Why doesn’t my elbow feel better after rest?
By Dr. Scott Glidden, DC
Lateral epicondylitis, or tennis elbow, is one of the most common injuries experienced among tennis players. What might start as an ache or a “twinge” at the outer elbow eventually grows into persistent pain. Rest, straps, cortisone, dry needling, and stretching are all commonly recommended treatments that may work for a bit, but then the symptoms come right back in days or weeks. Why doesn’t anything help?
What exactly is going on?
When looking at this problem, you need to consider a few things:
-What is under the spot that hurts?
-Where do the things under that spot go?
When it comes to an overuse injury like tennis elbow, its often either the muscles that rotate the forearm or those that extend the wrist and fingers at fault. If a muscle is used more than it is trained to do, your body’s response to that use is adhesion. Adhesion is a glue-like substance that sticks to overused muscles and ligaments in order to stabilize them so they don’t tear. Unfortunately, adhesion also limits strength and range of motion as well. You will slowly lose strength and endurance as well as become more symptomatic with continued use. “No pain no gain” does not apply here!
What is the fix?
The first thing I do with my patients with this problem is I have them grab my wrist and try to twist my forearm in both directions like a door knob. When the twisting is resisted, the effected muscles are challenged—reproducing the pain if it is indeed tennis elbow. If that test confirms it, finding an expert in finding and fixing adhesion is your best bet to eliminating the problem. Once resolved the muscles will stay healthy as long as you maintain a healthy load. Typing and texting use the same muscles, so keeping this in mind for proper load is key for avoiding injury. You can’t work at a computer all day and expect to be as prepared as you would on the weekend. If the pain isn’t reproduced or isn’t better with rest you should seek an orthopedic specialist for the problem since it likely isn’t a muscle or ligament problem.
Dr. Scott Glidden is a soft-tissue specialist in Milwaukee,WI. His practice focus is chronic unresolved muscle, nerve, and joint problems. You can find more information on him and his practice at selectspineandsport.com.
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