Topic of the Week: ELBOW PAIN: Do you play golf or tennis?

When painful symptoms show up in your elbow, one of the first things your chiropractor will ask is whether you play tennis or golf. Why?


Because of the nature of these two sports, there is a lot of strain placed on the elbows of these athletes. The tennis ‘back-hand’ will put a lot of stress on the extensors of the wrist, leading to potential strain and irritation of the common extensor tendon attached at the outside part of the elbow. Conversely, the golf swing can strain the flexors of the wrist, which attach via the common flexor tendon to the inside part of the elbow - especially if the person is in the habit of taking a big divot’, or repetitively striking the ground hard when hitting the golf ball. In fact, these injuries are so common in people who play tennis and golf that elbow pain has been labeled Tennis Elbow or Golfer’s Elbow, depending upon which side of the joint the symptoms show up.


Either situation will lead to inflammation and pain at the site where the tendons attach to the bone (diagnosis: tendinitis). As a result, you may feel some swelling and tenderness in the area of the injury.


The pain is usually dull, achy and constant, but if you try to grip something with your hand, it usually will become more sharp and localized. The first thing you should do is intermittently apply ice to reduce the inflammation. In addition, rest and avoiding any activity that aggravates the symptoms is recommended.


What if you don’t play one of these sports? Is this the only thing that can cause symptoms in the elbow? Absolutely not. A name is just a name. There are many different reasons why you might be suffering from pain in your elbow.


Just because you don’t play golf or tennis, this does not mean you don’t have one of these conditions. Painful tendinitis can be caused by any repetitive activity involving flexion/extension or twisting of the wrist and elbow. Throwing a ball for your dog, working in the garden, painting a wall or a fence - these are all common, non sport-related activities that could lead to tendinitis in the elbow and they should be treated the same: ice and rest. In the long-term, of course stretching and strengthening the area may help prevent the problem from recurring. However, whenever inflammation is present, one should be cautious about placing any load on a tissue that is already injured.


Sometimes, pain in the elbow is not related to stress and strain of tendons - instead, an irritation of nerves that pass by the elbow could be the cause of your discomfort. The two main nerves that travel through this area are the ulnar and median nerves.


The tricky thing about nerves is that no matter where the source of irritation is - local (a peripheral nerve) or where they exit the spine (as a nerve root) – the pain can be felt at any point along the nerve. This is why it is important to have your chiropractor assess the problem. Your chiropractor will be careful to look at your neck to assess your cervical spine for vertebral subluxations or disc herniations that may be pinching/irritating the nerve roots corresponding to nerves leading to the elbow. If performing orthopedic tests on your neck reproduces the pain in your elbow, the condition is more likely to be labeled radiculopathy rather than tendinitis.


Chiropractic adjustments are often very helpful in reducing radicular symptoms, sometimes in as little as one or two treatments! Of course, you should always have your spine checked regularly, in an effort to prevent symptoms, too.


Finally, the elbow joint itself should be assessed. The elbow is comprised of three bones, namely the humerus (the upper arm), plus the ulna and radius (the 2 forearm bones). Each one of these bones will articulate with the other two, forming joints. Trauma, infection, or repetitive stress and strain - any of these causative factors can create joint subluxation or pathology.


Luckily, your chiropractor is a joint specialist! After reviewing the presentation of your symptoms, and all the possible causes, your chiropractor will determine the best course of action to alleviate your pain.

Disclaimer: Information contained in The Wellness ExpressTM newsletter is for educational and general purposes only and is designed to assist you in making informed decisions about your health. Any information contained herein is not intended to substitute advice from your physician or other healthcare professional. Copyright © - The Wellness ExpressTM

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Exercise of the Week

Topic of the Week: Topic of the Week: Hormones, Exercise and Weight Loss

Someone once said: “I keep trying to lose weight.... but it keeps finding me!” Certainly one of the most frustrating aspects of weight loss is that after you reach your goal, you often find it difficult to maintain your new weight level. This seems to be especially true for those who are defined as obese. According to medical research, approximately 80 percent of obese people who drop pounds are unable to sustain their reduced weight. Scientists believe hormones play a key role in both weight reduction and weight gain.

Hormones: Loss and Gain:
In a study published in the New England Journal of Medicine, 50 overweight or obese patients underwent a 10-week low energy weight loss program. After the diet, they were found to have an increase in appetite producing hormones and the levels of these hunger hormones remained consistent for a year after the initial weight loss. This result is believed to be a main reason why it is difficult for people to maintain their reduced weight level, as study participants regained about 11 pounds (5 kgs) within a year.

One of the most studied hunger hormones is ghrelin, which is produced in the stomach and stimulates appetite. Scientists presented interesting research at the Endocrine Society’s 92nd Annual Meeting. In their study, the researchers administered either a salt water (placebo) injection or a ghrelin hormone injection to a small group of healthy adults – none of whom knew which type of injection they received. The study participants were shown pictures of high calories foods (chocolate, cake, pizza) and low calorie foods (salads, vegetables, fish). The participants who received ghrelin hormone injections were more likely to rate high calorie foods as appealing than those who received the placebo injection.

Another study published by the Endocrine Society revealed the amount of appetite hormones present in the body prior to dieting may be vital to predicting the likelihood of dieters’ regaining weight. Scientists measured body weight and appetite hormone levels on a group of participants before, during and after dieting. Those study subjects who had higher plasma levels of leptin and lower levels of ghrelin before they started the diet were more likely to regain weight. This knowledge could be used to develop better techniques to treat post-diet weight gain.

However, appetite hormones may have a much wider impact than just promoting or suppressing hunger. They may actually impact neurological disorders.

Scientists at UT Southwestern conducted investigations that showed the hormone ghrelin may actually reduce symptoms of stress-induced depression and anxiety. When a person is hungry, his or her body produces more ghrelin and this could explain why some people eat more when feeling overwhelmed or sad. Scientists used two types of mice in the research. A test group of mice that were put on a calorie restricted diet displayed lower levels of anxious or depressive behavior when exposed to stress - such as navigating mazes. Another group of mice also had a calorie restricted diet but they had been genetically engineered not to respond to ghrelin. The genetically altered mice showed higher levels of anxiety and depression when exposed to stress.

Orexin Spurs Fat Burning:
The brain-produced hormone orexin may provide an alternative way to treat obesity. Instead of controlling appetite, orexin appears to help a type of body fat, known as brown fat, to burn calories. Obese people are often deficient in orexin.

Researchers conducted experiments on mice and discovered a group of overweight mice that were orexin deficient actually ate less than a group of normal weight mice. This leads to the theory the overweight mice were heavier because of inefficient burning of calories rather than overeating.

While the results are promising, the research has only been conducted on rodents. Human trials would need to happen before any orexin treatments could become available.

A Powerful Ally to Battle Hunger:
While some hormones may make losing weight and keeping it off a challenge, you do have a friend in this hormonal battle: exercise.

A study that appeared in AJP Regulatory Integrative and Comparative Physiology indicates aerobic exercise seems especially beneficial because of its influence over the appetite hormones ghrelin (promotes hunger) and peptide YY (suppresses hunger). The test subjects participated in both treadmill running and weight training but at different times. Researchers tested the participants’ levels of appetite hormones and found that after the aerobic treadmill exercise participants had lower amounts of ghrelin and higher amounts of peptide YY. After the strength training session, the researchers discovered only levels of ghrelin were affected.

Need advice on exercise? Talk to you chiropractor!

Quote of the Week

Exercise of the Week: Calf Stretch, Variation 2

\Difficulty: Easy

Start: Standing behind a chair, or in front of a wall. Place hands on backrest or wall for balance.

Exercise: Place one foot behind other. Keeping heel on floor, bend knee and lean hips forward. You should feel tension behind lower leg, close to ankle. Hold for 30-60 seconds, relaxing muscles of lower leg. Switch sides, and repeat 2X per side.

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