March 2008

Metamorphic Massage Newletter

Elbow pain

Plant peas by Paddy's Day
says the Farmer's Almanac

Epicondylitis

Picture this - you've just taken a break from the computer to go and turn the soil in your garden so that you can plant your pea seeds by St. Patrick's Day. (President's Day in other parts of the country). But because you've spent so much time at the computer, and doing other "repetitive-use" activities, your elbow is painful and tender. At times, the pain radiates down into the forearm or into the upper arm.

"What is going on?" you wonder. It's epicondylitis, - also known as tennis or golfer's elbow. When a person overuses the forearm muscles, collagen breaks down in the tendon fibers that attach to the elbow, which can cause pain that radiates out from a specific point called a myofascial trigger point.

To figure that out what kind of epicondylitis you have, stand with your hands at your sides and the palms facing forward. If you feel soreness on the outside of your elbow, you have lateral epicondylitis (tennis elbow), which involves forearm extensor muscles
If you feel soreness on the inside of your elbow, you have medial epicondylitis (golfers elbow), which involves forearm flexor muscles.

How can I prevent epicondylitis?

• Do warm up stretches before sitting down at the computer or starting other tasks that use the forearms repetitively
  
• Use proper form when doing an activity (ie. good ergonomics at the keyboard)
  
• Ice your elbow after exercise or work.

How can massage therapy help epicondylitis?

Massage therapy can reduce pain by
* reducing tension in the flexor and forearm extensor muscles
* enhancing tissue mobility
* treat trigger points thus releasing the pain
* Deep friction massage can effectively treat the collagen degeneration by increasing circulation to the injured area, which helps to rebuild collagen. After the damaged fibers have healed, strength training is helpful to prevent further injury.

Massage therapy may be necessary for 4-6 weeks to bring about healing.

Other treatments that may help:

• rest or reduce activities that cause the tension
  
• do rehabilitative exercises, which can help bring about collagen repair and revascularization.
  
  Beneficial exercises include wrist extension and flexion and forearm pronation and supination. At your next appointment with Nikki, ask her to show you these exercises.
  
  
• use ice/cold packs
  
• take anti inflammatory medications- a controversial treatment because according to some practitioners, the condition rarely involves inflammation
  
• wear support bands on the forearm (some feel this is controversial because it may increase the rate of fatigue adding to the problem)
  
• surgery may be necessary if other treatments don't resolve the symptoms.

Metamorphic Massage
"where injuries are transformed into wellness"
Specializing in athletes with injuries

Nikki LMP -- provider of massage at 3 Olympic Games
WA Sports Massage Team - active member for 12 years

Hope to hear from you soon.
Nikki Nichols LMP, RN, BSN
Metamorphic Massage
206-499-4281
Nikki@metamorphicmassage.biz