Tennis Elbow – in the non-tennis playing individual!

What is tennis elbow?

Are you someone suffering from pain on the outside of your elbow and Dr Google is telling you that you have tennis elbow, despite never touching a tennis racquet in your life? Tennis elbow, otherwise known as lateral epicondylalgia, is an overuse injury affecting the outside of your elbow resulting in pain, tenderness and substantial limitations in functionality of the upper extremity.

Clinically tennis elbow presents as pain that is aggravated with repeated movements of the elbow or wrist, pain with lifting and decreased or painful grip strength.

Lateral epicondylalgia commonly affects those in office jobs, construction/repair, cleaners and healthcare workers and is associated with repetitive bending and straightening of the elbow joint for more than 1 hour per day.

In greater depth lateral epicondylalgia is both a load related and systemic based condition that ch

aracteristically has an acute inflammatory stage and a chronic degenerative stage. Lateral epicondylalgia affects the extensor carpi radialis brevis tendon and occurs when there is weakness and decreased capacity of the tendon to manage loads resulting in micro tearing within the tendon. This micro tearing further reduces the tendons capacity and elicits a pain response with in our body such that activities of daily living such as picking up a coffee cup can be sufficient enough to trigger pain.

Lateral epicondylalgia often goes hand in hand with a mild degree of shoulder girdle weakness. When using our arms for day to day activity we require a transfer of energy along the chain from shoulder to elbow to wrist – in tennis elbow a weakness in the shoulder leads to an increased demand on the elbow and wrist and hence an overload as discussed above.

The good news is that tennis elbow is generally self limiting meaning that within 6-12 weeks you are like

ly to experience significantly less pain, improved functionality and healing of the underlying tissues.

So how can treatment help?

Treatment of tennis elbow may involve soft tissue massage, joint mobilisation/articulation and mild or gentle stretching in combination with strengthening exercises to prevent reoccurrence. The goal of treatment is to reduce the duration of symptoms and associated disability. Treatment is thought to stimulate mechanoreceptors, which in return inhibits or blocks pain signals from nociceptors reaching the brain.

Your practitioner may also suggest a brace or assist you with taping techniques of the elbow to increase your function. Taping/bracing plays a role by placing tension at point on the muscle distally to irritated/damaged tendon site promoting healing of the damaged area.

In some cases injection of cortisone may be indicated however there is research to suggest that injection may lead to poorer long term outcomes in function and movement.

Getting started – What can I do from home?

The best thing you can do to help yourself is to rest from aggravating loads – this may include avoiding repeated wrist, forearm or elbow movements. It is important not to avoid all upper limb movement as this may further decrease the ability of your tendon to load! When completing movement or exercise it is important to take note of your pain levels – if what you are doing is increasing your pain rating by more than 1/10 it is advisable to stop that activity/exercise where feasible.

Caution should be taken with stretching, as overstretching may further increase tension/load on tendon and influence the pain response – when stretching the extensor muscle group you should complete this with your elbow bent at 90 degrees and stop if pain persists. The use of ice (cryotherapy) may be of benefit in reducing the inflammatory response and assist in reducing the acutely painful elbow.

Exercises that may be beneficial in reducing pain and improving the overall function are outline below:

1. Isometric wrist extension

• Start in a seated position with your forearm resting on a table and your palm facing down.• Place your other hand on the back of your affected hand.
• Attempt to lift your affected wrist up, whilst resisting the movement with your good hand (Ensure you keep your forearm in contact with the table.)
• Hold this position for 10 seconds
• Repeat 10 times, 3 times through with a 60 second rest between sets.

2. Scapular retraction

• Start in a standing position with your arms by your side and palms facing backwards.
• Gently push your hands backwards and feel a gentle squeeze between your shoulder blades (Ensure you keep your shoulders away from your ears)
• Hold this position for 2 seconds and slowly return to starting position
• Repeat 10 times, 3 times through with a 60 second rest between sets.

We encourage you to consult a health care practitioner if your pain persists or for more personal advice and advanced care of tennis elbow.

 

Tradie Tips

Are you a Tradie? Here are 5 tips to help you manage your aches and pains

Tradies are some of the most likely members of our community to be injured at work. The most likely injuries to occur to tradespeople are low back injuries, neck/shoulder injuries and elbow injuries.
Prevention is the best form of treatment. Here are a few things for tradies to be aware of in the coming months, to help prevent injuries in the workplace.

Warm-up

A lot of trades require heavy, repetitive lifting and other activities. This can put strain on the muscles, tendons, ligaments and joints of the body. It is absolutely vital that you take the necessary steps to prepare your body for the days work ahead. Some simple stretching and movement allows your soft tissues to warm up, which can decrease the risk of muscular injury.

Lift with your legs

Low back injuries are very common amongst tradespeople. This can often be associated with heavy lifting and poor lifting posture. When lifting something heavy, remember these few steps to help avoid the risk of a back injury.
– Keep your knees and hips bent.
– Keep your back as straight as possible.
– Hold the load as close to your torso as possible- closest to your centre of gravity!
– Use your gluteus and quad muscles as your main lifting muscles. These are the largest muscles in your body for a reason, so make sure you use them!
– Get somebody to help you! Assess the load, and if it is too heavy to lift on your own, make sure you ask someone to help you

Take regular breaks

Trade related work such as using power tools, overstretching your back and heavy lifting can take a serious toll on your body. It is vitally important that you take the necessary time to have a rest and a stretch ever 1-2 hours for 10-15 minutes. This will help reduce the risk of an injury, as it gives muscles, ligaments and joints time to recuperate after long periods of activity

Exercise

Although most trades work hard during the day, it is important to exercise regularly throughout the week also. Something as simple as going for a walk, or some basic resistance training can greatly reduce the chance of a workplace injury.

Don’t ignore injuries

Treatment and management of workplace related injuries can significantly reduce the effect they have on your body, and your business. Feel free to contact Peninsula Osteopathy + Allied Health to make an appointment and see what Osteopathy, Myotherapy or Exercise Physiology can do for you! Call us on 5253 2345, or book online at www.peninsulaosteopathy.com.au.

Correct lifting posture

1. approach the load- feet should be shoulder-width apart
2. bend your knees and hips
3. keep the load close to your torso
4. use your quads and glutes to drive yourself up

3 TOP TIPS FOR YOUR HIPS

Hip Anatomy and Impingement syndrome:

The hip joint forms a solid connection between the lower limb and pelvic girdle, thus meaning it is designed for stability and weight-bearing rather than to offer a large range of mobility. The joint is a ball and socket joint formed between the thigh-bone (Femur) and the pelvis (acetabulum) and gains its stability from large supporting ligaments and muscles.

In the healthy hip joint the femoral head is able to glide smoothly within the socket of the acetabulum however this can be impaired in patients who suffer from femoral acetabula impingement syndrome (FAI). Hip impingement or FAI is a condition in which the structure of the hip joint become modified causing an impaired capability of the femoral head to move freely and smoothly within its socket. Typically this will present as stiffness or tightness of the thigh, hip or groin, poor ability to flex the hip past a right angle and pain in the groin or front of the hip when flexing the knee towards the chest, running/cycling or sitting for periods of time.

FAI commonly arises from high impact sports or exercises that involve a large amount of jumping, changing direction and recurrent movement of the hip joint outside its normal range (such as football, dancing and golf) placing excessive and abnormal load through the hip joint. The stress of ongoing excessive load can lead to either a thickening of the femoral neck (CAM lesion) or deepening of the hip socket (PINCER lesion), or a combination of both which over time can result in damage to the cartilage of the hip joint.

In other cases FAI can be present from birth and be largely asymptomatic until later in life.

What are my treatment options?

In some cases surgical intervention may be required for successful treatment of FAI however there are many conservative measures that can be taken to improve hip functionality and reduce symptoms associated with FAI.
Osteopathic treatment may be able to assist in reducing symptoms of FAI. It is not uncommon with FAI for the muscles of the hip, pelvis and lower back to become tight acting on further limiting the range of motion available at the hip joint. Treatment of soft tissue massage and muscle stretching techniques can be used to help relax and lengthen these muscles, assist in reducing inflammation and ultimately reducing pain.

Exercise based rehab focused around promoting hip mobility may also assist in the ongoing management and reduction of symptoms – Here we have provided you with 3 of our favorite at home stretches and exercises to give a try!

1. Kneeling hip flexor stretch

2. Pelvic bridges

3. Hip adduction stretch (Frog stretch)

If you are currently suffering from hip or groin pain and would like further personalised advice on treatment and management options feel free to contact the clinic today to discuss whether Osteopathy or Exercise Physiology may be able to get you back into what you love doing!

Get A Weight Off Your Chest

With the recent fire disasters in Australia, the Bellarine region has been hit with poorer air quality which can lead to issues with breathing especially in those more susceptible.
Learn here a bit about asthma and how osteopathy may help with improving breathing.

What is Asthma?

Asthma is a common long-term condition of the lungs that causes the airways to become inflamed and narrow resulting in breathing difficulty. Asthma is most common in children, however is often carried into adult life.
It is estimated that 1 in 9 Australians experience Asthma – that’s approximately 3 children in an average Australian classroom or 2 players per footy team.

A range of things including poor air quality or airborne substances such as pollens and dust, respiratory infections, cold air or physical activity can induce Asthma. Symptoms often present as coughing, wheezing, shortness of breath and chest tightness.

Those who have been diagnosed as asthmatic often have and Asthma Action Plan and can manage or reduce symptoms with medications however today we will briefly delve into how osteopathic treatment may assist in managing some symptoms associated with asthma!

Anatomy and Asthma

The lungs are the major respiratory organ of the body that essentially allow us to breath. The lungs are protected by the rib cage and expand as we breath in and deflate as we breath out. The rib cage is made up of 12 ribs that have attachments to the 12 thoracic vertebrae at the back and to the sternum (chest bone) at the front either directly or indirectly through cartilage (It is important to note that ribs 11 and 12 do not attach to the front and are considered ‘floating ribs’). In between each rib is a small band of muscle fibre known as the intercostal muscles. These muscles work in with our Diaphragm – a large muscle that sits across the bottom of our rib cage and attaches to the ribs and lower vertebra to allow the ribs to raise and chest to expand as we breath.

As asthma can cause shortness of breath and breathing difficulty it is common for these muscles to become tired, fatigued or strained resulting in sub-optimal chest expansion, chest tightness and in some cases pain or discomfort. Asthmatics when exposed to triggers will often experience coughing fits, which can cause the joints of rib cage and spine (costovertebral joints) to sprain and become inflamed, irritated and very painful! Pain associated with rib sprains often presents as sharp and grabbing pain in the front or back of the chest that becomes worse when trying to take a deep breath in or rotate through the trunk.

This is where Osteopathy may be able to help you!

Osteopathy and Asthma

Your osteopath may be able to assist with biomechanical chest pain or tightness associated with your asthma. Your oribssteopath can work with you to identify tight muscle and restrictions within your rib cage, thoracic and cervical spine with the aim of improving respiratory motion.

Treatment techniques may include soft tissue massage techniques, muscle and joint stretching and joint manipulation where appropriate to promote mobility and therefore expansion of the chest cavity.

Tips for those with Asthma

The following exercises can be used to help promote mobility of the rib cage and thoracic spine and may be used to reduce chest tightness:
1. Cat/camel – Start on all fours and gently sink back down towards the floor whilst looking up to roof to make your tail bone stick up to the roof and a curve in your spine. Take a deep breath in and as you breath out reverse the movement by tucking your tail-bone in and arching through your back – mimicking the hump of a camel.
Repeat this manoeuvre 8-10 in a row and up to 5 times a day using your breathing to assist with flow.

2. Towel/foam roller stretch – If you have a foam roller this is great for this exercise, however you may use a towel folded in half width wise and rolled length wise to form a tube/cylinder shape. Place the roller/towel on a stable surface such as the ground and lay with the length of your spine along the length of roller/towel. Allow your arms to stretch into a “T” shape and relax off to either side of the roller/towel – this will open up through the front of your chest and promote some mobility through the back! You may like to gently rock side to side for more mobility based work.
Hold for 25-30 seconds, release and repeat up to 5 times in a row 2-5 times a day. This one is AWESOME at the end of a day for desk workers too!

*Depending on the size of your roller or towel you may need to use pillows to support your head to avoid straining the neck*

If you are suffering sudden onset or new occurrence shortness of breath, chest pains or difficulty breathing we recommend consulting your Doctor or emergency services as soon as possible as this may be a sign of more serious conditions.

For further information or to see if Osteopathy may be an option for you please give the clinic a call on 5253 2345 and have a chat to one of our friendly practitioners today!