Lateral and Medical Epicondylitis (Tennis & Golfers Elbow)

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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/ 

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