The elbow is part of the body that we rarely notice unless it hurts. Pain in the elbow is most often caused by injuries to the tendons. A muscle injury is sometimes involved as well, which may cause the pain to extend down the forearm. There are other structures that surround the elbow that can become inflamed or strained, but tendons and muscles cause the most problems.
Three common injuries account for the majority of pain in the elbow. If the elbow aches inside and is difficult to fully bend or straighten, most likely there is irritation inside the elbow joint. Pain felt on the outside or inside of the elbow is usually caused by tennis elbow or golfer’s elbow. In this article we will look at tennis elbow injuries.
What is it?
Tennis elbow is a slight teat or inflammation of the extensor carpi radialis brevis or longus mechanism, which may occur during a variety of different activities. The injury earned its name by plaguing several famous tennis players, but the vast majority of people with tennis elbow have never picked up a racquet.
The extensor carpi radialis brevis and extensor radialis longus are extensors of the wrist. Tennis elbow affects the tenoperiosteal junction of the brevis tendon in ninety percent of cases reported. To locate the lateral epicondyle, where the tendons attach, bend your arm at a 90 degree angle, as though you were going to shake hands with someone, and then lean sideways against a wall. As you push your elbow gently against the wall, the knobby bone you feel is the lateral epicondyle. The brevis tendon lies right on top of this bone. Tears can also occur in the body of the tendon, at the musculotendinous junction (in the muscle belly) or in the longus tendon at the supracondylar ridge of the humerus, but these are less common.
How and Why
This bothersome and often long-term injury is extremely common. It regularly affects people who lift heavy objects, scrub floors, wait tables, type at computers for extended periods of time, doing massage for a living, or performing various types of construction work — as well as those who play racquet sports. When racquet enthusiasts get tennis elbow, it’s usually because they haven’t warmed up properly, they’ve played for too long, or they have played with poor form, causing unnecessary strain to the extensor muscles of the wrist.
At first the pain from tennis elbow is hardly discernible, but about two weeks after the injury, the pain noticeably increases. During this interim, the tendon has suffered hundred of micro-tears with normal activity and/or sports, building a large V-shaped scar that begins to hurt. Activities that place stress on the injured structure(s) cause pain at the lateral aspect of the elbow. The pain may extend into the forearm as far as the wrist if various parts of the muscle/tendon unit are injured. Lifting movements can lead to severe, sudden pain, causing people with tennis elbow to drop even light objects. While this injury persist, activities as simple as shaking hands and opening doors may be painful.
Tennis elbow is frequently complicated by re-injury; it is often difficult for athletes or others whose livelihoods require using their hands to rest long enough to heal naturally. One contributing factor may be the decrease in pain that people experience when they are warmed up and active. This creates the illusion that what they are doing is not exacerbating the injury. As a result of repeated strain and tearing, the pain often reappears with greater force as time goes on.
Another factor that makes the healing difficult is tennis elbow’s characteristic V-shaped tear. The tear heals more quickly at the bottom portion of the V. At the top of the tear, the new tissue has a greater distance to span and therefore takes longer to knit together. Due to this uneven healing, the person starts to feel better before the tendon is fully healed and strengthened, so it is east to re-injure it and cause the formation of adhesive scarring to worsen.
Self-treatment is an option, but it takes patience. With rest alone, recovery is very slow. In those under 60, the average healing time is between six months and a year. For those over 60, healing may take up to two years. A few simple measures can speed the healing process. A person who stops activities that re-injure the elbow will often heal in 2-4 months. That includes both simple and strenuous activity that causes pain, for example, lifting a frying pan or playing the piano, as well as lifting a heavy box. Also applying ice and heat to the injured area daily can stimulate circulation. In mild cases an exercise program may be all that is needed.
A combination of deep massage of the forearm muscles and friction massage therapy of the tendon is often an effective treatment for tennis elbow.
Exercise Patience, tennis elbow is a very common cause of elbow pain, and without proper treatment, it can persist for many months or years. With a thorough understanding of this condition and the hands-on techniques necessary to treat it, you can speed the healing process. For example athletes seems to recover at a fast rate, that is because they have the access to massage therapy and physical therapy multiple times a day. Most of us do not have that type of access to treatment, so we must be patient in the healing process.
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