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  1. #1
    Sports Injury Guru ScottyDoc's Avatar
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    Default Tenosynovitis of the Elbow...

    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.
    Last edited by ScottyDoc; June 4th, 2011 at 08:42 PM.
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    I'm guessing I will ultimately have to break down and go to a Dr. for my injury. however i'm trying to narrow down what it is exactly what i have and this sounds kind of like it. The problem started a little over a month ago and I thought i just bruised something in my elbow bc that's what it felt like but as time went by it's gotten worse. I haven't worked out in a month now trying to let it heal but hasn't helped any at all.

    Basically it's my right elbow, it doesn't hurt so much when i bend it but whenever i grip something or make a fist and bend my elbow it kills me. Would that be considered tennis elbow or whatever? Also will time heal it or am i going to go to the Dr's? BC like I said it doesn't seem to be getting better on it's own. I'm tired of taking motrin and I don't really like taking stuff like that anyway. And it does mask the pain but I just want it better. Thanks for any replies.

  3. #3
    Sports Injury Guru ScottyDoc's Avatar
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    Quote Originally Posted by kbtoy View Post
    I'm guessing I will ultimately have to break down and go to a Dr. for my injury. however i'm trying to narrow down what it is exactly what i have and this sounds kind of like it. The problem started a little over a month ago and I thought i just bruised something in my elbow bc that's what it felt like but as time went by it's gotten worse. I haven't worked out in a month now trying to let it heal but hasn't helped any at all.

    Basically it's my right elbow, it doesn't hurt so much when i bend it but whenever i grip something or make a fist and bend my elbow it kills me. Would that be considered tennis elbow or whatever? Also will time heal it or am i going to go to the Dr's? BC like I said it doesn't seem to be getting better on it's own. I'm tired of taking motrin and I don't really like taking stuff like that anyway. And it does mask the pain but I just want it better. Thanks for any replies.
    First and foremost, it is always my personal and professional recommendation to have any problem presented to me on a forum to a health-care professional IN PERSON. I am a health-care professional, but without seeing you in person is impossible to be 100% accurate in my suggestions, as there may be what seems like a minor detail to you, but will say volumes to me that I might not get from simple conversation. With that being said, I do always try to give general helpful advice as you will read below!

    Tennis Elbow and Golfer's Elbow are both tenosynovitis of the elbow, the difference between the two is location. Tennis Elbow is Lateral, while Golfer's elbow is Medial. You can determine this by having your palm facing up, the medial aspect of the elbow is closest to your body and the lateral aspect is furthest from your body. But honestly, they are both treated the same and are only named that way because of the sport that most likely causes the injury is a repetitive motion that favors one side over the other. As far as what to do, it is a repetitive use injury so unless it happened from one day to the next and because of an injury or trauma, it is just a matter of rehabbing it: R.I.C.E. (Rest, Ice, Compression, Elevation) and a little E-stim (electrical stimulation) if available and as the pain subsides some very light exercises and stretches! Unfortunately, this is your body's way of telling you it does not like something that you are doing on a regular basis, and just like it took time for it to get as severe as it is, it will also take time to go away, the worst thing you can do is completely ignore it or take pain medication in order to continue doing what is hurting it to begin with. Don't get me wrong, I'm not against pain medication at all, it serves its purpose for sure, but should not be used to block the pain in order to continue doing what injured it in the first place, pain medication in no way shape or form speeds up the healing process, only blocks the pain to ease the body during the healing process! Good Luck my friend and I do recommend you get it checked out personally by a health-care professional and be smart... Listen to your Body, it is smarter than you think!
    Last edited by ScottyDoc; June 27th, 2011 at 04:26 PM.
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    Thanks so much for ur reply. i actually tried prying the symptoms into google yesterday and it seems like i do have tennis elbow since the pain is on the outside of the elbow. I am going to try a couple more things b4 I go to a Dr but i'm sure I will have to go. What r ur thoughts on prolotherapy? And would that work for something like tennis elbow? I'm guessing it will since we are talking about tendons. I'm thinking about doing this myself but not sure where to inject. (please don't take this as me asking for advice on how to do this myself as I would never expect u to do that being a Dr.). So i'm researching it more and will probably need to look at an anatomical chart. Either that or I will find aDr that does prolotherapy.

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    Sports Injury Guru ScottyDoc's Avatar
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    Quote Originally Posted by kbtoy View Post
    Thanks so much for ur reply. i actually tried prying the symptoms into google yesterday and it seems like i do have tennis elbow since the pain is on the outside of the elbow. I am going to try a couple more things b4 I go to a Dr but i'm sure I will have to go. What r ur thoughts on prolotherapy? And would that work for something like tennis elbow? I'm guessing it will since we are talking about tendons. I'm thinking about doing this myself but not sure where to inject. (please don't take this as me asking for advice on how to do this myself as I would never expect u to do that being a Dr.). So i'm researching it more and will probably need to look at an anatomical chart. Either that or I will find aDr that does prolotherapy.
    OK, I am in Nursing School, so I do know a little about taking blood and giving shots, but my primary focus at this point is Physical muscle and osseous manipulations due to the fact that I am also a Doctor of Chiropractic (DC). I do know a little about Prolotherapy and have done a little homework/research on it and yes, I do believe it will help you. As far as doing it myself, seriously, I have given and taken 100's if not 1,000's of shots, but unless I had been shown by a professional exactly how to do it, I would not try to do it myself, besides, even shots where I know exactly where to put them, I still get a fellow professional to do it for me, just because he/she can get the perfect angle while I concentrate on remaining perfectly still, usually that stuff had to go between the joint, I know with cortisone this is the case and it is extremely painful, I mean nothing I cannot endure, but would be extremely difficult to remain perfectly still, relaxed, not flexed, while giving myself the shot, all at the same time and perfect angle as to not hit the bone, which is when it feels like a bolt of electricity shoots through all your nerves, will make anyone jump no matter what the pain tolerance is. So I say NO WAY Bro, please go see a professional, this is both my personal and professional advice!
    Dr. Albert Scott Representative for FINAFLEX
    http://www.finaflex.com/
    Redefine Yourself.... REDEFINE EVERYTHING

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    Scotty, I am a fellow D.C. Why are you in nursing school? Adding to your scope of practice? In regards to this thread, I have some elbow bursitis and have found fish oil to be very good for it.

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