Author Topic: Elbow issue...  (Read 6189 times)

Elbow issue...
« on: 05 January, 2018, 03:45:31 pm »
Anyone know about elbows?  I did something to my right elbow last year while lifting/trying to break-up some heavy rubble.  I've been hoping it would just get better, but there's still an issue.

Basically, I can make a tight fist/hard grip with my arm bent (right angle) with no pain/ache, but, if I stretch my arm out straight and try to do the same, I get significant ache/'pain' at the elbow.  Sometimes repetitive finger movement can cause ache at the elbow.  If I knock my elbow on something it seems far more tender than the left elbow.  Forearm movement is Ok, without ache, but I begin to get an ache when riding (on hoods) probably because my arm is outstretched, and fingers operating shifter.

Hopefully my GP will shed some light eventually re physio etc... 3wks for appmt!
Cycle and recycle.   SS Wilson

hellymedic

  • Just do it!
Re: Elbow issue...
« Reply #1 on: 06 January, 2018, 01:48:17 pm »
The elbow's a big and complex beastie and you haven't really specified where on the elbow you are having your pain.

It's necessary to cock the wrist back (extend it) to make a good grip, as well as to curl up (flex) the fingers.

The extensor muscles attach to a 'common extensor origin' on the outside (lateral aspect) of the humerus. Pain at this point is commonly known as 'tennis elbow' and I guess this might be your problem.

The flexor muscles attach to a 'common flexor origin' on the inside (medial aspect) of the humerus at the elbow. Pain here is known as 'golfers' elbow' but people who suffer these woes do not necessarily partake of these (or any) sports.

Re: Elbow issue...
« Reply #2 on: 06 January, 2018, 02:26:18 pm »
As Helly says , not really enough info but my 10pence would be on laterl epicondylitis (TE).  This is a middle aged degenerative condition that occurs spontaneously and is not caused by work or activities. 

Physio or stretches on google will help but it generally settles over 12-18 months.  Patient who have steroid injections are more likely to have long term severe problems so avoid the steroid injections!

Remember your GP gets paid extra for every steroid injection.  If he offers you one ask them to share the profit with you and let us know their response!

Re: Elbow issue...
« Reply #3 on: 07 January, 2018, 09:46:35 am »
Thanks helly & chris.  If I outstretch my right arm and make a fist, in a kind of superman pose, so that the back of my hand is pointing up - the ache is in outside area of the elbow to the right and below the muscle (nr elbow) on top off my arm.  If I put my forearm at right angles to my bicep (with no ache when I make fist), this would be around the boney top, outer 'corner' of the elbow.  Someone at work suggested I could try doing orange squeezing (/stress ball) exercises??  Thanks for the info on steroids.  Is it reasonable for GP to send me for x-ray, and or physio?
Cycle and recycle.   SS Wilson

hellymedic

  • Just do it!
Re: Elbow issue...
« Reply #4 on: 07 January, 2018, 01:19:34 pm »
I don't think X-rays are helpful. Physio might be.

Re: Elbow issue...
« Reply #5 on: 07 January, 2018, 02:35:58 pm »
Sounds like tennis elbow.  I would find an epicondylitis clasp on amazon as a start and then look for stretches to relax the area.

Re: Elbow issue...
« Reply #6 on: 08 January, 2018, 06:58:59 pm »
Thanks, now trying a counterforce elbow brace and some exercises (without brace)...
Cycle and recycle.   SS Wilson

Re: Elbow issue...
« Reply #7 on: 16 January, 2018, 11:40:20 am »
I saw the GP, and then the surgery's physio.  Tennis elbow.  Basically treatment regime suggested is -  massage ibuprofen gel into area morning & evening, also ice pack (peas) each day 2x10mins, and these exercises https://www.arthritisresearchuk.org/arthritis-information/exercises-to-manage-pain/tennis-elbow-exercises.aspx  with the wrist flex every 1-2hrs.  Also, wear the 'elbow' brace at work/when using PC mouse, and cycling etc. 
Cycle and recycle.   SS Wilson

Re: Elbow issue...
« Reply #8 on: 17 January, 2018, 06:03:06 pm »
There is absolutely no evidence that Physio is of any benefit in altering the rate of recovery.

Re: Elbow issue...
« Reply #9 on: 17 January, 2018, 07:08:51 pm »
Ok, interesting. 

Found this from World J Orthop

Quote
Lateral elbow tendinopathy (LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation.

Perhaps ice packs, support braces, and massaging NSAIDs count as other 'modalities'...  I guess this is not exactly difficult to do, so if the TE is not serious, and if there's a chance it helps on top of simply time elapsed and resting...

I did wonder on the best order to do neurofen/exercises/ice pack - perhaps it makes no diffs then.
Cycle and recycle.   SS Wilson

Nelson Longflap

  • Riding a bike is meant to be easy ...
Re: Elbow issue...
« Reply #10 on: 17 January, 2018, 11:12:13 pm »
I *believe* the Chinese name for tennis elbow is "fifty year old elbow" (can a Mandarin speaker here confirm that?) And coincidentally (or not) I had TE at around that age. It disappeared spontaneously after about twelve months or so ...

Does your age profile match the Chinese name Andy?
The worst thing you can do for your health is NOT ride a bike

hellymedic

  • Just do it!
Re: Elbow issue...
« Reply #11 on: 17 January, 2018, 11:39:35 pm »
I *believe* the Chinese name for tennis elbow is "fifty year old elbow" (can a Mandarin speaker here confirm that?) And coincidentally (or not) I had TE at around that age. It disappeared spontaneously after about twelve months or so ...

Does your age profile match the Chinese name Andy?

Partner had golfer's elbow at 51...

Re: Elbow issue...
« Reply #12 on: 18 January, 2018, 01:09:19 am »
Re Chinese for Tennis elbow, I looked it up, the Mandarin version is 肱骨外上髁炎, something like outer humerus inflammation, or 网球肘 which is a literal translation of tennis elbow.

Re: Elbow issue...
« Reply #13 on: 18 January, 2018, 03:48:23 am »
There is absolutely no evidence that Physio is of any benefit in altering the rate of recovery.

Huh? Granted a biased source. but still
https://torontophysiotherapy.ca/physiotherapy-for-tennis-elbow/

Re: Elbow issue...
« Reply #14 on: 18 January, 2018, 10:23:36 am »
Ok we need to look at the quality of the evidence. Level one evidence shows no benefit to therapy.

Re: Elbow issue...
« Reply #15 on: 18 January, 2018, 10:51:25 am »
I'm of that age...    In hindsight I would probably have come away with TE even at 10-20 years younger, given the number of times I lifted the heavy concrete block above my shoulder height, to break large slab of concrete (raised at each end) - which I didn't realise was reinforced.  Wrong tool  for the job.   :-\
Cycle and recycle.   SS Wilson

Re: Elbow issue...
« Reply #16 on: 18 January, 2018, 06:26:20 pm »
Ok we need to look at the quality of the evidence. Level one evidence shows no benefit to therapy.

What evidence?

BrianI

  • Is it a bird? Is it a plane? No, it's Lepidopterist Man!
Re: Elbow issue...
« Reply #17 on: 19 January, 2018, 06:51:40 am »
There is absolutely no evidence that Physio is of any benefit in altering the rate of recovery.
Sources and citations to back this claim up? And don't say "Google it" in a typical Flat Earther's response....  😋

CrinklyLion

  • The one with devious, cake-pushing ways....
Re: Elbow issue...
« Reply #18 on: 19 January, 2018, 07:42:46 am »
I believe, although I could be wrong, that this is chrisbainbridge's area of professional expertise.

Re: Elbow issue...
« Reply #19 on: 19 January, 2018, 09:01:31 am »
This was probably the first to show no real difference in the long term
http://www.bmj.com/content/333/7575/939

Re: Elbow issue...
« Reply #20 on: 19 January, 2018, 09:13:48 am »
This was probably the first to show no real difference in the long term
http://www.bmj.com/content/333/7575/939
That study doesn't back up your first statement, Chris.

Quote
Physiotherapy was superior to wait and see in the short term; no difference was seen at 52 weeks, when most participants in both groups reported a successful outcome. Participants who had physiotherapy sought less additional treatment, such as non-steroidal anti-inflammatory drugs, than did participants who had wait and see or injections.
<i>Marmite slave</i>

Re: Elbow issue...
« Reply #21 on: 19 January, 2018, 09:25:31 am »
Charly, I am on holiday so posting on a phone so the posts are relatively short. The benefit at 52 weeks was zero. The reduction in use of NSAIDS, etc by the Physio group was small and probably a placebo effect from having hands laid on you.

The evidence from the placebo effect is strongly suggested by the evidence that there is no difference between any of the exercise regimes. These include neck manipulation!!

I will rephrase the statement to “there is no evidence that any particular set of exercises has any beneficial effect in the long term and that the short term benefit is almost certainly placebo.”

Re: Elbow issue...
« Reply #22 on: 19 January, 2018, 09:37:32 am »
Ok, I accept that this is your area of expertise, but the study does not agree with your statements

The study's conclusion was:
Quote
Physiotherapy combining elbow manipulation and exercise has a superior benefit to wait and see in the first six weeks and to corticosteroid injections after six weeks, providing a reasonable alternative to injections in the mid to long term.

I agree that the study is flawed in that it did not exclude pure placebo effect (there should have been a fourth group, where the participants received 'treatment' that amounted to consultation time and someone inspecting and touching their elbow).
<i>Marmite slave</i>

Nelson Longflap

  • Riding a bike is meant to be easy ...
Re: Elbow issue...
« Reply #23 on: 19 January, 2018, 07:32:41 pm »
Re Chinese for Tennis elbow, I looked it up, the Mandarin version is 肱骨外上髁炎, something like outer humerus inflammation, or 网球肘 which is a literal translation of tennis elbow.
Thanks Gerald.

I have to own up to spreading fake news ... in fact I've no idea about the Chinese for tennis elbow, my post above was faulty recollection of "fifty year old shoulder" as the Chinese for "frozen shoulder" ... which leads us off-topic.   :facepalm:

I don't know the Chinese for "muddled memory" either.
The worst thing you can do for your health is NOT ride a bike

Re: Elbow issue...
« Reply #24 on: 19 January, 2018, 09:59:58 pm »
Charly, I am on holiday so posting on a phone so the posts are relatively short. The benefit at 52 weeks was zero. The reduction in use of NSAIDS, etc by the Physio group was small and probably a placebo effect from having hands laid on you.

The evidence from the placebo effect is strongly suggested by the evidence that there is no difference between any of the exercise regimes. These include neck manipulation!!

I will rephrase the statement to “there is no evidence that any particular set of exercises has any beneficial effect in the long term and that the short term benefit is almost certainly placebo.”
That study was referenced in the article I posted earlier.
I'm curious...have you ever been injured?. Because I would much rather get treated and back to training quicker, than wait an undetermined amount of time. I've had plenty of minor injuries that would most likely have healed on their own, but have used physio to speed up and monitor the healing process.
Had the study been on say, 2 months, it might have been valid, but a year?
The only real conclusion from the study is that corticosteroid works but causes people to re-injure themselves.