Tennis Elbow - Centre Court

Tennis elbow and sensitisation.
A beaut topical review on tennis elbow (lateral epicondylalgia- LE) emerged in the last Journal of Physiotherapy (Bissett, LM, Vincenzino B 2015 61: 174). I think it’s the best review of the status of our LE knowledge. Importantly, the reminder that LE is “not self limiting and it’s associated with ongoing pain and disability in a substantial proportion of sufferers”. The authors refer to evidence that “sensitisation of the nervous system” contributes at least to the ongoing pain.
As an old clinician, I think I have tried most of the interventions that are reviewed - exercise, manual therapy/manipulation, orthoses, laser, ultrasound, acupuncture, shock wave therapy and multimodal therapy and I agree with the general consensus that not much helps. The authors state that “mobilisation with movement and exercise” are likely to be superior to “wait and see”.
Given that most of these interventions do not target “sensitisation of the nervous system” perhaps the poor equivocal outcomes are understandable.
The clip presents my thoughts, takes and technique for lateral elbow pain which are related to sensitisation of the nervous system. Maybe there are more in this group than we realise.
www.noigroup.com
www.noijam.com

[@Drstephenstokes]

I need some new shirts....

[@NeuroOrthopaedicInstituteNOI]

+The Philosophical Physician™ Dave's shirts are definitely a SIM

[@donna1390]

Does a parent/grandparent reaction to a child hurting themselves influence the child's pain memory? Eg if the child hurts themselves and you say come here and I will kiss it better or the child has a medical procedure and the parent uses a reward system .

[@activexbacks]

Love your explanation, and I got some new dance moves too!

[@perrywarren6550]

+Gavin Routledge ~~~Here's an Elbow Pain treatment just 5 steps at home to cure it fast! visit ~~~>>>> www.tenniselbow-new.tumblr.com
click it, hope it helps

[@rememberember]

Wonderful, thanks. BTW, epicondylalgia is misspelled in the description, leaving out the second "L". Dig the shirt and glasses!

[@kaylazemljic56]

pure genius! I love the analogies

[@optimalperformanceconsulta5813]

Good explanations and evidence based. JESLEETH Optimal Physiotherapy

[@kenyanphysiomartinongwen3064]

great video I am impressed

[@peterhumphry507]

I'm so glad I found this. Anything similar for medial epicondylagia (golfers elbow)? Thanks...

[@rscranman2002]

Great stuff David!

[@ashmibhanushali2159]

It's wonderful 🙌does it give long term effects?

[@brahimphilo]

How many repetitions ???

[@elbowtko]

Where can I find more videos like this one? DAVID!
This video is a gold mine!

[@NeuroOrthopaedicInstituteNOI]

On our youtube channel :)
We are also publishing Explain Pain Supercharged this year - It will come loaded with a series of educational videos.

[@oldandcrusty]

Man, I need NOI in Auckland! I'm convinced I have CRPS in my foot because of 5 years of tendonosis in wrists, elbows and shoulders. Anyone in Auckland who can give me some tips?

[@NeuroOrthopaedicInstituteNOI]

We have run Noigroup courses in Auckland, there are Noigroup trained health professionals in reach :)
www.thenakedphysio.com might be a good place to start

[@georgeleggott5340]

CRPS in your foot would typically occur secondary to a fracture in that same foot, so therefore it would be unlikely that CRPS exists in the region without previous trauma having occurred there. If its tendonitis you are referring to then that condition is typically very well localised to a specific tendon, would have manifested following a period of excessive loading and inadequate unloading, and would not result in CRPS type symptoms. Pain from tendonitis can be easily managed with isometric loading, titrated load, and eventual strengthening. You should see a physiotherapist about your symptoms.

[@helicart]

I am waiting for the day physiotherapists wake up that neural irritation has a lot to do with chronic systemic inflammation/oxidation .... and how that impacts joints (facets, GHJ, RUJ RHJ...), tendon repair/recovery, spinal cord, nerve root, and peripheral nerve and sheath health.
I don't think I have ever heard David Butler give equal weighting to appropriate hydration and nutrition in his approach to pain management/therapy.
there's enough research to show spine and nerve pain, whether nociceptive, somatic referred, or radicular, is heavily mediated by inflammation and the adhesions caused by repetitive inflammatory events.

[@dawnwarb5925]

they did the half floss

[@dawnwarb5925]

he felt her

[@sjsssong]

Thanks!!