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Lateral Epicondylitis or Tennis Elbow Treatment

January 13, 2020

>>Carson: Today we are going to talk about
lateral epicondylitis and treatment with it. Lateral epicondylitis also known as tennis
elbow is an irritation of the muscle tendon junction up on the outside of your elbow.
The red is the muscle the white is the tendon. We see that those extensor muscles start up
by the bone be coming in the muscle and then have that long tendon down to the hand and
the wrist. They end up working at your grip and grabbing like taking a door handle and
turning. You can feel those muscles contract. Most people tend to get that irritation right
up in that tendon. A little bit of muscle, a lot of that tendon, and sometimes it will
wrap right back down to the spot to be the most painful. Things that we want to do is decrease the
pain and the inflammation first, we’re going to work at getting the flexibility back in
that arm so it is not just that tightness that you feel, and we are going to break up
some of that scar tissue that we have around the elbow. To do that, we’re going to sacrifice
our intern’s elbow. Alex, if you can come here a second. Some different treatments that we have for
someone who’s got little lateral epicondylitis. If he’s a regular, good patient, we put a
paper towel right here to make sure we do not get coco butter on his sleeve, but he’s
the intern. A couple of different techniques we can use
– one is a form of deep muscle work or ART where we’re sliding on the skin to help getting
a good hold of that muscle tendon junction and breaking it up. He’s going to help me
by straightening his elbow. Nice slow control as I come right up to that thing and slide
along. He’s going to feel a little tightness and irritation in that spot. We’re very frequently going to start the treatment
by putting some ice and electric or heat and electric to soften the area up first. Some
days we’re going to use more massage therapy on this whole lower arm and upper arm to help
loosen up those muscles that much better and quicker. How’s that spot?>>Alex: Pretty good.>>Carson: Pretty good? Is that the winner
right there? Come on straighten the arm. It doesn’t hurt, does it?>>Alex: Not at all.>>Carson: Good, because once again, we don’t
care. The next thing that we are going to do is we’re going to use Graston Technique
to help slide along and break up some more of the scar tissue in the muscles and tendons. What I feel as I slide along are these small
little bumps. That’s that scar tissue through there. Can you feel that? What does it feel
like?>>Alex: It’s just like you’re scrapping across
a dirt road or something or gravel.>>Carson: Yeah. It’s got that little gritty
feeling. Right in through there is a pretty good little spot. Anybody who uses their arms a lot tends to
have scar tissue through those muscles in the forearm as we come up closer to that tendon,
that white spot where it attaches to the bone, it’s probably going to get a little bit more
tender for him. How am I doing right there?>>Alex: Good.>>Carson: Like I said, if he was a patient,
we’d say keep it comfortably tolerable. And comfortably tolerable, we define as a three
or four at a scale of ten. If you are biting your lip, that ends up being too much. How am I doing?>>Alex: Good.>>Carson: Three or four?>>Alex: Sure.>>Carson: Sure? Is that a “sure” because
you know I’m not going to let it lighten up?>>Alex: Yes.>>Carson: Okay. Right there I’ve got that
spot. It’s nice and sore. I can feel a big bump slipping over, and it is probably the
spot that he’s getting some of this pain at. As we break up that scar tissue, we’re going
to have little healing cells come in to help speed up the recovery on that little guy.
We’re going to break up those mounds of scar tissue – there we go – that contribute to
more of that pain and discomfort. How are we doing?>>Alex: Good.>>Carson: Great. Now can you really straighten
that arm for me? Pull it down as I stretch it. Now it opens that spot up a little bit
more and then I get my little favorite one right there where it [inaudible] sometimes
that tendon as it wraps around the bone, it’s a little bit more tender. He’s got that same
spot right there too. Most times when people have some pain, discomfort
on the lateral epicondyle, they also get some on the medial, so we’d end up working that
in the treatment cycle too. After we’re done with Graston, we’re going to decrease that
pain and irritation with an ice pack for 15 minutes. We’re going to have them iced several
more times tonight at home and work on stretching the forearm of both the wrist flexors and
extensors trying to loosen this area up and get that flexibility back to where it should

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