Elbow pain and Chiropractic? really?
Chiropractors are MORE than just Spine Doctors
In the wonderful world of manual therapy there is much more going on than the spine. Yup, I am a Chiropractor and I did just say that, there is more to the world of mechanical dysfunction than the spine. I know I know radical thought. Traditionally Chiropractors have been known for being very Spine centric. Believe me that is still true, most Chiropractors are pretty focused on the spine and its maladies. At ChiroMEDIX we realize that sometimes people are more than just a walking spine, and sometimes there is more treatment options than a spinal adjustment. That being said the spinal adjustment is a very powerful tool, and it is the rare occasion when a spine would not benefit from an adjustment.
“Just live with it"
Recently I have had a couple of more unique people present with some unique problems. To be honest most people show up at my door with a “bad back” and after we have that figured out and we have had some time to get to know each other, they feel comfortable asking me about their nagging knee pain, elbow pain or their shoulder or even maybe their jaw. They have some hope that they might not to have “just live with” which is what many of them have been told at some point in their life.
SIDE NOTE/ RANT I hope that I survive long enough to exist in a world where there aren’t such thing as a Chiropractors office or a Medical Doctors office, a world where Doctors of Chiropractic and Medical Doctors are at the same location working alongside councilors, physiotherapist, massage therapist, acupuncturists and naturopaths. Where we realize that a whole lot of providers can and should be working together to get people better. Okay RANT over.
Have you ever walked into a Coffee table?
A couple more “exotic” conditions have walked into the clinic recently, and I thought I would take a moment to highlight one. Elbow Pain: I have had a couple of patients come in with a chief complaint of elbow pain, some with pain into the forearm, and some with pain strictly at one spot on the bone in their elbow. What is often happening with these conditions is that either a repetitive motion or an acute trauma has caused a strain into the muscles that move the wrist. When these muscles get tight enough they actually pull on the bone that they are attached to. There is a baggy that wraps around bone called the periosteum, we all know this little covering even if we don’t know the name or didn’t know that it existed until a moment ago. The periosteum is the thing that hurts when we walk into a coffee table in the middle of the night. Our shins have a very exposed bone, and an therefore an exposed periosteum and it is very well innervated which means there are lots of nerve endings. Lots of nerve endings equals a lot of PAIN.
Great, I have Tennis Elbow now what?
When we pull on the bone and its associated baggy (aka Periosteum) it gets cranky. And when it gets cranky, you get cranky. “Great I have tennis elbow (pain on the outside of the elbow) or golfers elbow (pain on the inside of the elbow) NOW WHAT?” Believe it or not there are some things that we can do to help. FIRST Dr Google is Awesome we all love it. BUT Dr Google cannot do a through exam or history to make sure that you actually have anything so bring it to your Doctor of Chiropractic. Yup I didn’t say physio (they aren’t allowed to Diagnosis anything, that’s the role of Doctors, all kinds of Doctors, Medical, Podiatric, naturopathic, Chiropractic). Chiropractic Doctors are the way to go with all things mechanical. We will make sure you have a good solid diagnosis there is nothing worse than treating something that Dr Google told you that you had, and finding out 6 months down the road that wasn’t it exactly.
An accurate Diagnosis
Okay now that you have found the right place, and we have a good solid Diagnosis of said golfers/tennis elbow (or for all you keeners out there, lateral or medial epicondylitis) NOW WHAT.
“Hey Doc, how do we fix it?”
Rest First: you have to take the pressure off of the periosteum in order to allow it to heel. You have to stop pulling on that baggy around the bone, or no matter what else you do for treatment you are going to be helping. So, how do I rest it? Good question, considering those muscles are on whenever you bend your fingers good luck trying to completely rest those muscles. I have good news (first take away the really aggravating activity for a while (no baseball bats, or golf clubs or tennis rackets or chain saws for a little while). As for all the little motions that can be agg like (typing on this keyboard writing this article.) You can use an elbow strap (here’s a picture of one). Make sure you use it correctly, there is a little bump on the inside of the strap that needs to be put in the correct spot. Okay, if it hurts when you bring your wrist backwards then you need to put it on the back of your forearm, if it hurts the when you flex your wrist then… you guessed it, on the other side of the forearm (the front). This will theoretically allow the muscles to contract and pull on the strap rather than pulling on the baggy, allowing the baggy time to heal.
Get to the Root of the problem: (let’s not chase symptoms) We need to do some work on the muscles, why are they agg? (do we need to move your keyboard, or give you a wrist support or ant vibration gloves) remove or modify the thing that caused the problem in the first place (when we talk about getting to the root of the problem this is what we mean.)
Torture: Okay okay okay, I know you already hurt. But sometimes we have to get in there and calm the muscles down. There are several ways to do this. One is as simple as ice, it will decrease the swelling and the pain a little bit. Some are a little less “simple” we need to get into the muscles and help them calm down. We use a combination of soft tissue techniques at ChiroMEDIX. I use a pin and stretch type motion where I hold the muscle and then move the muscle under my finger. This technique helps to free up anything that is causing the muscle to stick to it’s covering or baggy (kind of like the baggy around bone). I have also been trained to use a technique called GRASTON it is an instrument assisted soft tissue work. Here are some pictures of the implements of said torture (to be honest they sound worse than they are, we run them over the body to find places that feel kind of gritty or bumpy, these areas are full of scar tissue and then we rub the instrument over the area to help break down the scar tissue. One of the other things that I might employ is tape. Yup tape! We lay it down on the offending muscles, and what it does is lift the tissues. It opens up all the layers of your body underneath it, and it allows things to flow and move and clean up better.
Wrap it up already… SHEESH
So there you have it. First: get a good solid Diagnosis (NOT just Doctor Google), Second: rest the tissues (use the strap and take away the big offending actions) and Third: get some Torture… uh… I mean treatment with your local Chiropractor.
About the author
Author Dr. Spencer Devenney is a Chilliwack Chiropractor, who graduated in 2009 from the Canadian Memorial Chiropractic College (CMCC) He has a clinical interest in all things mechanical, IE his motto is if it hurts to move it bring it to your chiropractor first. He really loves to write, and has been told that he writes the way he speaks… informal and down to earth. We overheard a patient talking to her daughter and she said “I basically feel like your brother just worked on my back, He is such a nice guy”! (Don’t worry we asked her if we could quote her and she was FINE with that…)