Find information on thousands of medical conditions and prescription drugs.

Epicondylitis

Tennis elbow (or lateral epicondylitis -- lat. epicondylitis lateralis humeri) is a condition where the outer part of the elbow becomes painful and tender, usually as a result of a specific strain or overuse. While it is called tennis elbow, it should be noted that it is by no means restricted to tennis players. Anyone who does a lot of work involving lifting at the elbow or repetitive movements at the wrist is susceptible to tennis elbow. more...

Home
Diseases
A
B
C
D
E
Ebola hemorrhagic fever
Ebstein's anomaly
Eclampsia
Ectodermal Dysplasia
Ectopic pregnancy
Ectrodactyly
Edwards syndrome
Ehlers-Danlos syndrome
Ehrlichiosis
Eisoptrophobia
Elective mutism
Electrophobia
Elephantiasis
Ellis-Van Creveld syndrome
Emetophobia
Emphysema
Encephalitis
Encephalitis lethargica
Encephalocele
Encephalomyelitis
Encephalomyelitis, Myalgic
Endocarditis
Endocarditis, infective
Endometriosis
Endomyocardial fibrosis
Enetophobia
Enterobiasis
Eosinophilia-myalgia...
Eosinophilic fasciitis
Eosophobia
Ependymoma
Epicondylitis
Epidermolysis bullosa
Epidermolytic hyperkeratosis
Epididymitis
Epilepsy
Epiphyseal stippling...
Epistaxiophobia
EPP (erythropoietic...
Epstein barr virus...
Equinophobia
Ergophobia
Erysipelas
Erythema multiforme
Erythermalgia
Erythroblastopenia
Erythromelalgia
Erythroplakia
Erythropoietic...
Esophageal atresia
Esophageal varices
Esotropia
Essential hypertension
Essential thrombocythemia
Essential thrombocytopenia
Essential thrombocytosis
Euphobia
Evan's syndrome
Ewing's Sarcoma
Exencephaly
Exophthalmos
Exostoses
Exploding head syndrome
Hereditary Multiple...
Hereditary Multiple...
Hereditary Multiple...
Hereditary Multiple...
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Medicines

With tennis elbow, the common extensor tendon origin at the lateral epicondyle of the humerus is irritated, inflamed, damaged and potentionally torn.

In the case of tennis elbow, most tennis players with harder, more forceful serves feel gradually worsening pain after ten to twenty serves have been hit. The stress on the elbow can be great due to the centrifugal force applied to it. This force can, over a short period of minutes, develop into the specific problem known as tennis elbow.

Symptoms

  • Outer part of elbow (lateral epicondyle) tender to touch.
  • Lateral elbow pain radiating to extensor aspect of the forearm.
  • Movements of the elbow or wrist hurt, especially lifting movements.
  • Exquiste tenderness to touch, and elbow pain on simple actions such as lifting up a cup of coffee.
  • Pain usually subsides overnight.
  • If no treatment given, can become chronic and more difficult to erradicate.

Treatment

Rest and ice are the treatment of choice. Stretches and stengthining excercises are essential to prevent re-irritation of the tendon. Acupuncture has been proven to be beneficial. With physiotherapy, Ultrasound can be used to reduce the inflamation. Manual therapy (a form of physiotherapy) is an important part of the treatment; it helps to relieve the muscle spasm and helps to stretch out the tightened tissues.

As a last resort, intra-articular steroid injections can give symptomatic relief for a period of time. Splints may be helpful if the tendon is torn. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce pain, and inflamation. If conservative measures fail, release of the common extensor origin may be helpful.

Although not necessarily founded in clinical research, the tennis player's treatment of choice is frequent icing for inflammation, and taking ibuprofen, itself an anti-inflamatory agent.

Read more at Wikipedia.org


[List your site here Free!]


Championship Chiropractic
From Dynamic Chiropractic, 6/18/05 by Devitt, Michael

An Interview With Michael Miller, DC

Almost a quarter-century ago, Dr. Michael Miller became the official chiropractor of the New England Patriots. Since that time, he's treated hundreds of players, watched ownership of the team change hands three times, and seen the Patriots go from one of the worst franchises in the National Football League to a team for the ages, winning three of the past four Super Bowls - including a 24-21 victory over the Philadelphia Eagles in Super Bowl XXXIX in February 2005.

In this exclusive interview with Dynamic Chiropractic, Dr. Miller provides some insight into what it's like to provide chiropractic care to the NFL elite.

DC: How did you first get involved with the Patriots? Did you have any experience with other sports teams before you started working with them?

MM: They were basically the first professional team that I began working with. It began when they introduced me to a few players who had nagging injuries and were slow to respond to conventional medical treatment. They asked me if I could take a look at some of the players and see if there was some way I could rehabilitate them.

The first player who came into contact with our offices was Rick Sanford, a defensive back. That was 24 years ago. He played for the team for seven years. We were able to get him back into perfect playing form, and as a result of him being impressed with the results he had with chiropractic care, when he left professional football, we were able to influence him into becoming a chiropractor. He's one of a few NFL players who have become chiropractors. He's a chiropractic physician in South Carolina now.

I've been the official chiropractor for 24 years now. Of the 32 NFL teams, there are approximately 27 chiropractors associated with teams at this time. Some have official status; others are consultants or see players on an asneeded basis.

DC: Do you travel with the Patriots during road games, or do you just work at home games at Gillette Stadium?

MM: My position with the Patriots involves me being present during minicamps, training camp, preseason games, regular-season games (both home and away), and postseason games.

DC: Did you get to go to the Super Bowl? What was that experience like?

MM: The first Super Bowl win following the 2001 season was the most exhilarating and exciting one for me, only because I had been working with the team for many years, and I had experienced two championship seasons where we won the AFC [conference championship], but did not win the Super Bowl. [The first Super Bowl win] climaxed at the end, with Adam Vinatieri's field goal winning it in the last few seconds.

It was very exciting. Emotionally, it's something that can only be likened to the emotional feeling on my wedding day, or at the birth of my children. It brought tears to my eyes just to be able to jump up in the air and know we'd finally won the biggest event the NFL sponsors. Since then, we've won two other Super Bowl championships. The Kraft family [the team owners] has done everything in its power to offer the players any benefits they can as far as treatments or anything they feel would be beneficial to the players becoming successful on the field. [They] decided a chiropractor should go on road trips with the team. With the presence of chiropractic, in the case of someone who was having musculoskeletal problems, you could address the situation on the field, see the player in the locker room, before, during or after the game, and the rehabilitation process would allow the player to remain active and become a contributing force on the team.

As a matter of fact, as a result of that, Romeo Crennel, who was the defensive coordinator for the Patriots and just became head coach of the Cleveland Browns, informed the chiropractor on [the Browns] that he now expects him to go on road trips with the team, as the Patriots have done. [Romeo] felt that the Patriots' head coach knew and understood that this is an important force to be dealt with, and that it gave an edge over other teams that didn't use chiropractors on their away games.

DC: When did you start going on road games with the team?

MM: Approximately 10-11 years ago.

DC: On average, how many players do you treat in a given week during the regular season? Do you also see any players between games?

MM: During the games, I see an average of at least 40 players, coaches, and other personnel who are affiliated with the team. I would say just about 90 percent get chiropractic services, because the present coaching staff of the Patriots has almost mandated chiropractic care with the players. The coaches speak about it at team meetings, as the new players and rookies come into the team in the preseason. During mini-camps, they explain the significance of chiropractic, and that we have a chiropractor who has had phenomenal results in dealing with injuries and preventing them from occurring, and that they would like the players to proactively be treated [by] me and begin a chiropractic course of care.

During the season, if there are any injuries, they (the medical staff) will generally send the player to my office to be evaluated. By game time, just about everyone on the roster is adjusted, and you start to learn the idiosyncrasies of each player, because each one wants certain things checked on them. Some are very firm with extremity adjusting; others enjoy use of a specialized technique that we use, called Graston Technique. Basically, it takes me about four hours before the game to go through the entire roster.

DC: So, you're at the stadium several hours before kickoff, already working on players?

MM: Yes. And then during the game, if anything were to occur other than something mild that we could correct on the field, we generally would bring the player into the locker room and see what we could do.

DC: Do you see the players as frequently during the off-season? How many of them come in for care?

MM: I would say the majority of players who are veterans on the team and know the importance of chiropractic come here in the off-season when they're in town, on a weekly basis.

DC: What types of conditions do you see most frequently with the football players? Do you have any success stories you could share about working on certain players?

MM: We treat a myriad of different problems, from cervical spine injuries to "stingers" and "burners," where the players have numbness and pain radiating into the upper extremities. We treat them for migraine headaches, shoulder and brachioradiculitis problems, where there's some irritation from the cervical spine into the upper extremities. We treat them for thoracic problems, lumbar spine sprains and strains, sciatic nerve irritation, and different extremity problems that may occur during the season. We've had to do extremity adjustments on the temperomandibular joint in the jaw. We've done shoulders, ankles, toes, knees, fingers - you name it. Any part of the body that's been exposed and injured, we check, and they do get significant results with it.

In the last few years, we began [using] Graston Technique, which utilizes stainless-steel instruments. These instruments are able to work with some soft-tissue mobilization, where the doctor is actually able to feel resistance in the tissue where there's been some myofascial irritation or scar tissue, and the bars, as they run over the tissue, break up and release some of the fibrotic tissue, and rebuild collagen fibers to restore the tissue back to normal function. With one of the players who has had chronic problems with hamstring issues, [linebacker] Willie McGinest, we used this technique last year. We started using it on him, with amazing results. For someone who would constantly have hamstring issues, once that technique was used on him, it seemed to break down and rebuild the tissue, and he became a dynamic force on the team.

When the players see you doing something different with another player, they almost get a form of jealousy. They'll say, "Why are you using that on him? Why haven't you tried that on me?" They want to see "the magic bars," as they call them. So, we've used it on other players for plantar fasciitis on their feet, Achilles tendonitis, and problems with epicondylitis of the elbows. When Corey Dillon joined the team last year, he had a history of chronic hamstring and low-back complaints. We used the technique on him, with the same amazing success. He became the leading rusher, made it into the Pro Bowl, and helped us to achieve our goals and win [another] Super Bowl championship.

The thing about our team is each player has a philosophy that the success of the team is measured by the sum of its parts. There are no individual heroes. Every player contributes to the success and to a championship, and as you go from game to game, it seems that with this team, there are always one or two players who stand out in each game; make a play that results in a turnover or turns things around so that the team wins the game. They know that all of their actions contribute to the win. It isn't just a select group of players who are responsible week after week for bringing the team success.

DC: Speaking of the team aspect, how do the other members of the medical staff view chiropractic? What's the opinion of the medical doctors and the athletic trainers?

MM: I was with the first trainer on the Patriots for 20 years. We started out together, and there was a perfect bond between the two of us. He had respect for what I did, and I had respect for his profession. We worked hand in hand. He would actually send every player as they were introduced to the team over to my office, so we would get to introduce ourselves to the player at an early stage. We'd familiarize them with the philosophy of chiropractic, and discuss with them the fact that if they did choose chiropractic care, they would have an edge over people who didn't utilize the service, because it would prevent a lot of the injuries that may have been hampering them in the past. We would reduce the likelihood of those injuries occurring. So, we always had a good relationship.

The medical team and I have mutual respect for one another. When it comes to an injury on the field, the head orthopedic surgeon will usually go on the field with one of the trainers. I do not go out for that. They will assess the player. The player may say, "I strained my neck. I felt a little jolt in my neck. Can I see Dr. Miller?" Usually, it's not a problem, unless they feel that the player needs X-rays prior to rule out a fracture. They have enough respect to say, "Yes, you should see Dr. Miller. Let's go that route."

It's been very good. All of the trainers on the team, including the head trainer and his assistants, some of the orthopedic staff, and the massage therapist, are all patients of mine as well.

DC: So, you're seeing everybody, not just the players.

MM: Right. We're not getting any anti-chiropractic sentiment. That's from the direction of the head coach. When they know that he utilizes chiropractic care for himself and wants it for his players, they embody his philosophy.

DC: That's a pretty powerful statement. The head coach's philosophy sort of trickles down to the rest of the team and the organization.

MM: Exactly. And through my 24-year association with the team, we've always treated the head coaches and assistant coaches. So they (the trainers) see that. They know the head coach believes in it. And the trainers have to embody what the head coach believes, or there would be friction from that end. But it's a very good combination of talent on the team, and everyone knows their place and knows that one person isn't responsible for keeping the players on the field. It's a combination of work from all of the professions.

DC: In addition to the Patriots, do you see other patients?

MM: I have a private practice in Norwood, Massachusetts, where we see the "weekend warrior" types. I've also seen professional hockey players, speed skaters, powerlifters, boxers, golfers, Golden Gloves champions, and so on. I enjoy the sports injury part of it, because I'm certified in sports injury and rehabilitation. That's the primary part of my practice, but we have patients who come from all different niches that they participate in, whether it's weekend sports, college sports, or high school athletics. The office is pretty varied as to the types of patients we see. It's not just devoted to sports injuries.

DC: What kinds of differences do you see between treating a member of the Patriots versus a typical patient who comes into your office?

MM: The conditions may be similar in what you treat, but professional or elite athletes are more aware of their bodies. They're aware when something isn't in alignment. They can tell. Their bodies are obviously much more conditioned than the average athlete as well, because they're exercising five or six days a week. Their tone is different, and they rehabilitate a lot faster than an average person who may be out of shape. The major difference is they're aware of when their machinery isn't working at 100 percent efficiency. They're much more in tune with their bodies, and they are more committed to getting an end result, whereas once the average patient starts to feel better, they will say, "Well, I'm fine now, my symptoms have alleviated." They have the philosophy that there's nothing wrong with them unless they're in pain. The professional players come in on a preventive basis. With or without pain, they know they want to maintain the integrity of their spine.

It's a lot of work. Sometimes, doctors come to me and say, "I'd love to do what you're doing. It must be awesome to deal with professional athletes, especially when they're world-recognized champions." But they don't understand the commitment involved, or the hours spent away from your family to travel. It's not just a glorified position. There's a lot of work involved. Some of the orthopedic staff who go with us on the road, they're there in case an injury occurs that they may be involved in the treatment of, but they're in a more relaxed state. They don't have to be constantly seeing one player after the other.

DC: You're basically working from kickoff until the game's over.

MM: Exactly. And then after the game, the elite athletes are allowed by the training staff to be treated. So, when I'm on the road, and even after a home game, they may allow half a dozen of the high-profile players to remain afterward for me to check, because they don't want to go the rest of the week before they come to my office again. We obviously don't have the time to go through four hours after the game and see the whole roster, although there are times where I think in the players' minds, they would like to do it over again. I just don't have the energy left after treating as many players as I do.

DC: What advice would you give to a chiropractor who wants to work with a sports team? How can he or she get involved and get that relationship going?

MM: I would recommend that first of all, they get out in the community and show commitment to the community they practice in, by participating in some of the high school events. They should also take different postgraduate courses in sports injury programs, rehabilitation programs, and different chiropractic seminars that deal with those issues. It's very hard to get into the market of becoming a sports chiropractor for an NFL team, an NBA team, or a Major League Baseball team, because the doctors there are pretty much well-positioned. They've worked for it, and they have a relationship with the team. A lot of the younger doctors who call my office want to get involved with professional sports teams. Unless you get a doctor who decides to retire and leave the team, it's hard to see someone taking over.

DC: There are only so many of those jobs to go around.

MM: Yes, and there are hundreds, perhaps thousands of doctors who would like the opportunity to work on professional teams. I think that working on college teams, or applying for positions on the Olympic Committee and trying to get on there, will help. It's all name recognition. Once you establish results with a professional athlete, that athlete works for you. I started out with one player on the team 24 years ago. Now, I've seen hundreds and hundreds, all because it mushroomed as a result of the results with other players, and how they interpret what you do and the commitment you have for them.

It's not an easy system to get into, but if you're doing it even on a college or high school basis, the reward for the results you get, and the appreciation you get from the players, are the most rewarding things you can have in life. The players recognize your commitment. As a player understands what you've done for them and they appreciate you, they start to give game balls to you. They'll score a touchdown or get an interception - and all of a sudden, they'll come over to you and want you to have [the] ball. I've had players give me their first NFL touchdown ball. Adam Vinatieri, the kicker on our team, gave me a pair of his shoes in appreciation for helping him out. Those little things mean more to me than any other monetary reward, because they're things that can't be replaced, and they come from the player's heart and soul. They appreciate what you've done, they see the results in themselves, they feel better, and they want to give something back to you.

DC: Thank you.

Written by Michael Devitt, senior associate editor of MPAmedia. You can contact Michael at (714) 230-3181 or MDevitt@MPAmedia.com.

Copyright Dynamic Chiropractic Jun 18, 2005
Provided by ProQuest Information and Learning Company. All rights Reserved

Return to Epicondylitis
Home Contact Resources Exchange Links ebay