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Tennis Elbow

How can I avoid another bout of Tennis Elbow?

Question

I’m looking forward to playing tennis this summer but worried that I will get a flare-up of tennis elbow. At its worst, the pain affects my hand and wrist as well as my elbow, and stops me doing anything with that arm -eve, lifting a paper bag is agony. Could you explain why this happens and offer any suggestions?

Answer

This inflammation of the elbow joint, medically called lateral epicondylitis, occurs frequently with people who play tennis and can also result from any repetitive strain injury or a one- off trauma.

The elbow area is complicated biodynamically. The three bones involved are the humerus in the upper arm, and the ulna and radius in the forearm. The elbow joint flexes and extends due to the action of the biceps (in front of the arm) and triceps (behind the arm). The elbow also rotates around its axis, both with the palms facing forwards and when they face backwards. These movements are carried out by the muscles attached to the bone surfaces around the elbow. above and below. Muscles end in tendons, which cover the joints and, with the help of fibres, strengthen them. The muscles that control the wrist movements are attached to three elbow joint connecting to the three bones (humerus, ulna and radius).

There are several ways in which you can injure or strain the elbow joints

  • Carrying heavy objects: here the gripping muscles of the wrist have to close in to prevent the object from slipping out. Additionally, the weight-bearing power of these muscles has to withstand the gravitational pull, and this stretches and strains both the muscles of the forearm and their tendons, which are attached to the outer joint of the elbow.
  • Repetitive movement of the wrist this includes computer and other manual work - writing, massaging, knitting, driving, chopping, cutting, hammering, etc.
  • Flicking backwards: the motion that gives rise to classic tennis elbow is an incorrect backhand, where you flick the ball for halfully rather than doing a full long stroke with follow through.
  • Sleeping with your arm bent under your head or pillow: during deep sleep your muscles are completely relaxed and the 'dead weight' of the head and neck strains the elbow joints. The muscles controlling your forearm and wrist, are attached to the fragile joint on the outer surface of your elbow, where there is virtually no protection or buffering, so maximum strain is experienced. With tennis elbow, firstly the tendons around the joint are inflamed and then the actual joint becomes involved. The characteristic symptoms are pain, swelling, heat, joint stiffness and loss of function (not being able to bend your elbow, carry or grip things).

Bones and tendons are white because they are poorly supplied with blood. This means that fractured bones and torn or injured tendons take longer to heal than muscles and skin, which have a rich blood supply. Moreover, because hand or wrist, movements are essential in everyday living, you can’t rest the joint completely and even little movements put a strain on the joint.

Here are my suggestions:

    Diet

  • Nourishing foods include avocados, ginger, chicken broth, whole organic milk, cod liver oil, shark fin soup (for calcium), and turmeric (an anti-inflammatory) as flavouring.
  • Avoid citrus or sour fruits: excess stomach acid increases pain in the body and slows down healing in tendons and joints. This anecdotal observation is familiar to practitioners of traditional medicine, but the exact reason for the correlation is currently unclear. My own feeling is that excess stomach acid over a long period can change the pH (potential Hydrogen) acid/alkaline balance of blood and tissues, which may affect the collagen content in ligaments and tendons, thus weakening them.
  • Supplements

  • Take Alive Joint and Ligament Support : one twice daily for two months. Or: mix half a teaspoonful of turmeric powder and one teaspoonful of manuka honey in half a cup of warm organic milk drink once daily for two months.
  • Massage

  • Apply Dr Ali's Joint Oil on the elbow rub your palm vigorously to generate frictional heat. Do this for two minutes or so, two to three times daily, until the pain disappears.
  • Apply Alive Peppermint Balm or Tiger Balm (available at health food stores and chemists) on the joint at bedtime.
  • Exercises

  • Tighten your fist, hold for five seconds, then release. Repeat ten times in the morning and evening.
  • Lace the fingers of both hands together, squeeze palms together then release and stretch hands outwards, pulling away from each other. Do this five times, twice a day.
  • Wear a support or normal bandage over the elbow to keep it warm.
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