Tuesday, August 1, 2017

Acupuncture As A Treatment For Tennis Elbow

Tennis elbow, which is also known as lateral epicondylitis or extensor tendinopathy is a condition that causes pain outside of the elbow. The primary cause for this condition is degeneration or inflammation of the tendon of the extensor muscles near the elbow due to strenuous overuse. Most tennis players do get this condition, but it is also common to people who repetitively stress the muscles around the elbows such as decorating, painting, weight lifting or typing.  Tennis elbow develops gradually over a period of days or can develop suddenly, and the injury can be difficult to treat if it is chronic.

Acupuncture For Tennis Elbow

The main symptoms of tennis elbow are elbow pain when pressing outside of the elbow, and the pain tends to worsen when the wrist is straightened, twisted or lifted.  One also feels weakness in the wrist when performing simple tasks such as opening the door.  It is important to seek treatment so as to ensure quick recovery and also reduce the chances of reoccurrence. The common types of treatment include physiotherapy, non-steroidal anti-inflammatory medication, local steroid injections, bracing and surgery. However, acupuncture has been used for a while now, and most studies show that it is an effective way to treat tennis elbow by alleviating the symptoms. Most people will prefer this method of treatment because it is natural.
Acupuncture for tennis elbow is a way of Traditional Chinese Medicine (TCM) for treating pain, and it has been accepted in the modern western medicine. In TCM, the Qi flows along the meridians which are pathways in the body. The theory behind its work is that it helps unblock the body channels where energy flows from the cells.  When the channels are blocked, then there is the restriction of energy flow, hence leading to serious symptoms such as pain. When acupuncture is done, these blocked areas are released, hence minimizing pain on the elbow.
Another way that acupuncture for tennis elbow works to relieve pain is by stimulating the nervous system and releasing neurochemicals hence promoting emotional and physical well being. When the pressure points are stimulated during acupuncture, the brain receives messages to reduce stress and pain which then reduces anxiety and allows one to relax.
Acupuncture for tennis elbow also relieves symptoms such as inflammation and pain through:
  • Stimulation of the nerves in the muscle and other tissues, hence leading to the release of the endorphin hormone and neurohumoral factors and changes the pain process in the spinal cord and brain.
  • Delivery of analgesia through the alpha-adrenoceptor mechanisms.
  • Modulation of the limbic- paralimbic-neocortical network
  • Increasing the release of adenosine, which contains antinociceptive properties.
  • Promotion of the vascular and immunomodulatory factor release, hence reducing inflammation.
  • Increasing local microcirculation, which aids in the dispersal of swelling, hence improves muscle stiffness and joint mobility.
Acupuncture for tennis elbow treatment is administered when the person is either in supine or sitting position, and the acupuncturist knows the exact points that the needles need to be placed. The acupuncturist uses 40mm sterile, disposable acupuncture needles which are rounded which makes it easier for the needle to enter the muscle tissue beneath the skin without causing any injury or damage. When the needles are placed in a particular region, then they stimulate the points that cause blockage and increase the blood flow to the area, hence allowing the healing process to start, reduces inflammation and strengthens the tendons.
The insertion points of acupuncture for tennis elbow are usually not near the elbow, and this is because if the intricate energy circulation blocks one part of the body, it will have effects of the energy blockage in another place.  Some of these points include:
  1. Large intestine 10 also called LI 10 or Arms Three Miles, which is located 1 inch below the elbow fold on the forearm.  Stimulation at this point helps relieve immobility and arm pain and eases inflammation of the elbow by stimulating energy flow along the large intestine channel.
  2. Large intestine 11 also called LI 11 or Pool at the Crook which is located in the large hollow that is found on the outer end of the elbow creases. When this area is blocked, it becomes tender hence acupuncture will heat and relax the arm sinews.
  3. Large intestine 12 also called LI 12 or Elbow Bone which is located above the elbow fold, and when it is stimulated, it relieves numbness, reduces pain that moves up towards the shoulder, relaxes the sinews and relieves inflammation and swelling.
  4. Large intestine 5 which is located on the radial side of the wrist and inside a depression between the brevis tendons and extensor pollicis longus. When stimulated it relieves wrist pain.
  5. Large intestine 6 also clad LUO Connecting Point, which is located just 3 inches higher than the large intestine and towards the elbow. When stimulated, it relieves pain in the wrist, arms, and elbows.
  6. Lung point 5 also known as Cubit Marsh which is located at the elbow crease outside the biceps brachii tendon. Stimulation at this point helps relieve pain in the upper arm and also regulates water level within the body hence balances the water involved in inflammation.
  7. Lung point 6 which is located 5 inches away from lung point 5 towards the wrist when the palm is facing up. When stimulate it relieves pain in the forearms, wrist, and elbow.
  8. Heart point 3 also known as Lesser Sea, which is located between the cubital crease end and the medial humerus epicondyle. When stimulated it relieves pain, tremors, numbness in the lower arms and hands.
  9. Triple warmer 6 which is located 3 inches above the TH4 and in the middle of the ulna and radius on the radial side at the tip of the olecranon Iine and the digitorium muscle extensor. Applying pressure helps relieve shoulder and arm pain, and shoulder and back heaviness.
  10. Triple warmer 10 also known as TH 10 or Celestial Well, which is located 1 inch above the olecranon process in a depression. When stimulated it reduces the elbow pain, swelling, and tendinitis.


Friday, May 19, 2017

Tennis Elbow Exercises

Tennis Elbow Exercises
Tennis elbow also commonly known as lateral epicondylitis is caused when the muscles of the forearm that attach to the elbow are injured. It is as a result of the inflammation of the extensor tendon. It can be caused by repetitive activity and is sometimes common in tennis players as well as people in the painting, plumbing and carpentry profession.
Tennis Elbow Symptoms
Symptoms of tennis elbow include a painful or burning sensation on the outside of the elbow and the strength in your grip of objects becomes weaker. You may even find some simple tasks a bit more difficult to perform such as opening the door. If these symptoms develop over time, they could get worse and will require treatment.
Tennis Elbow Treatment
This involves reducing symptoms of pain. Some methods of treatment are available at http://elbowpainsolutions.com/elbowpain/tennis-elbow-painful-truth/ and more are listed below.
Ice: This is used to apply cold compression for about 15 minutes or less to the injured tissues.
Elbow Brace: You can also wear an elbow brace to help with the prevention of further injury and to help with the healing process. The brace will apply compression and change the direction of forces allowing the injured tissue to rest.
Rest: This form of treatment cannot be emphasized enough. Continuous use of the elbow will slow down the recovery process and make it very difficult to press. Avoid gripping and lifting heavy objects to help heal.
Massage: Carefully rub across the painful area for about 5 minutes. Be sure to not press too hard. You may feel some mild pain when massaging the injured area. If the pain worsens, seek the services of a doctor to help with the treatment process.
Surgery: This is the last resort to the treatment of tennis elbow and is used in cases where the above remedies have not worked in helping the injuries heal. The injury could take up to 8 weeks to heal after surgery.
Exercises: Tennis Elbow Exercises that help with stretching and strengthening are very important to the healing process. Some people may opt to use painkillers before carrying out these tennis elbow exercises to help stay active without causing extra pain.
To help ease the pain from the injury and in some cases prevent further injury from occurring, listed below are a few exercises you can try out.
  1. Ball Squeeze
This tennis elbow exercises helps with improving your grip on objects and improving your ability to perform day to day tasks with ease. Hold the tennis ball in your hand and make a fist around it to allow you to squeeze the ball. Hold this position for about 6 seconds then relax for about 10 seconds. Repeat this process 10 times to help strengthen your muscles.
  1. Wrist Extension
While seated, hold a 2-pound dumbbell in your hand with your palm facing down. Rest your elbow on your knee comfortably. Curl your wrist towards your body to extend your wrist, then return it to the starting position. Repeat this process 10 times on each arm.
  1. Supination Exercise
Stand with your feet apart to the width of your shoulders. You can also choose to do this exercise while seated with your elbow resting on your knee. While holding a can or dumbbell, bring your arm out in front of you parallel to the floor. Rotate your palm up and then rotate it back to face the other direction. Repeat this 20 times or so for each side. You can try and isolate the movement of your lower arm by keeping your elbow very still.
  1. Triceps Stretch
Tennis Elbow Exercises
Tennis Elbow triceps Exercises
This tennis elbow exercises may be a bit difficult. Bend your arm behind your back and put some gentle pressure on your elbow using your other arm. This will help you feel the stretch. Hold this position for about 30 seconds and then release. You can do this exercise 3 times in a day to help reduce stiffness and improve your range of motion.
  1. Forearm Flexor
Sit in a chair and let your forearm lay flat on an armrest or on your thigh. Hold a 2-pound dumbbell in your hand with your palm facing upwards. Flop your wrist over the armrest or knee while holding the weight and slowly bend your wrist upwards until it is in line with your forearm. Repeat this for about 10 reps for each side, 3 times every other day.
  1. Wrist Flexion
Hold a 2-pound dumbbell while seated with your palm facing upwards and your elbow resting on your knee or on the chair’s armrest. Flex your wrist by curling it towards your body while your palm faces upwards. Return to starting position and repeat this rep about 10 times. Try to isolate wrist movement by keeping the rest of your arm very still.
  1. Towel Twist
Hold a towel with both hands while sitting on a chair with your shoulders relaxed. Twist the towel using both hands in opposite directions as if you are wringing water out of it. Repeat this process about 10 times in one direction then switch.
  1. Forearm Extensor
Raise your arm in front of you to about 90 degrees. Turn your hand so that your thumb faces downwards then bend your wrist. With your other hand grab the other fingers and slowly pull on them to increase the stretch on your forearm. Hold this position for about 30 seconds and then release. You can carry out this exercise at least twice in one day to help with improved blood flow. This will in turn help with speeding up the healing process.
Seek Medical Advice
Before starting any tennis elbow exercises, consult a doctor. Their diagnosis will help in ruling out any serious injuries. Exercises work well when the inflammation has significantly reduced as it may make the condition much worse. If you experience any pain after having done any of these exercises, use some ice to help relieve the pain, let your arm rest and consult with a doctor for better advisement.

Modifying Squats, Ankle Sprains, and Training Older Clients

Inner Circle Updates

My Last webinar recording on “5 Recommendations to Kick Start Your PT Career” is now available to watch as well. In this presentation, I talk about some of the important things that any student or new physical therapist or strength coach should focus on early in their career.  I’m amazed at some of the things I hear from students and see online.
This webinar will cover:
  • Why you shouldn’t sell your soul to one specific “system”
  • The ONE most important thing you need to work on to be effective
  • How to always be learning but also gaining skill, not just knowledge
  • Why you shouldn’t rush into starting a private practice

Not an Inner Circle Member yet?!?  In addition to these webinars and this month’s exclusive discount, Inner Circle members have access to years worth of webinars, an exclusive member-only forum to interact, and more!


The #AskMikeReinold Show

On this week’s episode of The #AskMikeReinold show we talk about quadriceps to hamstring ratio in ACL rehabilitation, the choice between a PhD and a DPT, and if we would pass the PT boards right now!
To see past episodes, subscribe, and ask us a question for the show please click below:



Elite Baseball Performance

If you have any interest in baseball performance, training, or rehabilitation, you are going to want to check out my new website at EliteBaseballPerformance.com.
The mission of the site is to provide cutting edge, but trustworthy, information to enhance baseball performance.  There’s too much crap on the internet right now about baseball.  I want to fix this and create an ultimate resource for every baseball player, parent, coach, rehab specialist, and strength specialist.
I’ve developed an amazing advisory board and contributors like Dr. James Andrews and Dr. Glenn Fleisig of ASMI, MLB players Josh Beckett and Craig Breslow, MLB athletic trainers Stan Conte and Ken Crenshaw, and other amazing people like Eric Cressey, Alan Jaeger, Paul Reddick, Lantz Wheeler and more.
We have a bunch of great articles, resources we recommend, and even some educational programs available already.

As first published on mikereinold.com

Monday, May 15, 2017

Elbow Pain

The elbow is a joint formed where three bones come together. It lets you throw, swing and lift objects. If anything happens to this joint, it could result in elbow pain.
Elbow pain is mostly as a result of over exertion. Repetitive hand or wrist movements are associated with sports, jobs and day to day tasks. If you are heavily involved in lifting objects and swinging objects such as rackets and golf clubs, you could easily be prone to experiencing elbow pain. In some other cases, elbow pain may be as a result of diseases.

Causes of Elbow Pain

Common causes of elbow pain range from diseases to fractures. The elbow is less prone to wear and tear than many other joints but is still susceptible to injury.
Some of these causes include tennis elbow, arthritis in its various forms which include rheumatoid arthritis or osteoarthritis, bursitis, a broken arm, golfer’s elbow, stress fractures, tendinitis and sprains, and strains.

Strains and Fractures

Sometimes, one could end up with a dislocated or fractured elbow. If one of the bones forming the elbow gets knocked out of place it will result in a dislocated elbow. When this occurs, it is best to consult a doctor as soon as possible.
A fractured elbow is as a result of one of the bones breaking and this will require immediate medical attention as well. Sprains and strains are also quite common causes of elbow pain. A strain is caused by a muscle tear when too much pressure is exerted onto elbow muscles when lifting objects or playing sports.

Tennis Elbow

Common diagnoses of elbow pain are tennis elbow and golfer’s elbow. This is dependent on the location of the pain. Elbow pain diagnosed as tennis elbow is a condition that can develop over time due to repetitive motions. People affected by tennis elbow include those in the professions of painting, plumbing, typing, and carpentry. People who enjoy playing tennis, squash, and weightlifting are also subject to tennis elbow. This will result in more stress applied to the tendons and could result in an injury.
Treatment of elbow pain can be simple and easy resulting in reduced pain and the ability to perform tasks with much more ease.

Diseases

An example of a disease that can cause elbow pain is arthritis. Arthritis can come in form of osteoarthritis or rheumatoid arthritis. Rheumatoid arthritis is the most common to occur in the elbow and can cause this joint to swell. Osteoarthritis occurs when a cartilage in the elbow breaks down causing the bones to rub together and this, in turn, causes pain.

Diagnosing Elbow Pain

Diagnosis is done by a medical professional through any one of the following methods: the use of CT scans, physical examination and study of medical history, x-rays, magnetic resonance imaging (MRI) and conducting a biopsy of bursa fluid.
These methods will help identify the cause of elbow pain and identify a mode of treatment to ease the pain.

Treating Elbow Pain

The steps involved in the treatment of elbow pain include identifying the location of the pain, identifying the cause and eventually seeking medical assistance to help start the healing process.
Get a head start on treating your elbow pain to prevent it from being more painful and unbearable. The treatment may involve surgery or medicine and can sometimes include simple remedies and exercises.

Exercises

Gentle stretching is one way to reduce elbow pain as long as it is done carefully. Stretching in a pain-free manner helps improve your motion overall and improves blood flow to help speed up the healing process. Perform these stretches 3-5 times in a day to reduce elbow pain. Do not rush this process. If you experience pain after stretching, use some ice to help ease the pain and put your elbow to rest.
Counterforce Braces
Elbow braces are commonly used to prevent injuries and also to help in healing elbow injuries or reducing elbow pain. These braces help in dissipating the force from the muscles before it can get to the point of elbow pain. The brace should fit accurately; it should not be too tight such that it prevents blood circulation. Acquiring an elbow brace can be upon recommendation from a doctor after diagnosis.
Numerous factors are involved when looking for elbow braces. Be sure to consider cost, fit and how they are best suited to your healing process before going out to buy one. To help with making a more informed decision, check out http://elbowpainsolutions.com/elbowpain/tennis-elbow-strap-will-work-best/.

Ice Or Heat

Placing some ice on the injured area for a period of about 15 minutes in a day can help reduce the swelling and pain. This can be done at least once a day to help with the treatment process.
Applying heat to the area affected can help improve blood flow thus speeding up the healing process. Be sure to avoid direct heat contact with the skin and instead use a hot pack. Place this around the elbow and forearm area to treat the elbow pain.

Prevention Measures

To prevent any causes of elbow pain, it is important to sometimes take breaks from repetitive tasks to help strengthen the muscles around this joint. Be sure to warm up adequately, stretch as regularly as possible and correct any wrong techniques being used during sports or when lifting objects. Consult a doctor to advise on other preventive mechanisms that you can use to help in preventing elbow pain.

Recovery

Do not rush the recovery process when healing from injuries that cause elbow pain. The extent of damage differs with each person and so does the healing rate. Once you are properly healed you should be able to lift or grip objects and even flex with much more ease and without experiencing any elbow pain. The elbow will no longer be swollen or inflamed thus signifying that you have now recovered and can return to your former level of activity. Just be sure to not over exert yourself.

Is training your rotator cuff stupid?

So right now there’s a weird trend going on in regard to shoulder rehabilitation.  For some reason I think it’s become unpopular to train the shoulder and more specifically the rotator cuff when you have shoulder pain.  Here are some trends I’m seeing going on in the blogosphere and podcastland.
  • “You need fix your breathing to get your shoulder better”
  • “The neck is the major issue and if you don’t address it your shoulder will always hurt”
  • “Your problem is obviously based in your core”
  • “Your shoulder isn’t doing it’s job because something down the chain isn’t working”
I get it, I’m a big fan of regional interdependence (How joints further from the painful area can be the cause of pain) but come on.  There is an enormous plethora of research to show that training the cuff (with basic boring exercises) is effective for rehabilitating shoulder issues.
Besides that, I think we’re confusing people.  People already have a tough time finding good therapists who can help them with their specific needs.  Now they’re looking for therapists who address breathing as a first line treatment for subacromial impingement syndrome.  I have patients coming in who have come up with all sorts of weird treatment ideas for their pain problems.
In a lot of ways I agree and I’ve probably created part of this issue myself.  Of course the core, spine, and shoulder blade is important from a rehab perspective.  In many cases a seemingly unrelated joint like the ankle can be related to someone’s pain.  Yes we need to be aware of this, but we can’t overlook the obvious.  If you’ve got a painful shoulder we can’t ignore this joint.  It’s perfectly reasonable to prescribe specific exercises for the rotator cuff and scapular stabilizers.  Honestly you could make the statement that it’s malpractice not to.  If your therapist gives you basic rotator cuff strengthening, please do it, especially if you want to get better.
Of course you’ll need to progress to harder exercises after the basic rotator cuff and scapular protocol.  You’ll also have to address any underlying movement, programming and periodization issues that are leading to continued pain.  I just think too many people are skipping the basic phase 1 exercises in favor of sexier correctives and popular trends.
Sorry for the rant but I wanted to make sure people are getting this information.  Yes, good therapists should still prescribe shoulder strengthening exercises.  If your therapist treats the shoulder directly it doesn’t mean they’re a bad therapist.  Treating local joints and looking at things like breathing and movement are definitely important still.  Just please don’t get carried away.
As first published on http://fitnesspainfree.com/

5 Reasons to Cross-Train for Race Season

April is here and preparation for race season is in full swing. Whether you love marathon, obstacle or adventure races, cross-training will add huge value to your performance. Cross-training is a broad term that can include resistance training, mobility/stretching, and low impact endurance activities such as cycling and rowing. These activities combined with running not only boosts performance but considerably reduces the overuse injuries common to runners.

Here are the top 5 reasons to add a cross-strengthening program into your training plan:
1. Greater Performance
Cross-training benefits running performance and allows for longer periods of training.  Because of the impact on your joints caused by running, few runners (especially beginners) can handle more than 6 hours of running/week without running into injury. By including low-impact endurance activities such as cycling and rowing, allows you to train twice the amount whilst improving your cardiovascular fitness.
2. Mobility
Mobility refers to the overall range of motion a joint can move through. This is more than simply flexibility (muscle length) as it also refers to how well the nervous system controls the joint/muscle.  When you have trigger points(knots) in your muscles, your control of that muscle is inhibited and stretching won’t always help. So, in addition to your stretching program, try using a foam roller and release balls to get deeper into your muscles allowing for better mobility.           Look for a restorative class in your area that uses myofascial release or a good massage always helps!
3. Strength
The key to a great performance for any athlete or weekend warrior begins with strength. Back, core and hips are among the most common areas of the body that require proper strengthening when first starting a running program. These areas often take the brunt of the impact associated with running and produce the most explosive force(hips) during an activity. Building strength initially involves lighter weight and great attention to detail as proper technique is the priority. Finding a qualified trainer to help you build a solid strength foundation will not only improve your running, but aid in post-workout recovery and injury prevention.
4.  Power
            A further benefit to strength training is improving power.  Power is your body’s ability to produce high amounts of force in short periods of time.  As a runner, by improving your power, you will also improve your stride length and efficiency thereby improving your running pace.  This can be done with HIIT (high intensity interval training) workouts defined by short, intense bursts of activity followed by a rest interval.
5. Injury Prevention
Cross-training not only prepares the body for the rigors of running, but also for what happens after. Over 50% of overuse injuries runners experience relate to a weakness in the hips (gluts mainly) thereby affecting other structures down the chain in the lower limbs ie. knees/ankles.  By strengthening the hips, core and surrounding structures, you drastically decrease your chance of injury.  We recommend starting with 1-2 low impact endurance activities per week of about an hour such as cycling to lower the impact your joints experience.
As first published on http://fitnesspainfree.com/