Posted On: April 15, 2020
Lateral epicondylitis or “tennis elbow” is a common cause of lateral elbow pain in middle aged individuals. The reason that the prevalence is higher in this age group is that the muscle most involved in this problem, the extensor carpi radials brevis, atrophies with age.
Individuals in this age group will often continue to try to perform tasks that they could do when they were younger. This can easily lead to micro tears in the tendon of the weakened and atrophied muscle.
Over the years I have treated weekend warriors from Lake Forest, tennis professionals from Highland Park, and golfers from Wilmette. It spares few individuals. I have even seen plumbers and electricians with this condition.
Rehabilitation is simple but not always easy. It consists of: relative rest, anti-inflammatory measures, wearing a counter force brace, manual therapy, stretching and strengthening.
Relative rest does not always mean totally quitting the activity. If, for instance, it only hurts during a player’s back swing, they can often still work with a pro to develop their footwork, work on forehands, and eliminate spin on their back hand while wearing a counter force brace.
My favorite anti-inflammatory is ice. With the elbow you should ice ten minutes on and off through a cotton barrier like a tee shirt. If your elbow hurts after activity do this every day for about a half hour. In the early more inflamed phases, it may require that you do it even as often as an hour a day.
Massage techniques professionally applied (transverse friction and myofascisal release) can be useful in helping to organize tissue into a stronger and more pliable muscle tendon unit.
Stretching of the wrist extensors is key. You have to perform this type of stretch 3-5 x 30 seconds per day. This can be done by holding the affected limb straight in front of your body palm down. Then pushing on the back of your hand with the other hand fully flexing the wrist.
Strengthening the wrist extensors is the ultimate remedy. Working to rebuild the atrophied muscles with palm down reverse wrist curls or using a tool like the Theraband FlexBar is crucial. The problem that slows down recovery is often times how involved the tendon is. If a person has had a long-standing unaddressed issue, it will take longer. People that have less damaged tendons will take less time and those with more damage will take longer.
One should always see a physical therapist or a chiropractor who is experienced in orthopedics and sports injuries to establish the diagnosis and direct care.
Stay well and stay active.
North Shore, Dr. J and the staff were great. I started out with a pinched cervical nerve which was causing extreme pain and numbness in my arm. Surgery had been ruled out by the neurosurgeon after an MRI. My physical recommended a regimen of physical therapy which I undertook with NorthShore in November. At that time I had consistent pain in the range of 8-9 out of 10. I had trouble sleeping, driving and performing most normal daily activities due to the constant pain. I have now been through two series of physical therapy sessions with North Shore over a couple of months and the pain and numbness are completely gone. Based on my experience I would highly recommend North Shore for physical therapy treatment and the staff is extremely friendly and helpful as a bonus! Jon HeintzelmanJonathan Heintzelman
All aspects of the rehab program were done with professionalism. Intake evaluation, exercise program, massage therapy and exit evaluation were all excellent and yielded excellent results for me. All of the staff are friendly and efficient. Dr. Johnson, Jeannette, Cyprian and Mary are friendly and make an otherwise difficult experience much more tolerable. I have gone to them on two occasions over the last several years for different injuries and, in both instances, my problems were resolved. I highly recommend them.Lee Eddy
I was a patient 6 years ago, with lower back pain and herniation. My PT was excellent and I was back to exercise and resolution of pain and herniation. Recently I have had hip pain and and tingling down my leg. My evaluation with DR Johnson was very thorough and spot on. The PT with Dre was incredible. I am now pain free with a resolution of the tingling as well. I will definitely return for any future problems that may arise!Barbara Bank
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