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Newsletter for April 2017

Welcome to our Newsletter for April 2017
This months newsletter main topics will be about Tennis Elbow (Lateral Epicondylitis) and Golfer Eblow (Medial Epipcondylitis), which will include injury description, causes and rehabilitation techniques. It will also include information about foam rolling for every sporting and injury needs.

What is Tennis Elbow?
Tennis elbow is caused by a strain to tendons in the forearm. The most common cause is over use of the muscles which are attached to the bone at this part of the elbow especially the muscles which pull the hand backwards (wrist extensors). All the extensor muscles of the hand attach to the elbow at the outer part (the lateral epicondyle). If they are strained or over used they become inflamed, which means they are swollen, painful and tender to touch.
Rarely the inflammation comes on without any definite cause, and this may be due to an arthritis, rheumatism or gout. Sometimes the problem is partly due to a neck problem which is causing pain in the elbow via the nerves in the neck.
Activities that involve gripping and twisting of the forearm can cause this type of strain. Just because of the name tennis elbow actually in most cases aren’t actually related to tennis or any kind of exercise, it can be due to occupation or lifting.

Symptoms: These vary dependent on the severity of the injury. The outside of your elbow will feel tender to the touch, restricted elbow movements and possible swelling. You may also have pain further down your forearm. Repetitive movements of the wrist will make the pain worse.

Rehabilitation Advice:

Rehabilitation Advice: Rest the forearm muscles whenever possible. Apply the PRICE principles of protection, rest, ice, compression and elevation when the injury is acutely painful. Ice massage or ice can be used as cryotherapy to elbow. Ice should be applied for 20 mins at a time (10 mins on, 10 mins off and 10 mins off). Ice massage consists of rubbing the ice in small circles all over the affected area. Hold the plastic in place with one hand and rub the ice over it with the other hand. Continue for about 7 to 10 minutes. Make sure you apply oil to the area to reduce the risk of ice burn to the area. Do not apply ice direct to skin. Self-massage to loosen off tight extensor muscles, ask therapist how this can be applied. Stretches can be found below. Also additional help can be by using anti-inflammatories and tennis elbow supports. When the injury is not in the acute stage apply heat in combination with the ice as this will help stimulate blood flow and help reduce the inflammation. A tennis elbow brace can be worn which will help by taking the strain off the tendon by applying pressure across the muscles and changing the angle of pull on the tendon and relieving tension on the painful part of the tendon. Sports massage techniques may be applied to both the tendon and the connecting muscles. Applying sports massage to the muscles of the forearm can help reduce tension in the muscles improving their function which long term should help reduce the strain on the tendon at the elbow. In addition to this ultrasound treatment work effectively by reduce the inflammation within the tendon.

However, if tennis is your main sport and you are suffering with Tennis Elbow below these can be some factor that may need to changed within your sport.

Equipment Modifications: Using the wrong tennis racquet may have been a contributing factor to your injury. Guidelines for racquet selection for non-tournament players are provided below.

Racquet material – Graphite composites are currently considered the best in terms of torsion and vibration control.
Head size – A midsize racquet (95-110 square inches) is preferred. The popular oversized racquets cause problems because they make the arm susceptible to injury due to the increased torque effect of shots hit off-centre.
String tension – stay at the lower end of the manufacturer’s recommendation. While higher string tensions provide improved ball control, it also increases the torque and vibration experienced by the arm.
Stringing material – synthetic nylon (re-string every 6 months).
Grip size – A grip too large or too small lessens control and promotes excessive wrist movement.

Check out this literature review about tennis elbow injuries!
Golfer’s Elbow

What is Golfer’s Elbow?
Golfers Elbow is caused by repeated wrist flexion or bending the wrist, particularly against resistance such as holding a golf club. It occurs from throwing actions, as well as in occupations such like carpentry or working at a computer work station. It tends to occur after a period of repeated overuse. The tendon of the wrist flexor muscles on the inside of the elbow becomes painful and inflamed at their attachment point on the inner elbow.

Symptoms:
The main symptoms are pain and tenderness on the bony bit on the inside of the elbow called the medial epicondyle, especially when having a strong grip on an object for too long or repeatedly. There will be general weakness in the wrist and pain will be reproduced by bending the wrist palm downwards and rotating the wrist inwards. This injury usually comes on gradually over time and is uncomfortable. The injury can stem form a small niggle within the forearm or recurrent stiffness before it develops into a painful injury causing the athlete loss of function.

Rehabilitation Advice: Rest the forearm muscles whenever possible. Apply the PRICE principles of protection, rest, ice, compression and elevation when the injury is acutely painful. Ice massage or ice can be used as cryotherapy to elbow. Ice should be applied for 20 mins at a time (10 mins on, 10 mins off and 10 mins off). Ice massage consists of rubbing the ice in small circles all over the affected area. Hold the plastic in place with one hand and rub the ice over it with the other hand. Continue for about 7 to 10 minutes. Make sure you apply oil to the area to reduce the risk of ice burn to the area. Do not apply ice direct to skin. Self-massage to loosen off tight flexor muscles, ask therapist how this can be applied. Stretches can be found below. Also additional help can be by using anti-inflammatories and tennis elbow supports.
When the injury is not in the acute stages apply heat in combination with the ice as this will help stimulate blood flow and help reduce the inflammation. A tennis elbow brace can be worn which will help by taking the strain off the tendon by applying pressure across the muscles and changing the angle of pull on the tendon and relieving tension on the painful part of the tendon. Sports massage techniques may be applied to both the tendon and the connecting muscles. Applying sports massage to the muscles of the forearm can help reduce tension in the muscles improving their function which long term should help reduce the strain on the tendon at the elbow. In addition to this ultrasound treatment work effectively by reduce the inflammation within the tendon.

Foam Rolling

Foam rolling is a simple self-manual therapy technique often used to improve flexibility, recovery, and athletic performance. Though much more research is needed to clarify the effects of foam rolling, recent investigations have indicated that it is an effective method for improving flexibility, subjective markers of recovery (i.e. DOMS), and athletic performance.
Studies have suggested:

3-5 sets of 20-30 second repetitions.
3-5 times per week performed on a consistent basis to achieve and retain the chronic effects on flexibility.

Foam Rolling and Flexibility

Evidence has shown that foam rolling does improve short-term flexibility and that this improvement lasts up to, but no longer than, 10-minutes. Moreover, foam rolling has also been shown to improve long-term flexibility when it is performed on a regular basis.

Foam Rolling and Recovery
Foam rolling is to speed-up the recovery process post-exercise and reduce the effects of DOMS. However, until recent years there has been very little evidence-based information to validate the effectiveness of this technique. Recent research has demonstrated that foam rolling can reduce the sensation of DOMS following exercise. The ability of foam rolling to reduce the sensations of DOMS following exercise should suggest that this technique may serve as a valuable tool for athletes – particularly during strenuous training and competition periods.

However further research is needed around the subject needs to be explored such as:

The interaction between foam rolling, mechanoreceptors and muscle activity.
Foam rolling’s ability to improve athletic performance (i.e. jumping, sprinting, strength)
Foam rolling and recovery – its effects on subjective and objective measures.
Optimal protocols for the practical application of foam rolling (i.e. sets and repetitions).
Foam rolling’s effect upon diverse populations (i.e. genders, ages, and sporting level).

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