Tennis (Golf) Elbow and Chiropractic Care

A report on the scientific literature 


By

Mark Studin DC, FASBE (C), DAAPM, DAAMLP


"Tennis elbow [or lateral epicondylitis] is a painful condition that happens when tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm" (Mayo Clinic Staff, 2010, http://www.mayoclinic.com/health/tennis-elbow/DS00469/DSECTION=symptoms). Tennis elbow is also called "golfer's elbow" and according to Owens, Wolf, and Murphy (2009), "...has been demonstrated to occur in up to 50% of tennis players. However, this condition is not limited to tennis players and has been reported to be the result of overuse from many activities. Lateral epicondylitis is extremely common in today's active society" (http://emedicine.medscape.com/article/1231903-overview).

Owens, Wolf, and Murphy (2009) go on to explain, "Any activity involving wrist extension [upward bending] and/or supination [twisting] can be associated with overuse of the muscles originating at the lateral epicondyle [outer elbow]. Tennis has been the activity most commonly associated with the disorder. The risk of overuse injury is increased 2-3 times in players with more than 2 hours of play per week and 2-4 times in players older than 40 years. Several risk factors have been identified, including improper technique, size of racquet handle, and racquet weight [and the same holds true for any sport or activity]. For work-related lateral epicondylitis, a systematic review identified 3 risk factors: handling tools heavier than 1 kg, handling loads heavier than 20 kg at least 10 times per day, and repetitive movements for more than 2 hours per day...Patients present complaining of lateral elbow and forearm pain exacerbated by use. The typical patient is a man or woman aged 35-55 years who either is a recreational athlete or one who engages in rigorous daily activities" (http://emedicine.medscape.com/article/1231903-overview).

In tennis, the USTA (United States Tennis Association), and in golf, the PGA (Professional Golf Association), along with almost every professional sports team in the United States and internationally, now employ chiropractors as part of their medical staff. They recognize the competitive edge that it gives their players in both avoiding and treating injuries. Professional sports are a big business and the owners want to protect their investments, the players. On a daily basis, as highlighted above, many of us are exposed to the negative effects of lateral epicondylitis.

According to
Fernández-Carnero, Fernández-de-las-Peñas, & Cleland (2008),  the application of a cervical spine thrust manipulation (chiropractic adjustment) produced an immediate bilateral increase in pain pressure thresholds, or less pain at the elbow in patients with lateral epicondylitis and an increased pain free grip on the affected or painful side. The implication in sports and everyday life is that lateral epicondylitis, tennis elbow, golf elbow, packaging elbow or any other name attached to the activity causing this problem, has been clinically proven in randomized clinical trials to have positive outcomes with chiropractic care.

These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for patients with lateral epicondylitis. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.




References
1. Mayo Clinic Staff. (2010, Obtober 21). Tennis elbow, symptoms. MayoClinic.com. Retrieved from http://www.mayoclinic.com/health/tennis-elbow/DS00469/DSECTION=symptoms
2. Owens, B. D., Wolf, J. M., & Murphy, K. P. (2009, November 3). Lateral epicondylitis. emedecine from WebMD. http://emedicine.medscape.com/article/1231903-overview
3. Fernández-Carnero, J., Fernández-de-las-Peñas, C., & Cleland, J. A. (2008). Immediate hypoalgesic and motor effects after a single cervical spine manipulation in subjects with lateral epicondylalgia. Journal of Manipulative and Physiological Therapeutics, 31(9), 675-681.

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Elbow Pain (Tennis Elbow, Golf Elbow) and Chiropractic

A report on the scientific literature 



By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

 

Tennis elbow, golf elbow, shooter’s elbow "is a condition where the outer part of the elbow becomes sore and tender. It is commonly associated with playing tennis or other racquet sports, though the injury can happen to almost anybody. The condition is also known as lateral epicondylitis ("inflammation of the outside elbow bone"), a misnomer as histologic studies have shown no inflammatory process. Other descriptions for tennis elbow are lateral epicondylosis, lateral epicondylalgia, or simply lateral elbow pain...The peak incidence is between 30 and 60 years of age historically" (Wikipedia, 2010, http://en.wikipedia.org/wiki/Tennis_elbow).
 
Symptoms include pain on the outer part of the elbow (lateral epicondyle), point tenderness over the lateral epicondyle – a prominent part of the bone on the outside of the elbow, gripping and movements of the wrist hurt, especially wrist extension and lifting movements, activities that use the muscles that extend the wrist (e.g. pouring a pitcher or gallon of milk, lifting with the palm down) are characteristically painful, and morning stiffness.1
 
In December of 2008, a research article reported on the effects of chiropractic cervical manipulation (adjustment) on the pain pressure threshold, or the minimal amount of pressure to cause pain, along with grip strength, or the amount of strength in the hand. The results of the research concluded that the application of a cervical spine adjustment produced an immediate bilateral (both sides) increase in pain pressure threshold (decreased pain) and an immediate pain free grip on the affected side.2
 
This is one of the reasons that both professional golf and tennis organizations maintain chiropractors at high profile events as it is reported that the scores of the players have improved with chiropractic care. However, this also explains why chiropractic has been helping in work and at home in everyday life with a similar diagnosis.
 
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to elbow pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.com and search your state.



References:

1.  Wikipedia, The Free Encyclopedia. (2010, August). Tennis elbow. Retrieved from http://en.wikipedia.org/wiki/Tennis_elbow

2.  Fernández-Carnero, J., Fernández-de-las-Peñas, C., & Cleland, J. A. (2008). Immediate hypoalgesic and motor effects after a single cervical spine manipulation in subjects with lateral epicondylalgia, Journal of Manipulative and Physiological Therapeutics, 31(9), 675-681.

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