• Dr Spencer Devenney

4 Steps to Treat Tennis Elbow

Updated: Jan 28

Fixing You From Head to Toe:

Chiropractors Are More Than Just Spine Doctors


In the world of manual therapy, there is much more at play than just the spine. Traditionally chiropractors have been known to be very spine-centric. In many cases, this is still true. At ChiroMEDIX we realize that people are more than just a walking spine, and oftentimes there are more treatment options than a spinal adjustment. Although a spinal adjustment is a very powerful tool, and it is the rare occasion when a spine would not benefit from an adjustment, we need to be aware of what your body needs, from head to toe.


“Just Live With It”


I have recently had a few patients present with some unique problems. Most patients first come to me with a “bad back.” After we have their back problems under control and we have had some time to get to know each other, they feel comfortable asking me about their nagging knee pain, elbow pain, their shoulder, or maybe even their jaw. They have renewed hope that they might not have to “just live with” pain anymore.

 

Sidenote: Healthcare in Harmony


I can't wait to live in a world where Doctors of Chiropractic and Medical Doctors are at the same location working alongside counselors, physiotherapists, massage therapists, acupuncturists, and naturopaths. A whole range of health care providers working together to get people better sounds like the ultimate way to heal bodies.


Ever Walked Into a Coffee Table?


Elbow Pain. I have had a few patients come in suffering from 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 on 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 covering that wraps around a bone called the periosteum - a part we all know well, even if we don’t know the name. The periosteum is the part that hurts when we walk into a coffee table in the middle of the night.  Our shins have a very exposed bone, and therefore an exposed periosteum, and it is very well innervated which means there are lots of nerve endings. Lots of nerve endings equal a lot of PAIN.


Great, I Have Tennis Elbow. Now What?


When we pull on a bone and its associated covering (periosteum), it gets aggravated. And when it gets aggravated, you get pain. Tennis elbow is pain on the outside of the elbow and golfers elbow is pain on the inside of the elbow. If you are suffering from one of these conditions, there are some things that we can do to help. 


Step 1: Get an Accurate Diagnosis

Although Google is a great resource, it is, unfortunately, unable to do a thorough exam or medical history for you. Although physiotherapists are a great resource, they are unable to diagnose, so your first step should be to contact a doctor. They can be medical, podiatric, naturopathic, or chiropractic. In the case of tennis elbow, chiropractic doctors are the way to go, as they are able to diagnose and treat all things mechanical.


“Hey Doc, How Do We Fix It?”


Step 2: Rest

You have to take the pressure off of the periosteum in order to allow it to heal. You have to stop pulling on that baggy around the bone. How do you 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, there are ways to rest this injury. First, eliminate the obvious aggravating activity for a while - no baseball bats, golf clubs, tennis rackets, or chain saws for a little while.  Then focus on all the little motions that can be aggravating, like typing on a keyboard for example. You can even use an elbow strap. 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. If it hurts when you bring your wrist backward then you need to put it on the back of your forearm. If it hurts when you flex your wrist then put it on the other side of the forearm (the front). This theoretically allows the muscles to contract and pull on the strap rather than pulling on the baggy, allowing the periosteum time to heal.


Step 3: Get To the Root of the Problem

Let's not chase symptoms. We need to do some work on the muscles. Why are they aggravated in the first place? Do we need to move your keyboard, give you wrist support or anti-vibration gloves? Remove or modify the thing that caused the problem in the first place.


Step 4: Torture

I know you are already in pain. But sometimes we have to calm the muscles down directly. There are several ways to do this. One is as simple as ice. Ice will decrease the swelling and ease the pain a bit. Other options are a little less 'simple.' We need to get into the muscles and help them calm down. At ChiroMEDIX, we use a combination of soft tissue techniques. I use a pin and stretch motion in which I hold the muscle and then move it under my finger. This technique helps to free up anything that is causing the muscle to stick to its covering or baggy (like the baggy around the bone). 


I have also been trained to use a technique called 'Graston.' It is an instrument-assisted soft tissue work. 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. We then rub the instrument over the area to help break down the scar tissue. 


Another thing I might employ is tape. We lay it down on the offending muscles, and it lifts the tissues. It opens up all the layers of your body underneath it, and it allows things to flow, move again and clean up better.


So there you have it.  First, get a good solid diagnosis. Second, rest the tissues by using a strap and taking away offending actions. And finally, 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. His motto is 'if it hurts to move it, bring it to your chiropractor first.' 

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