Tennis elbow: I am getting an injection!

Why does tennis elbow happen?

Besides the acute trauma to the elbow from a fall, accidents etc, one of the most common chronic pain of the elbow is tendonitis due to repetitive gripping. Pain on the outside of the elbow is called lateral epicondylitis a.k.a. tennis elbow. This condition can be due to repetitive lifting upward motion of the wrist combined with the turning up position of the forearm.  Carpenters, secretaries, plumbers, teachers, contractors, electricians and painters as well as people who play sports such as tennis players tend to suffer from that type of injury.

JMM_lateral_epicondylitis_tennis_elbowIn this picture, repetitive pull from your forearm muscles irritate the tendons where they insert your upper arm bone. Muscles are able to change length meaning, they can contract and relax, however tendons and ligaments do not change length, when they do, you end up with a sprain. Ouch! Due to repetitive pull from the muscles and inability for the tendons to change length, tendons get irritated and inflamed which creates a pain-spasm-pain cycle at your elbow.

What does research say? (contact me if you want to full articles)

There are many different injections that your doctor can give you. There is strong pilot-level evidence supporting the use of prolotherapy, polidocanol, autologous whole blood and platelet-rich plasma injections whereas polidocanol and glycosaminoglycan showed no effect compared with placebo.

Although botulinum toxin shows marginal benefit due to it causes temporary paresis of finger extension, and all trials were at high risk of bias in the studies that I came across.

Research findings indicates that corticosteroid injections are effective at short-term follow-up, and physical therapy interventions are effective at intermediate- and long-term follow-up. Pooled results showed that beyond 8 weeks, glucocorticoid injection was no more effective.

Today, the most trending treatment for tennis elbow is PRP injections. PRP (platelet rich plasma) procedure is as follows: your doctor draws your blood then separates good stuff from the rest. Under the guidance of an ultrasound they inject your platelet concentrated plasma on the injury site- in this case your elbow. The results are phenomenal since it helps with helping and breaking pain-spasm-pain cycle as I previously mentioned. However the catch is, research shows PRP is effective for about 6-8 weeks, meaning it gives you a little boost if you are already in rehabilitation. If you are not doing anything other than  getting injections for your elbow pain, I’m sorry to say this my friend but your pain will return.

prpelbow.png

Lets get you out of that pain

When it comes to treatment, you need to see a physical therapist for a thorough biomechanical assessment of your upper extremity to assess what is weak and tight, what is inhibited and where the dysfunction is. You want the pain to go away forever right?! Then you need to get to the root of the problem instead of masking it.

Home remedy to buy you some time until you make your appointment

Ice

Forearm stretches

Elbow brace will restrict movement therefore will stop repetitive pulling at the injury site. You can purchase one from any drug store.

 

Rogue fitness also has some equipment that you can use. Check out the link:

http://www.roguefitness.com/lifting-straps-wraps/protection-supports/elbow-sleeves

 

Take home points

  • Repetitive pull is what is causing your elbow pain
  • Injections will only help you short term
  • You need a proper biomechanical assessment of your upper extremity to find the root of the problem
  • Be smart, do not prolong seeking help!

 

 

 

images retrieved from:

https://www.hss.edu/conditions_tennis-elbow-overview.asp

http://www.am-meditech.com/AMMeditech/PRP.shtml

http://www.benjamindombmd.com/elbow-3/non-surgical-treatments-for-elbow-injuries-and-conditions/

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