How to Help Epicondylitis

(Originally posted on bcotoronto.com on Feb 7th, 2013)

Tennis and Golfer’s Elbow are exceedingly common injuries. We hear about them on the news and in life all the time but they are another one of those things that is only really a vague notion for most people. Tennis Elbow and Golfer’s Elbow, called Lateral and Medial Epicondylitis respectively, are characterized by aching pain that can become sharp with movement and is generally accompanied by a feeling of heat in or around the elbow.

The elbow acts as a starting point for almost all of the muscles of the forearm, wrist and fingers with only a few exceptions. Our ability to bend our wrist and move our fingers actually originates in our elbow. In fact, all the muscles that move our fingers and wrist backwards start from one fairly small point (the lateral epicondyle) and the same is true for the muscles moving our fingers and wrist forward (the medial epicondyle). These sites are called the “Common Origin” of these muscle groups and when they get inflamed this large mass of muscle can cause significant pain and this is the cause of epicondylitis.

Bony ElbowMedial and Lateral epicondylitis are injuries where inflammation generally rises from overuse of the muscles. Any of the muscles can trigger this because they are all so closely associated at the elbow. It is a common misconception that these are only sports injuries. Muscular overuse can arise from any repetitive activity even if it does not involve exertion or strength. Activities where grip strength and fine motor skills of the fingers are involved commonly result in epicondylitis, such as manual labour jobs with hand tools, administration staff at a keyboard all day, or hobbyists building models or electrical circuits. It is also possible to have epicondylitis arise from a direct trauma to the elbow like with a fall or other injury but this is less common than repetitive strain.

Tennis and Golfer’s elbow can be quite debilitating but they do not have to be. Epicondylitis can be treated fairly easily in most healthcare settings and even at home. If you break the condition down, the two main components are inflammation and muscle spasm. To reduce inflammation, attack it with cold to slow down the chemical reaction of inflammation and acupuncture, naturopathy, and massage, as well as ultrasound are extremely good at reducing inflammation. Anti-inflammatory foods like turmeric, dark berries, and ginger are excellent additions to this effort.

To deal with the muscle spasm, chiropractic, massage, and gentle stretching are your best friends. For Medial Epicondylitis place the palms of your hands together and bring them close to your chest like a stereotypical prayer position. Then slowly lower your hands, bringing your wrists further into an extended position while keeping your palms pressed together. You should feel the stretch travelling up from your wrist (or even the fingers) into the elbow along the front of your forearm.

Forearm StretchFor Lateral Epicondylitis the stretch is a bit more involved. Hold your arm out in front of you and flex your wrist. Then twist your wrist so your fingers are pointing out to the side (your fingers should travel below your wrist, not above it) and gently pull it further into this twist and flexion with your other hand. You should feel the stretch travelling up from the back of your hand into the elbow along the back of your forearm. Remember, while stretching take long deep breaths to help get the most oxygen possible into the muscles to help them relax.

Mills StretchSo you can see that Epicondylitis need not be a pain in your life. There are many routes to healing this condition.

Thanks for reading,
Dr. Ben

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