The Elbow


By Othon Molina, Ph.d.c, LMT

First of all I want to make it clear that this information is not to diagnose nor prescribe, and it should not take the place of the advice of your doctor. This is intended to complement conventional medicine, not to replace it. Consult with your doctor before starting any kind of nutritional or physical program.

The elbow is a rare place for an injury unless you play tennis or are a pitcher. Three bones come together in this joint; The Humerus, the ulna and the radius, as well as a capsule, and a whole bunch of ligaments. The most common injury is what they term tennis elbow, it can be on the inside (medial) or the outside of the joint (lateral). The muscles there on the lateral side are the extensors. On the medial side or inner side of the elbow are the flexors. Carpenters or tennis elbow pain runs from the elbow to the wrist at times it’s very painful. The problem with this injury is that it gets better as you play and then it gets worse again that night or the next day. You can re-injure this tissue by playing again, as it seems that it feels better when you warm up, then you feel it later.

The test

Flex the hand at the elbow, and press on the dorsal part of the hand forcing it down. This stresses the extensor muscles and the pain will be felt right at the source of the injury. Usually on the lateral side (outside) of the elbow on the radius muscle origin.

Treatment

RICE or better MICE (Movement Ice Compression and Elevation) is a good way to treat this injury. The ice bag on the elbow, and the extension and flexion of the hand will accelerate the healing. Movement is important in this injury as we want to reduce the adhesions, as these can cause further injury later. The key is to not use it in the way it was injured. Take a few weeks of your tennis game. If you re-injure the area it can take months to get better.

DTF (Deep Transverse Friction massage) is one of the best ways to accelerate the healing. It will also break up the scar tissue formation. It will keep it from healing wrong, and causing future injury. The other approach is a corticosteroid injection. It has to be injected right in the exact point or it well not be effective. If the doctor misses the spot it will return in a week or two. After the initial acute condition is over, the best way to treat this injury is to strengthen the muscles. Use some dumbbells starting with five pounds. Support your arm and elbow on a table and with your palms down, lift your hand towards the ceiling extending the hand. After a few days or a week, work up to ten pound dumbbells.

If it’s a chronic weak muscle, sometimes this can be from imbalanced muscles in the arm. Weight training is better when you use free weights. This way, all the peripheral muscles and supporting groups get strong as well. These stabilizing muscles are injured when there is a weak one in the group. Remember the weak link will always gets injured.

The other injections for unstability are proliferants or Prolo-therapy (Dextrose and lidocaine), they are good on chronic, or long term stubborn injuries. These injections will create a scar tissue to help support the elbow at the joint and will allow the body to heal the area. Also injections PRP or Ozone or Gludathione, whatever you are able to get with a holistic doc, great as some healing nutrients are always beneficial.

Inner elbow pain

Pitchers elbow or golfers elbow are common names for this injury. Even some overuse syndromes like vacuuming or house cleaning can create pain in this area. It attached to the ulna and commonly called the funny bone. Once again you may not even know what caused this injury to begin with unless you are a pitcher, tennis player, or carpenter.

Test

To test this condition you flex your hand at the wrist, and the therapists pushes on the palm of the hand, forcing it dorsally (back of the hand).

Treatment
MICE is of course the treatment of choice during the acute phase. DTF is great for this area as the muscles are easy to get to. An old injury or a chronic condition will also respond to this treatment although it will take much longer to help it get better.

A corticosteroid injection is helpful if the DTF does not make it better in a few weeks. It could take several injections to work. For the old and chronic injury proliferant injections may be necessary to strengthen this tendon.

After the acute injury phase you need to strengthen the muscles by using dumbbells to strengthen the muscles. Fix the arm resting your elbow on a table, hand the hand over the side, palm up and flex the muscles lifting the hand by bending the wrist. These exercises need to be kept up during the healing at phase two. The best would be to continue them for life, if you are doing something that stresses them to have gotten the injury then you need to keep them strong for life.

Arthritis of the elbow

Arthritis is just another form or irritation, or lack of lubrication can cause this problem. Usually injuries to the elbow can get chronic, or just worse and worse with time if not treated. This can lead to arthritis in any joint for that matter. I then becomes more and more difficult to use the elbow, even opening up a jar of peanut butter hurts. You can get this from pitching 90 mile an hour baseball or just being a housewife doing pots and pans. it’s another of life’s little mysteries why it happens.

The test

Force the elbow to bend as far as it will go, when you try to straighten it it will hurt just as bad. The ache can be constant, and of course any movement will hurt.

Treatment

If it’s a mild case aspirin will help, with the use of a sling. However if it’s not better in a couple of weeks see a doctor.

The worse thing to do again like bursitis is to massage it. It will not help, RICE will only help for a few hours, it could take months to get better on it’s own after the acute phase.

The best treatment is an injection of corticosteroid, given a few days apart for two or three treatments will do the trick. Wearing an arm sling will keep it less irritated, as movement will just increase the pain. No stretching or manipulations for this condition, you will make it worse and it will take twice as long to heal. Of course the injections PRP or Ozone or Gludathione, whatever you are able to get with a holistic doc, great as some healing nutrients are always beneficial.

 

For any questions please call:
Othon Molina Ph.D. c LMT
(909) 730-5733

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