Lateral and Medical Epicondylitis (Tennis & Golfers Elbow)

Lateral and Medical Epicondylitis (Tennis Elbow and Golfers Elbow)

Lateral Epicondylitis (Tennis Elbow) and Medial Epicondylitis (Golfer’s Elbow) do not only affect professional athletes. In fact, most of the cases of these actually happen in non-elite athletes. A range of factors may contribute especially repetitive or awkward motion of the arm, elbow or forearm, excessive keyboard and mouse use with a non-ergonomic, uncomfortable setup.

Lateral Epicondylitis is the inflammation of the lateral epicondyle (outside of the elbow) which cases pain and tenderness, especially on twisting door knobs or holding the steering wheel.

Medial Epicondylitis can cause discomfort on the inside of the elbow in pulling and flexing of the elbow.

Dr Justin Lim and Dr Selina Lim have worked in the Emergency Departments in major Australian and European Hospitals and they understand the importance of ensuring and confirming the diagnosis and instituting the optimal treatment program for you.

Professor Yoland Lim Health Care’s program is a natural form of treatment aimed at getting you back to being able to participate in everyday activities. Patients referred by Sports Physicians and Orthopaedic doctors may have had cortisone injections with limited benefit. Fong Yang Therapy, Professor Yoland Lim Health Care's form of acupuncture is used, "without drugs, without side effects".

Plantar fasciitis

Plantar fasciitis is a common condition in which the thick fibrous plantar fascia tissue that connect the calcaneus (heel bone) to the toe are inflamed often causing severe pain. Although it is seen equally in both active and sedentary people, plantar fasciitis is particularly known to affect those between the ages of 45 to 65 years old. Studies have shown that women are almost 2 and a half times more likely to be affected by this condition than men[1].
It is actually a degenerative process so should actually be termed 'plantar fasciosis'[1], although some patients have swelling and oedema associated with this.
Common symptoms include sharp pain, swelling and tenderness in the foot and heel area. The pain could be worse in the morning and in severe cases can cause limping. However, it is important to note that not all people with this condition experience pain. Some have heel spurs with just numbness[2].
Studies have shown that a substance called adenosine which is released during acupuncture is believed to have an anti-inflammatory effect[3].

References

Clark, R. J., & Tighe, M. (2012). The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupuncture in Medicine: Journal of the British Medical Acupuncture Society, 30(4), 298–306.
Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011;84(6):676-682.
Goldman N, Chen M, Fujita T, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci. 2010;13(7):883-888. doi:10.1038/nn.2562.
Hempel, S., Taylor, S. L., Solloway, M. R., Miake-Lye, I. M., Beroes, J. M., Shanman, R., et al. (2014). Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs.
Langevin, H. M., Bouffard, N. A., Churchill, D. L., & Badger, G. J. (2007). Connective Tissue Fibroblast Response to Acupuncture: Dose-Dependent Effect of Bidirectional Needle Rotation. The Journal of Alternative and Complementary Medicine, 13(3), 355–360. doi.org/10.1089/acm.2007.6351
McDonald, J. L., & Janz, S. (2017). The Acupuncture Evidence Project, 1–81. acupuncture.org.au/OURSERVICES/Publications/AcupunctureEvidenceProject.aspx

[1] Medicine Today Volume 20 Number 9 September 2019

[2] healthdirect.gov.au/plantar-fasciitis

[3] evidencebasedacupuncture.org/present-research/acupuncture-plantar-fasciitis-2/

Post workout recovery

Incorporating exercise into our daily lives is important for our physical wellbeing as well as our mental and emotional health. Whether just starting back doing exercise after some time off, or due to vigorous training, muscle fatigue and soreness may occur.

Muscle fatigue is defined as your muscles feeling weaker and tired over time and after repeated movements. It decreases the ability of your muscles to perform[1]. Muscle soreness is another normal side effect which can occur post exercise. Typically referred to as delayed onset muscle soreness (DOMS), this can last up to 24-48 hours after exercise and is due to inflammation within the muscle[2].

As exercising physically breaks down the muscle fibres cells, and affects our immune system and connective tissues, it is vital to ensure proper recovery post workout or exercise[3]. Skipping recovery can lead to symptoms of overtraining like decreased performance, elevated blood pressure, poor sleep, a general irritability and decreased immune strength[4].

Post workout recovery typically involves three pillars4:

1. Nutrition – ensuring ample protein and high-quality carbohydrates are part of your diet

2. Hydration

3. Sleep

Professor Yoland Lim Health Care teaches elite athletes and recreational exercises, the concept of in depth mindfulness and its positive effect on wellbeing and training.

References

[1] Anthony (2018, April) What Causes Muscle Fatigue? healthline.com/health/muscle-fatigue

[2] National Kidney Foundation. Understanding Muscle Soreness – How Much is Too Much? kidney.org/content/understanding-muscle-soreness-%E2%80%93-how-much-too-much

[3] Willis (2019, September) Muscle soreness? Body fatigue? Exercise recovery is important, and shouldn’t be overlooked abc.net.au/news/health/2019-09-07/muscle-soreness-and-exercise-recovery/11483346

[4] Kassel (2018, July) Your Post-Workout Recovery Guide healthline.com/health/post-workout-recovery#1

Rotator Cuff Injuries

The rotator cuff consists of four muscles and their tendons found at the shoulder joint that is responsible for shoulder movement and rotation[1]. The shoulder is made up of three bones:

1. Humerus: the upper arm bone

2. Scapula: the shoulder blade, and the

3. Clavicle (collarbone).

Like the hip joint, the shoulder is a ball and socket joint where the humerus fits into a shallow socket in the scapula[2]. Along with the unique anatomy of the shoulder and the rotator cuff muscles, rotation of the shoulder is possible with the presence of a lubricating fluid known as bursa.

Like all joints in our body, injuries can occur. Unnatural shoulder movements are the prime suspect of rotator cuff injuries. These include[3]:

Pushing off with arms such as when rising from a chair.
Repetitive reaching including swimming, push ups, house painting, auto mechanic work and pitching a baseball.
Forceful/abrupt overhead movements such as in throwing sports, racquet sports, wrestling and pulling to start a lawn mower

These can then lead to symptoms of:

severe pain
weakness in the arm
crackling sensation upon moving the shoulder and
swelling and tenderness[4]

There are effective strategies to relieve pain and manage the injury such as refraining from engaging in repetitive tasks, managing pain using pain killers and inflammatory drugs and receiving treatment from a physiotherapist[5].

References

[1] Rotator cuff tears: An evidence based approach. World J Orthop. 2015 Dec 18; 6(11): 902–918.Published online 2015 Dec 18. doi: 10.5312/wjo.v6.i11.902PMCID: PMC4686437PMID: 26716086

Senthil Nathan Sambandam, ncbi.nlm.nih.gov/pmc/articles/PMC4686437/

[2] American Academy of Orthopaedic Surgeons. Rotator Cuff Tears orthoinfo.aaos.org/en/diseases--conditions/rotator-cuff-tears/

[3] Harvard Health Publishing – Harvard Medical School (2018, December) Rotator Cuff Injury health.harvard.edu/a_to_z/rotator-cuff-injury-a-to-z

[4] Canberra Orthopaedics. Rotator Cuff Problems canberraorthopaedic.com.au/conditions-treated/rotator-cuff-problems/

[5] Health Direct (2018, January) Rotator cuff injury healthdirect.gov.au/rotator-cuff-injury

Sport Injuries

Sport Skin Treatment Dr Justin Lim Dr Selina Lim Professor Yoland Lim Health Care Laser JUVEFACE

Sport injuries are common occurrences and are typically caused by overuse, trauma or direct impact of muscles and joints[1]. In 2011-12, the Australian Institute of Health and Welfare reported 8% of all injury hospitalisations during that year were due to injury sustained while playing sport[2].

There are two kinds of sports injuries: acute and chronic. An injury that occurs suddenly such as a sprained ankle is known as an acute injury whereas sport injuries caused by repeated overuse of muscle groups or joints are known as chronic injuries[3].

Common types of sport injuries include3:

Contusions (bruises). These are often caused by blunt force such as a kick, fall or blow
Stress fractures
Dental damage
Hamstring strain
Groin strain
Ankle sprains
Cuts and abrasions
Dehydration

As the type and severity of sports injuries varies between individuals, treatment varies between individuals. It is important to see a medical practitioner if pain persists after a couple of days.

Strategies to prevent and reduce the risk of sports injuries include[3]:

Thorough warm up
Wearing appropriate footwear
Using good form and technique
Allowing adequate recovery time
Drinking plenty of fluids, before, during and after

References

[1] John Hopkins Medicine. Sports Injuries hopkinsmedicine.org/health/conditions-and-diseases/sports-injuries

[2] Australian Institute of Health and Welfare (2014, November) Australian sports injury hospitalizations 2011-12. aihw.gov.au/reports/injcat/168/australian-sports-injury-hospitalisations-2011-12/contents/summary

[3] Better Health Channel (2015, August) Sports injuries betterhealth.vic.gov.au/health/HealthyLiving/sports-injuries