Tennis Elbow

When there is inflammation of the tendons on the outside of the elbow at the lateral epicondyle of the upper arm, the condition is known as tennis elbow. This condition is caused by certain repetitive movements of the wrist Tennis players are not the only people who are affected by this condition, which is also known as lateral epicondylitis. Activities like hedge clipping, tennis, excessive use of a screwdriver or hammer, painting or any such activity that involves repetitive motion of the wrist which also requires constant gripping may lead to tennis elbow. Though, the real cause of tennis elbow is not clearly defined, it is due to tears of the tendons that attach the forearm muscles to the bone of the arm at the elbow joint.

Symptoms of tennis elbow

• Pain over the outside (lateral) of the elbow
  
• Pain while lifting or carrying objects or gripping even light objects such as a coffee cup.
  
• Pain radiates down the forearm.
  
• Tenderness is felt on or below the joint's bony prominence.
  
• Pain due to tennis elbow may last for about 6 to 12 weeks.
  
• The discomfort may be for a short duration or it may last for several years.

Normally the pain due to tennis elbow sets in gradually, though at times it may also occur suddenly. Most patients complain of pain in the dominant arm. Manual workers like painters, plumbers, carpenters and gardeners who use their hands face the risk of developing this symptom. Many sports participants like racquet sports players, golfers, fencers are also prone to tennis elbow syndrome.

Tennis elbow is not simply caused by inflammation of the tendons alone, consider experts. The degenerative process either due to aging, or repetitive use of the forearm may also be responsible. If there is poor blood flow in that area, it does not heal completely and accessing nutrition and oxygen necessary for healing becomes difficult. This condition will lead to small tears in the tendon because of its degeneration and is revealed as symptoms of tennis elbow.

X-rays help to diagnose tennis elbow for patients who have the usual symptoms near their forearm. If the doctor has any confusion, an EMG is sometimes obtained to confirm the diagnosis of a tennis elbow. Pain over the outside of the elbow may sometimes occur due to instability of the joint, elbow arthritis and radial tunnel syndrome. Though the symptoms of these conditions are normally distinct, they can be confusing at times.

Even after the initial injury is healed, these areas tend to tear again. Hemorrhage will result because of this condition and there will be formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Inflammation is caused due to leakage of collagen. The blood flow in this area is cut off because of the pressure developed due to inflammation. It can also squeeze the radial nerve that controls muscle in the arm and hand.

When your elbow is involved in any activity, always take care to warm up your arm for a few minutes before starting. Apply a pack of ice over the arm for 15 or 20 minutes, if you experience severe pain in that area after use. If the usual measures like rest, anti-inflammatory medications and stretching routine do not yield good results, then in rare cases surgery is considered. Tennis elbow can be prevented by:

• Lifting objects with the palm facing your body.
  
• Using hand weights, you can do strengthening exercises.
  
• Before starting any stressful activity, stretch the relevant muscles by grasping the tips of your fingers.
  
• Be cautious to avoid a relapse. Try to modify or just discontinue the action that caused the strain. Frequent breaks during the activity will help prevent this condition.
  
• Strapping a band around your forearm just below the elbow will help as a support. Using bands can cut off blood circulation and thus delay healing and so it is best to use these bands only after tennis elbow has healed completely.
  

Knee Tendonitis

Tendonitis is one of the most common injuries that affect the knee. In simple terms it means inflammation and/or rupture of the tendons of the knee. Knee Tendonitis is also called 'Jumper's knee' as it was first described in the takeoff leg of high jumpers. It occurs in dancers, runners and players and anyone who runs and jumps regularly suffer from it. Typical symptoms of knee Tendonitis or Tendinitis as this condition is also known as:

• Knee tendonitis produces pain, tenderness and stiffness near/on the knee joints.
  
• Worst pain is experienced when ascending or descending stairs or when getting up from a seated position.
  
• Chronic pain is common due tendon and ligament weakness and cartilage deterioration.
  
• Inflammation of the tendons in the knee occurs. The inflamed tendons are painful when moved or touched.
  
• The tendon sheaths are visibly swollen. This may be due to accumulation of fluid and inflammation.
  

Causes
Knee tendonitis is caused by overuse, injury or due to aging.

• A small tear or inflammation in the knee caused the pain in knee tendonitis.
  
• Inflammatory diseases such as rheumatoid arthritis can also cause knee tendonitis.
  
• Popliteus Tendonitis is caused by excessive inward rolling of the feet. This is called 'pronation'. This occurs when excessive stress is put on the tendon, thereby causing a tear or inflammation in the tendon.
  
• Pes anserine Tendonitis is characterized by inflammation of the medial knee. This often coexists with other knee disorders.
  
• Semi membranous Tendonitis is characterized by posteromedical aspects of the knee and tenderness. Here resisted flexion and 'outward turned strain' occurs.
  

Treatment for Knee Tendonitis

Modern medicine

• Orthopedic surgeons recommend conservative treatment for knee tendinitis. Physical therapy and injections are commonly administered.
  
• Modern treatment regime includes rest, cryotherapy, non-steroidal anti-inflammatory drugs, physical therapy and massage.
  
• For the athlete who wants to improve his/her condition much faster, cortisone injections are given every one to two weeks.
  
• Surgery for knee tendinitis is rare. However if the person develops a tear in the tendon,surgery is the only answer.
  

Natural treatment for knee tendinitis

• Prolotherapy: In knee tendonitis that occurs in sports persons, the athlete is encouraged to perform exercises during the healing process. This natural medical treatment helps to strengthen structural weaknesses in the.
  
• The MEAT treatment consists of tendon and strengthening of ligaments by movement, exercise, analgesics and treatment by herbal supplies. The approach here is to encourage the damaged tissues to heal as quickly as possible without decreasing the inflammation quickly with ice or anti inflammatory drugs.
  
• A heat pad could be applied on the pain area for 15 -20 minutes to relieve pain.
  
• Similarly cold therapy can also be resorted to.
  
• Bracing is considered by sports persons to provide stability to the knee and thereby relieve pain by stimulating the nerve fibers which makes the wearer feels that the joint is more stable and secure. Football players, racers and skiers particularly benefit from such bracing.
  
• Avoid activity that can cause pain.
  

Bone Spurs

A bony growth formed on a normal bone is termed osteophyte or bone spur. It is an extra bone. Although bone spur can be smooth, it can cause wear and tear with pain in the area when a bone rubs with other bones or soft tissues such as ligaments, tendons or nerves in the body. The most common places in the body where bone spurs occur include the spine, shoulders, hands, hips, knees and heel.

Causes of bone spurs

The body tries to repair itself by building extra bones. These are formed in response to pressure, rubbing and stress that exist over a period of time. Bone spurs can also be formed due to the aging process. Cartilage breaks down and wears away with age. This leads to pain and swelling in some cases when bone spurs are formed along the edges of the joint. When ligaments get tight, bone spurs could be formed. Activities such as dancing and running that lay stress on the feet, excess weight or poorly fitting shoes could lead to formation of bone spurs.

During such times that long ligament gets inflamed and the bone tries to mend itself, a bone spur can form on the bottom of the heel. Pressure behind the heel from frequently wearing shoes that are too tight can cause bone spur at the back of the heel. This is also popularly called 'pump bump' as women who wear high heels suffer from this.

When tendons move through a narrow space between the top of shoulder and upper arm, they rub on the bones. Bone spurs can form in this narrow area. This can pinch the rotator cuff tendons resulting in irritation, inflammation, stiffness, weakness and pain. This condition is called rotator cuff disorder. It occurs with age and due to repetitive tearing of the tendons, especially among athletes, baseball players and in painters who frequently have to work with arms above their heads. Traumatic injury and poor posture can also be potential bone spur causes and can lead to spine bone spurs.

Bone spur symptoms

Signs and symptoms of bone spurs depend upon their location. A bone spur in the knee is painful to the extent that it can bend your legs and prevent the knee from operating smoothly. A bone spur on the vertebra can narrow the space that contains spinal cord and can cause weakness or numbness in the arms and legs. A bone spur in the hip can make movement painful and reduce the range of the hip joint. Bone spurs in the shoulder can hinder rotator cuff movement. Bone spur in fingers appear as hard lumps under the skin and they can make the joints in the fingers look knobbly. When bone spurs begin to press on other bones or tissues thereby causing a muscle or tendon to rub, they can break that tissue can cause swelling, pain, and tearing. Bone spurs in the foot can cause corns and calluses when tissue builds up to provide an added pad over the bone spur.

Bone spur diagnosis

A bone spur is visible through an x-ray. But it is rare to take x ray just to see whether a person has bone spur or not. For instance if an X ray is taken to evaluate, say, an arthritis problem, bone spurs should be visible. During physical exam the doctor can feel around the joints to determine exactly where the pain comes from.

Treatment of bone spurs

As such bone spurs do not require any treatment unless they cause pain and damage to other tissues. Treatment should be directed at the causes, symptoms rather than the bone spurs themselves. Such treatment aimed at the cause of bone spurs include weight loss to take the pressure off the joints and for stretching the affected area when bone spurs occur in the heel cord or at the bottom of the your feet. In the case of plantar fasciitis and shoulder pain, it is better to get an ultrasound done or deep tissue massage on the advice of a physical therapist. Treatment could include rest, ice, stretching and non steroidal anti inflammatory drugs such as ibuprofen. Learn to protect your joints in case you are suffering osteoarthritis. In case of bone spur on the foot, changing footwear or adding padding or a shoe insert may help. A podiatrist may be consulted if the corns and calluses become bigger problems. A doctor could suggest a corticosteroid injection at the painful area to reduce pain and inflammation if the spur continues to cause symptoms. Bone spurs can be surgically removed or treated as part of surgery to repair or replace a joint when osteoarthritis has caused considerable deformity or if the range of motion becomes limited.