Tenosynovitis of the elbow!

[ScottyDoc]

Tenosynovitis of the elbow:

Tenosynovitis is inflammation of the lining of the sheath that surrounds a tendon (the cord that joins muscle to bone). This causes difficulty or pain when moving the joint, joint swelling as well as palpable pain in and around the joint.

Tenosynovitis of the elbow is usually categorized into a few different more common names:
tennis elbow (lateral epicondylitis)
(http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001485/)
or
golfer’s elbow (medial epicondylitis)
(http://sportsmedicine.about.com/cs/elbow/a/elbow3.htm)
or
Nursemaid's elbow (dislocation of the radial bone in the elbow)
(http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001978/)
or
Bursitis (inflammation of the Bursa)
(http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001456/)

If tenosynovitis is not treated, the tendon may become permanently restricted or it may tear (rupture). If you are experiencing very sharp or unbearable pain or suspect a tear (rupture) please schedule an appointment with your primary health care provider or an Orthopedist, attempting to rehabilitate a torn tendon will only cause further pain & injury.

The most common form of both of these above mentioned injuries is over-use. Both above forms of tenosynovitis of the elbow are common in weight lifters because we can’t help but over-use our elbows, they are necessary for most upper body movements. Also, more so in weight lifters, they can and often do occur together (medial & lateral) causing the entire elbow joint to hurt & be inflamed.

OK, time to talk rehab, first and foremost with any acute or injury of inflammation, I try to always teach people to remember the acronym RICE (R=rest. I=ice, C=compression, E=elevation) Notice the number one on the list is rest, you can’t rehab an injury if you continue to cause trauma, this is not a work through the pain kind of thing, it will not just go away. How long you need to rest it depends on you and your body, everyone is different. There are no exercises that will help this heal, it is an over-use injury, that needs time to heal... RICE. In addition, after approximately 48-72hrs of initial onset of the injury, I like to put my patients through contrast baths: 15mins of heat followed by 15 mins of ice. Always do the heat first and follow with ice. The heat speeds up the blood flow, vasodiolation of the blood vessels allowing more oxygen and healing nutrients to the site, but must be followed by ice, because if allowed to pool, it can worsen the inflammation process. Think of this as a pump, heat allows the good stuff in, then you pump it back out so it does not stay causing further swelling & inflammation.

Now, once it is no longer acute and inflamed, strengthening it is a different story. Any exercise that strengthens the muscles of the forearm will also strengthen the tendons which attach them to the elbow joint (wrist curls, reverse wrist curls, reverse curls, hammer curls,hand grippers, squeezing a tennis ball, etc). I would also include some warm up wrist rotations with a 3 or 5lb dumbbell, nothing heavy, this is just to loosen them up and warm them up, nothing more. I also recommend some sort of pre-workout heat, weather it be a hot pack or some type of ointment (ie. biofreeze, icy-hot, etc.) and also, ice it down after any upper body workout that stresses the elbow joint.

I hope this information helps, the above websites are very good, very informative with more detail than I have in this thread, also they have some pretty good pictures, so you can actually visualize where & why you are experiencing pain in your elbow as well as whether it is (lateral or medial) epicondylitis or both.

 

[wicknilly]

good post!

 

[ScottyDoc]

Thank You! I am on a bunch of these boards trying to make extra money being a REP for FINAFLEX, but at the same time, I want to contribute to each and every forum and Chiropractic is my profession and helping with sports related, musculoskeletal injuries is my expertise, so why not share!

 

[ScottyDoc]

OK, I seemed to have a little miscommunication with my company and the Mod’s here at Anabolicminds.com, I believe we have it all straightened out now and I am now allowed to promote the company I work for & myself as a representative of that company.

Hello fellow exercise and nutrition buff’s, I would like to introduce myself as an official representative for Redefine Nutrition. Redefined Nutrition is the maker of FINAFLEX products. My name is Dr. Albert Scott, I am a Chiropractor by trade and personally, have been weightlifting for over 20 years. Chiropractically, I have worked with and treated a large number of collegiate and professional athletes as well as your typical self -trained athlete from the gym, like myself.

The reason why I am here introducing myself today is to offer my services as an official representative of Redefine Nutrition to help answer any questions out there about our products.

Also, be advised that within a matter of days we (Redefine Nutrition) should have its very own Forum in which I will send links to all my friends and the people who have followed me on my logs and people I have followed as well... Thanks guys for all the support!

 

[JohnBrinks]

Ive had tennis elbow for years, my doc said its untreatable (lazy Bstard), hed rather miss-inform me than admit he doesnt know I suppose. I know SD Im in bits. I broke my elbow about 6 years ago, when it came out of the cast I had this retched condition. I think it was caused by leaning on my elbow too much while in bed with my girlfriend the whole 6 weeks :sgrin:. I put pressure on the thing all the time and it got traped in my elbow and inflamed. Thats my theory anyway.


It seems to have almost gone away in the last two months! Not because Im on steroids, which I started 4 weeks ago, they certainly have sped it up, but it started getting better before then.

Ive always been lazy with training triceps cos all I ever seemed to do was make my medial head and long head bigger and my lateral head seemed to be dissapearing, so Ive been afraid of training them in fear of loosing my horse shoe shape alltogether.

Well Ive done some reaserch and Ive found some good exercises and with the right form and my lateral head is getting bigger. Now that Ive ballanced the strength between my triceps and biceps my elbow is fine. Just a few months ago I could never fully straighten my arm because of pain and the ligament (or tendon I dont even know which one) was constantly getting traped in my elbow. Thank God now its ok.

 

[nerdalert]

Hey Doc, what is your take on acupunture as a treatment for tendonitis? I have pain in both elbows from time to time and am having a flareup right now that hurts so bad I can't tie my shoes without a shooting pain in my forearm. It can't hurt right?

 

[ScottyDoc]

Hey Doc, what is your take on acupunture as a treatment for tendonitis? I have pain in both elbows from time to time and am having a flareup right now that hurts so bad I can't tie my shoes without a shooting pain in my forearm. It can't hurt right?

First off, I have heard some great, incredible things about acupuncture, but have never personally experienced it! I have heard from other professionals in my field to always look for an Asian acupuncturist who was trained in Asia, that the schools we have here are sub-par compared to their schools, besides it is an ancient art that has been perfected for 1000's of yrs! So give it a try, like you said, it can't hurt, I would be willing to bet it would help!

Second, just some quick info on your supplementation.... are you taking MSM, Glucosamine, & Chondroitin? Those are the 3 major/basic ingredients in any joint pain/joint relief vitamin. Here is a little vitamin experiment for you, give this a try. 1.1g(1,100mg) of Glucosamine (sulfate or potassium sulfate); 1.2g(1,200mg) Chondroitin Sodium Sulfate; 500mg of MSM; & 2g(2000mg) of a good Omega 3-6-9 essential fatty acid blend. OK, take those 4 products at those dosages or higher 3 times per day (morning(wake), mid-day, night(before bed). I don't mean for you to split the dosages I have given you by 3, I mean for you to take the above dosages 3 times per day, just want to be clear with that. It is a lot, but try that for a month and unless you have a serious musculoskeletal issue, which I could only diagnose in person, you should see some improvement. What I recommend to my patients is to continue that dosage until pain is 80-100% gone, then start to cut the dosage, as in maintain the levels in your body. Once pain is gone or near gone, you can cut the dosage by 1/3 taking it morning and night, then if you continue to feel pain free, you can cut it down to my original above dose 1 time a day, or divide the dose into 2 or 3 times a day, which is recommended to constantly keep it in your bloodstream.

Which, while I'm at it, I'll just say for most all vitamins, if it says take 3 caps 1 time per day on the label, I take 1 cap 3 x's a day, unless there is a specific reason on why to take it at a certain time, like post cycles are best at night because that is when your body is producing Testosterone while you are at rest, then I split it up whenever possible to always keep as much of what I'm taking in my bloodstream at any given time, kind of a rule of thumb!

Finally, my last suggestion, strong forearms, help support strong elbow and wrist joints, as well as your biceps and triceps. You are on this site, so my assumption that you work out should be a good one. A great many people who workout neglect to work their forearms regularly. Wrist curls, reverse wrist curls (dumbbells or barbells), you can buy or make a wrist curl "Thingy" with a broomstick, rope, & some weight where you role the rope around the broomstick using your wrists, easier to buy it at Walmart approx. $10 + $5(weight plate) = <$20, I have one and I use it about 1 x a week in my apt. I just stand on a chair and curl it one way, ease it down, and curl it up the other way, then again each way and that is a set, get 3 sets and your forearms are on fire, if not, increase the weight! Another thing I own, and you can look these up online is hand grippers, I'm not talking about Walmart or sports shop cheapies, I'm talking about the "Captain of Crush" made by www.IronMinds.com, made strong will last your lifetime and come in levels, the hardest level has only been closed by a handful of people in the world, excellent, I keep 2 different strength levels in my car and every time I drive to school (30mins away) I just keep supersetting those bad boys until I can't take it anymore, take a 5min break, then at it again!

Well, I know that was a bit long winded, but those are my suggestions, good luck!

 

[EasyEJL]

any thoughts on foam/tennis ball rolling as a part of self myofascial release?

 

[ScottyDoc]

any thoughts on foam/tennis ball rolling as a part of self myofascial release?

Myofascial release is always an excellent way to help with any sore muscles, ligaments, or tendons, good point! It can be done personally to oneself with a foam roll or tennis ball, can also be done cold by freezing a paper dixie cup of water and tearing paper away and giving oneself an ice massage, massage therapist, etc. Other helpful tools are EMS (electrical muscle stimulators). And of course don't forget the basics....HEAT & ICE. I did another post about when to use heat and when to use ice. Ice is used for the 1st 72hrs after an injury (acute), then the injury is considered to be (chronic) and you use heat. I still love the affects of ice, I like to use both once it becomes chronic. 15mins of heat followed by 15mins ice, always ending with ice, helps vasoconstriction, less swelling = less pain. Or if you follow a workout, I would do Ice followed by heat followed by ice, the reason why I start with ice is because you are already hot.

Hope this helps guys, again thanks for the post on Myofascial release, excellent point (highly recommended)!