Elbow issue...

[chrisbainbridge]

The conclusion of the study is not what the study results say. The study results say no benefit at 1 year   So how can they conclude that physio is better?

The conclusion was written to continue to allow Physio’s to treat tennis elbow despite the results. This is the problem when you want the study to support you in doing what you enjoy but the results are negative. You find a pseudo endpoint and change your final outcome.

Jakob, tennis elbow is not due to injury. Steroid injections reduce the pain but leave you on average worse off at 1 year.  I am almost at a situation where I would call a steroid or njrction for tennis elbow within 9 months of onset negligent. I no many GPs do it and are paid for it but the evidence is no longer there for any treatment.

This is true for almost all Physio actually. When you carry out good quality trials Physio is no better than placebo. Surgery for tennis elbow is almost certainly the same and for knee arthroscopy for arthritis and some shoulder conditions.

We are now looking at sham operations for many musculoskeletal conditions and I suspect we will stop a lot of operating.

[Jakob]

I'm either not being clear enough or you're deliberately misreading me.
Phsyio will make you return to activity earlier than doing nothing.

[Polar Bear]

I would suggest that physio MAY allow you to return to activity earlier than doing nothing. 

And yes, I have had injuries and physio as well as injuriez and no physio but I am a sample of 1 and statistically irrelevant.   Each incidence will be unique, obviously, including placebo reaction.

There is little substitute for properly independent peer reviewed research. 

[chrisbainbridge]

Jakob.  I am not deliberately misreading you.  Any physiotherapy exercise of any type will speed up your recovery.  It is called the placebo effect.   Our own trial which was adequately powered, and met its defined endpoints showed no difference between placebo and active treatment.  At the time of inclusion they were all awaiting surgery and 50% of them in both groups at 1 year no longer wanted surgery suggesting that tennis elbow is a self limiting/healing condition.

If you want to speed up pain relief of your tennis elbow I would suggest seeing the most highly priced therapist that you can find, who will promise to realign your chakras, stick needles in parts of your body linked to your elbow and chant mystical healing songs over you.  The cost of the therapy is very important. 

Does physiotherapy make your tennis elbow better  - No.  Does a powerful placebo effect make your tennis elbow less painful  - YES!

[Jakob]

If you want to speed up pain relief of your tennis elbow I would suggest seeing the most highly priced therapist that you can find, who will promise to realign your chakras, stick needles in parts of your body linked to your elbow and chant mystical healing songs over you.  The cost of the therapy is very important. 

Erhh, that does not sound anything like any physio I've ever met.

[rafletcher]

If you want to speed up pain relief of your tennis elbow I would suggest seeing the most highly priced therapist that you can find, who will promise to realign your chakras, stick needles in parts of your body linked to your elbow and chant mystical healing songs over you.  The cost of the therapy is very important. 

Erhh, that does not sound anything like any physio I've ever met.

But then you don’t have the advantage of being a practicing surgeon who deals with such things - or not as would seem to be the current thinking. Chris does.

[chrisbainbridge]

Quote from: chrisbainbridge on Today at 12:51:48 pm
If you want to speed up pain relief of your tennis elbow I would suggest seeing the most highly priced therapist that you can find, who will promise to realign your chakras, stick needles in parts of your body linked to your elbow and chant mystical healing songs over you.  The cost of the therapy is very important. 

Erhh, that does not sound anything like any physio I've ever met.

That would be because it is not the exercises that make the difference but the placebo effect.  The more impressive the placebo the better the effect.

[Jakob]

Quote from: chrisbainbridge on Today at 12:51:48 pm
If you want to speed up pain relief of your tennis elbow I would suggest seeing the most highly priced therapist that you can find, who will promise to realign your chakras, stick needles in parts of your body linked to your elbow and chant mystical healing songs over you.  The cost of the therapy is very important. 

Erhh, that does not sound anything like any physio I've ever met.

That would be because it is not the exercises that make the difference but the placebo effect.  The more impressive the placebo the better the effect.

Again, are you really sure you are talking about physio therapist and not chiropractors? Never had a physio even hint about 'chakras' or 'healing'.

[chrisbainbridge]

You misunderstand me, I suspect deliberately. The placebo effect I am suggesting, somewhat tongue in cheek, will be greater with my therapist.

[Andrij]

Should we form a club?  I'm just back from my GP who has confirmed tennis elbow.  Yet another reason not to like tennis! 

[andyoxon]

Should we form a club?  I'm just back from my GP who has confirmed tennis elbow.  Yet another reason not to like tennis! 

I'm not doing that well with the exercises for my rubble elbow, but managing to wear a 'counterforce' brace at work and cycling - which seems to help, but may not...   

[hellymedic]

Is 'rubble' elbow an AutoCorrect/Complete/predictive text 'feature'?

Would nonn know?

[andyoxon]

'Rubble elbow' is my concreting-breaking, DIY-fail elbow injury...   

Still doing little in the way of specific exercises, however I am consistently wearing the brace.  Possibly some improvement seen, and riding the bike is fine now (200km untested yet).