. They’re utilizing the improper mechanical drive, as an alternative of utilizing their physique to rotate via the ball. Identical factor with the medial elbow. I feel that’s one other stable one.
Mike Reinold:
I feel possibly to sum it up for this episode, I’ll add yet another, possibly the fifth one for this one and I’d simply say and this is perhaps somewhat much like Dan’s. I feel Dan’s was extra round let’s differential diagnose lateral elbow ache and what’s occurring with the elbow. I might say, I actually, actually need you to clear the cervical backbone. I really suppose that that’s a big contributor within the issues that I see with lateral epicondylitis, is it’s coming from the cervical backbone. Generally you might be utterly asymptomatic from cervical points too. You might be utterly asymptomatic, however the analogy I have a tendency to make use of is let’s say we’ve a 5 lane freeway of nerves taking place your arm and for no matter cause, we’ve a bulge, stenosis or one thing, who is aware of, one thing’s occurring and solely 4 of these lanes are speaking down there, however you’re nonetheless dwelling life at 100%. You then’re going to overload that.
Mike Reinold:
This muscle is being overloaded by 20%, simply by dwelling regular life as a result of it’s solely getting 80% of your sign. Does that make sense? That will not really work physiologically, however it’s an excellent concept to elucidate to someone, to go off that, however I feel conceptually that’s one factor that I usually suppose individuals miss, is that typically we’re having some cervical neurogenic points that go together with this they usually’re simply overloading their grip of their elbow. Okay.
Mike Reinold:
Strong suggestions proper there. I like how none of our suggestions concerned what to do for therapy, proper? None of them is like, do that train or do that. I feel everyone knows mobility. I feel everyone knows power and eccentrics and stuff like that might be vital for lateral epicondylitis. I feel everyone knows that, however we nonetheless all appear to wrestle with the chronicity and the way lengthy these take to return again. Possibly there’s one thing deeper we have to do with workloads or differential prognosis or a few of their strategies they’re utilizing or possibly even a number of the cervical backbone put collectively. I feel that’s a very, actually good 5 tip course of you may undergo to see if we are able to get higher at lateral epicondylitis.
Mike Reinold:
Good, nice query. Thanks a lot, Paul. Admire it. When you’ve got a query like that, head to mikereinold.com, click on on that podcast hyperlink and you’ll fill out the shape to ask us extra questions and hold us going. We’ll hold doing this so long as you guys hold answering questions. Though I haven’t cleared that with everyone. Is everyone good with that? I didn’t ask everyone. Okay, good. We’ll hold answering questions so long as you retain asking them. We’re right here for you guys. Simply tell us. Head to iTunes, head to Spotify. Subscribe so you will get updates each time we’ve a brand new episode and we are going to see you on the following episode. Thanks a lot.
