1, tennis elbow
Tennis elbow (lateral epicondylitis of humerus) is inflammation and pain of tendon at the starting point of extensor muscle of forearm outside elbow joint. This kind of pain is caused by chronic tearing and strain caused by repeated exertion of forearm extensor. When a patient grasps or lifts an object hard, he will feel pain in the affected part. Tennis elbow is a typical example of overwork syndrome. Tennis and badminton players are more common, and housewives, bricklayers, carpenters and other people who do elbow exercises repeatedly for a long time are also prone to this disease.
2. Etiology
The extensor forearm tendon contracts and tenses when grasping something (such as a tennis racket). Excessive use of these muscles will cause tendon degeneration, degeneration and tearing at the starting point of these muscles, which is also commonly known as tennis elbow.
1, tennis elbow causes include
① incorrect tennis technique, inappropriate tennis racket size or tennis racket line tension, incorrect golf grip or swing technique, etc. 2 excessive arm activities, such as tennis, badminton and baseball; Other jobs, such as painting, boating, using a hammer or screwdriver, etc.
2. Risk factors of tennis elbow.
Play tennis or golf; Engage in the work of repeatedly stretching your wrist when you need to make a fist; Unbalanced muscle exertion; Decreased flexibility; Grow old.
3. Clinical manifestations
The onset of this disease is mostly slow. At the beginning of tennis elbow symptoms, patients only feel pain on the outside of elbow joint. Patients feel pain in the upper elbow joint, and the pain can sometimes radiate upward or downward, feeling sore and uncomfortable and unwilling to move. You can't take things with your hands. Holding a shovel, carrying a pot, twisting a towel and knitting a sweater will aggravate the pain. Generally, there are localized tenderness points at the lateral epicondyle of humerus, sometimes the tenderness can be released downward, and even there are mild tenderness and active pain on the extensor tendon. There is no redness and swelling locally, and the flexion and extension of elbow joint are not affected, but there may be pain when forearm rotates. In severe cases, when you stretch your fingers, wrists or chopsticks, it will cause pain. A few patients feel that their pain is aggravated in rainy days.
4, check
The starting point of extensor carpi radialis brevis can be found during the examination, that is, the external upper tenderness of elbow joint. The range of motion of joints is normal, and local swelling is not common. When the patient's forearm is pronated and the wrist joint repeats the injury mechanism from palm flexion to dorsal extension, external upper elbow pain will occur.
X-rays are generally not needed. If necessary, X-ray examination can be used to find out whether the bones of elbow joint are normal and whether there is calcium deposition at the proximal end of extensor tendon.
Step 5 diagnose
The diagnosis of tennis elbow is mainly based on clinical manifestations and physical examination. The main manifestations are lateral pain and tenderness of elbow joint. Pain can radiate along the forearm to the hand, the forearm muscles are tense, the elbow joint cannot be completely straightened, and the elbow joint or wrist joint is stiff or limited in activity. The pain is aggravated when doing the following activities: shaking hands, turning door handles, holding things with palms down, playing tennis with backhand, swinging golf, and pressing the outside of elbow joint.
Step 6 deal with
According to the specific situation of patients, a personalized treatment plan is formulated, and the purpose of treatment is to alleviate or eliminate symptoms and avoid recurrence.
(1) Non-surgical treatment
(1) Take a rest, avoid activities that cause pain, and don't exercise, especially tennis, until the pain disappears.
(2) Ice on the outside of elbow joint 1 week, 1 day, 4 times, 1 time, 15 ~ 20 minutes. Don't touch the ice when the towel is wrapped in ice to avoid frostbite.
(3) Take aspirin or non-steroidal anti-inflammatory painkillers (such as ibuprofen).
(4) Protective equipment The use of compressive protective equipment on the forearm can limit the force generated by the forearm muscles.
(5) application of hyperthermia before traction therapy and exercise preparation.
(6) Traction Therapy When the acute pain disappears, gently pull the elbow and wrist according to the doctor's advice, and keep the pulling state for 10 second, and repeat for 6 times.
(7) Strength training Strengthen the strength training of extensor carpi according to the doctor's advice.
(8) gradually resume exercise. According to the doctor's advice, start the arm movements required for exercise (work activities).
(9) local closure of cortisone injection of cortisone drugs at specific parts of the elbow joint can diminish inflammation and relieve pain.
Extracorporeal shock wave therapy (10) can improve local blood supply and relieve inflammation, and has a good effect on tendinosis.
(2) Surgical treatment
If tennis elbow is advanced or intractable, after six months to 1 year of regular conservative treatment, the symptoms are still serious and affect life and work, and surgery can be taken. There are minimally invasive arthroscopic surgery and minimally invasive open surgery to remove unhealthy tissues, improve or rebuild local blood circulation and heal bones and muscles.
(3) Prevention
1. Correct the action of hitting the ball with the straight arm, so that the big arm and the small arm keep a fixed and elastic angle when swinging backwards or forwards.
2. Use wrist pads and elbow pads to protect wrists and elbows. The elbow pads have strong support. Restrict the rotation and straightening of wrists and elbows.
3. When playing ball, wrapping elastic bandage around forearm muscle abdomen can reduce the occurrence of pain, but the tightness should be moderate.
If you are diagnosed as tennis elbow, you'd better stop practicing until you fully recover and correct the wrong movements.
(4) Massage operation method
(1) means rubbing for several minutes.
(2) Rub your fingers for a few minutes.
(3) Rub the sole locally for 2-3 minutes.
(4) Local wet and hot compress.
(5) Point out local Quchi, Waiguan, Shaohai and Hegu points.
7, tennis matters needing attention
1. Choose a qualified court, because tennis requires a high court, and the uneven and smooth ground can easily lead to accidents such as falling and spraining your ankle.
2, the racket is too heavy, the deep muscles of the arm are more laborious, relatively easier to strain, and the higher the possibility of tennis elbow. Female exercisers should choose pat. Too heavy rackets can easily make their arms too strong, which does not meet the aesthetic requirements of women.
3. Stretching ligaments before exercise helps to reduce sports injuries, and lower limbs, waist and arms need to be warmed up. Generally speaking, it takes 10 minutes to warm up in summer and about 20 minutes in winter.
① Bend leg press and stretch waist and lower limbs.
② Twist the waist, rotate the waist and move the waist.
③ One hand clasps the elbow joint of the other hand and pulls it in different directions, pulling the ligament of the hand.
(4) the toes rotate the ankles and move the ankles.
⑤ Turn your ankles with your hands crossed.
4. When the athlete's limbs are sore and a little weak, but he still needs to continue to exercise, he can wear protective tools such as knee pads, elbow pads and waist pads according to the different pain parts. But if you just start exercising, don't wear it if you don't have any discomfort, otherwise it will bind your body, affect your flexibility and be prone to accidents.
5, playing tennis, the waist rotates violently, often in a semi-squatting position. Therefore, people with low back pain and knee arthritis (knee pain is often dull) are not suitable for this sport.
6. Tennis exercises the lower body, especially the lower leg. Tennis is played 1 3 times a week, and it is best to play 1 hour each time. Playing often will grow muscles.
7. The coach's help is very important in the beginner's stage. Without a coach, it is difficult for you to analyze, judge and understand your real situation. You will lack understanding of correct actions, let alone control and correct them.
8. It is recommended to choose professional tennis shoes. If you don't, you must wear sports shoes, because all courts refuse to enter the stadium with leather shoes.
9. You should find a friend who shares your interest in self-study.
10, get familiar with the ball first. Lift the ball, and with the help of the elasticity of the racket and its own control, let the ball keep hitting the racket. Pay attention to how you feel when the ball falls on different parts of the racket.