New Tennis Elbow Treatment

[dowjones]

Passing along info...DJ

From http://www.featureblog.com/blogs/tennis/

Shockwaves Serve Up Tennis Elbow Relief by ARA

(ARA) - A new medical device is offering a means for Americans to keep the ball in their court when it comes to tennis elbow pain. Nine million Americans suffer from the condition, which results from on-the-job as well as sports injuries. Tennis elbow's hallmark symptoms include nagging pain, difficulty extending the arm and grasping objects. It is caused by stress of the tendon attached to the bone of the lateral or outer portion of the elbow. In the past, chronic sufferers used either passive therapy or aggressive surgical solutions that yielded somewhat unsatisfactory results. Passive means of addressing tennis elbow pain include the use of braces, non-steroidal anti-inflammatory drugs (Advil, Motrin, aspirin, etc.), rest and physical therapy. More aggressive treatments have utilized anything from steroid injections to invasive surgery. The problem? These treatments offer varying degrees of success, many can be painful and almost all require more recovery time (and hence more money) than most patients anticipate. Earlier this year the U.S. Food and Drug Administration (FDA) granted approval of the first high energy single application Extracorporeal Shock Wave system for treatment of tennis elbow. The device, called the OssaTron, has been providing a non-invasive surgical treatment for approved orthopedic conditions like heel pain. Now people who suffer from chronic tennis elbow have access to the same treatment relief. How does it work? The OssaTron procedure delivers electrohydraulic high-energy shock waves (similar to those used to treat kidney stones) to the damaged tissue. This increases blood flow, reduces inflammation and ultimately stimulates healing. FDA-sanctioned studies have indicated that electrohydraulic shock wave systems like the OssaTron are highly effective. In a recent study, 90 percent of patients received a benefit from the treatment and 64 percent had an excellent or good outcome with a single OssaTron treatment. "The burdens associated with elbow splints, arduous rehabilitation programs and long healing periods are lessened with noninvasive surgical procedures such as the OssaTron," said Dr. Evan Collins, Baylor orthopedic surgeon. "The procedure is efficient and offers patients quick relief without the potential complications associated with invasive surgery." Tennis elbow sufferers can learn more by calling (888) 969-4335, or by visiting www.healthtronics.com. Courtesy of ARA Content About the author: Courtesy of ARA Content

 

[jc_rex]

good read! the effects though (the increased circulation and decreased inflammation) are similar to the effects of ultrasound therapy we use in most clinics for treatment of acute tennis elbow.. it would be interesting to see how this compares to that...

 

[LuckyR]

I can buy this from alogic standpoint. It confirms my own experience in getting rid of TE w/ weight training...

 

[heycal]

I can buy this from alogic standpoint. It confirms my own experience in getting rid of TE w/ weight training...

What was your weight training routine to to get rid of TE?

Also, what would be the connection between weight training and what this article is talking about?

 

[LuckyR]

What was your weight training routine to to get rid of TE?

Also, what would be the connection between weight training and what this article is talking about?

I used freeweights and did wrist curls and regular curls. The article notes the increased blood flow from the "shock waves". Well, they don't mention it directly but my reading between the lines is that the shock waves destroy tissue at a microscopic level and the body's repair mechanism increases blood flow to effect the repair, and perhaps repair the TE as well.

Weight use is considered to also do microscopic muscle damage and the repair leads to bigger and stronger muscles as well as greater blood flow.

 

[heycal]

I used freeweights and did wrist curls and regular curls. The article notes the increased blood flow from the "shock waves". Well, they don't mention it directly but my reading between the lines is that the shock waves destroy tissue at a microscopic level and the body's repair mechanism increases blood flow to effect the repair, and perhaps repair the TE as well.

Weight use is considered to also do microscopic muscle damage and the repair leads to bigger and stronger muscles as well as greater blood flow.

Can you tell us how many curls, what type, what weight, for how long/often, cured the TE? What was your recipe for success?

 

[LuckyR]

Can you tell us how many curls, what type, what weight, for how long/often, cured the TE? What was your recipe for success?

I don't necessarily have a lot of upper body strength (although I have a very strong grip), think Davydenko...

I used a set of dumbells from 15 - 35 pounds. I used the higher weights for wrist curls, 2 - 4 sets of 10 - 12 reps (to failure). And the medium weights same sets and reps for regular curls. I did it every other night for about 1 1/2 - 2 weeks. That is when I noticed my arm pain (when not playing) was gone.

I used racquet switching and string switching (no change in tension, I string kind of high at 60#s) to get the arm pain to go away when playing.

 

[chess9]

I don't necessarily have a lot of upper body strength (although I have a very strong grip), think Davydenko...

I used a set of dumbells from 15 - 35 pounds. I used the higher weights for wrist curls, 2 - 4 sets of 10 - 12 reps (to failure). And the medium weights same sets and reps for regular curls. I did it every other night for about 1 1/2 - 2 weeks. That is when I noticed my arm pain (when not playing) was gone.

I used racquet switching and string switching (no change in tension, I string kind of high at 60#s) to get the arm pain to go away when playing.

The conventional wisdom is that ligaments and tendons cannot be strengthened because they have no blood supply. However, there are some who think that prolotherapy works by raising collagen levels in the L & Ts. Frankly, I'm skeptical, but would like to think that lifting has, by some indirect mechanism, an effect on the ligaments and tendons. I've lifted for years and have few tendon and ligament problems compared to my peers. Maybe I'm just lucky....

-Robert

 

[LuckyR]

The conventional wisdom is that ligaments and tendons cannot be strengthened because they have no blood supply. However, there are some who think that prolotherapy works by raising collagen levels in the L & Ts. Frankly, I'm skeptical, but would like to think that lifting has, by some indirect mechanism, an effect on the ligaments and tendons. I've lifted for years and have few tendon and ligament problems compared to my peers. Maybe I'm just lucky....

-Robert

Hey I just report the news...

 

[heycal]

I don't necessarily have a lot of upper body strength (although I have a very strong grip), think Davydenko...

I used a set of dumbells from 15 - 35 pounds. I used the higher weights for wrist curls, 2 - 4 sets of 10 - 12 reps (to failure). And the medium weights same sets and reps for regular curls. I did it every other night for about 1 1/2 - 2 weeks. That is when I noticed my arm pain (when not playing) was gone.

Davydenko? Try Schwarznegger. You're implying you do wrist curls with 35 lb weights? I'm only up to 15 lbs pain free... (I do about 50 reps, every day, having gotten the notion somewhere that lower weight/higher reps on a daily basis is best for TE.)

Also, why higher weight for wrist curls than bicep curls? Isn't that kind of backwards?

Either way, if you could cure your TE pain in less than 2 weeks from weight training, sounds like you caught it in the early stages.

The conventional wisdom is that ligaments and tendons cannot be strengthened because they have no blood supply. However, there are some who think that prolotherapy works by raising collagen levels in the L & Ts. Frankly, I'm skeptical, but would like to think that lifting has, by some indirect mechanism, an effect on the ligaments and tendons. I've lifted for years and have few tendon and ligament problems compared to my peers. Maybe I'm just lucky....

But isn't it common to prescribe stengthening exercises for TE sufferers, and aren't there many like LuckyR who report good results with it?

As for weight training in general, in my own case I think swinging around dumbbells for years made my forearms/elbow vulnerable to TE -- in fact, I think I had a touch of TE from weight lifting even before I started playing tennis again regularly. And now I can't lift hardly at all, and things like chin-ups have become real elbow killers.

 

[LuckyR]

Davydenko? Try Schwarznegger. You're implying you do wrist curls with 35 lb weights? I'm only up to 15 lbs pain free... (I do about 50 reps, every day, having gotten the notion somewhere that lower weight/higher reps on a daily basis is best for TE.)

Also, why higher weight for wrist curls than bicep curls? Isn't that kind of backwards?

Either way, if you could cure your TE pain in less than 2 weeks from weight training, sounds like you caught it in the early stages.



But isn't it common to prescribe stengthening exercises for TE sufferers, and aren't there many like LuckyR who report good results with it?

As for weight training in general, in my own case I think swinging around dumbbells for years made my forearms/elbow vulnerable to TE -- in fact, I think I had a touch of TE from weight lifting even before I started playing tennis again regularly. And now I can't lift hardly at all, and things like chin-ups have become real elbow killers.

Of course I had to work up to the 35#s. I probably started at 20 or 25#s. Also remember I was going to failure in 10 - 12 reps. If you are doing 50 (I bet not to failure) then you can clearly up your weight right now, without any increased strength.

You referred to high reps, low weight, that is for increased stamina, in my understanding. I was going for more bulk (I use the work "bulk" loosely). That is what I was referring to in my OP, comparing it to the article that was posted. BTW that is also the reason for the every other day regimen.

For me, I can lift a lot more with wrist curls than regular curls, since my hand is a lot shorter than my forearm, so I have a lot more leverage (I did mention that my arms look like Davydenko...).

Also as far as the time to painfree, remember I am taking about pain when not playing tennis. Painful strokes took longer and required an equipment change.

As to your experience with regular weight training, it doesn't suprose me at all since extra strain on your arm could predispose you to overuse. A friend of mine who is a Family Practitioner is fond of saying that he sees TE "every single day, but never from playing tennis..."

Good luck!

 

[chess9]

"But isn't it common to prescribe stengthening exercises for TE sufferers, and aren't there many like LuckyR who report good results with it?

As for weight training in general, in my own case I think swinging around dumbbells for years made my forearms/elbow vulnerable to TE -- in fact, I think I had a touch of TE from weight lifting even before I started playing tennis again regularly. And now I can't lift hardly at all, and things like chin-ups have become real elbow killers.[/QUOTE]


Oh, yes, lots of lifters get GE and TE from overdoing it. My lifting partner has a sore left elbow right now from doing a heavy dumbbell curl routine last week. He can barely tie his shoes right now.

I don't know if lifting aids TE. That sounds controversial, and we never do controversial here.

-Robert

 

[rasajadad]

In my recovery from TE, both my PT and an athletic trainer (that my Orthopedic surgeon referred me to) had me lift. Both confirmed it was to "strenthen surrounding and supporting muscles." I did notice that after lifting, my elbow felt better. I attributed this to the increased bloodflow in the area. Now I bring thera-bands to the court to get warmed up pre-match.

 

[tricky]

Frankly, I'm skeptical, but would like to think that lifting has, by some indirect mechanism, an effect on the ligaments and tendons. I've lifted for years and have few tendon and ligament problems compared to my peers. Maybe I'm just lucky....

It's not really the blood flow, but the lactic acid produced from lifting high reps with light weight (i.e. hypoxic stress from ATP.) Pooling lactic acid into the area around the tendons/ligaments stimulates collagen synthesis (i.e. similar application is used in some cosmetics and wound healing models.) The more often this is done (at least 3x-a-week, but it can be done everyday), the quicker the tendons/ligaments rebuilds.

If you're feeling very mild tendonitis, you would want to use very light weights and just work 20-100 reps with intermittent breaks. If you do curling movements, it's actually better to just limit the ROM toward flexion (i.e. each rep is kind of a "pumping" action.) First, it creates the burn quicker (and the burn is the actual stimualtor.) Second, limiting the stretch imposes less possible damage to the tissue. Again, this mechanism is nothing like what goes on for stimulating muscle or getting stronger.

For people who lift heavy, it's a good idea to finish off the heavy work sets with a 10-15 set that causes a lot of burn. And it's good to do this at least two to three times a week, so that future tendonitis is mostly avoided. Bart Starr, inventor of 5x5, recommended exactly that to avoid injuries.

 

[heycal]

I don't know if lifting aids TE. That sounds controversial, and we never do controversial here.

I think it depends on how we define "lifting". I definetely hastened my TE by working out with free weights for several years, yet wrist curls using small weights is often prescribed to TE sufferers to increase their strength.

So I guess I'm trying to cure an injury that was partially induced by weight training by... weight training. Hmm....

 

[Ulam]

The OssaTron procedure delivers electrohydraulic high-energy shock waves (similar to those used to treat kidney stones) to the damaged tissue.

Does it break up kidney stones? If so, will it break up tissue scar?

 

[LuckyR]

Does it break up kidney stones? If so, will it break up tissue scar?

Unlikely, since kidney stones are literally rocks ie brittle and even the most dense scar tissue is, well, tissue...