Tennis Elbow, Golfer's Elbow and Tommy John Surgery
The anatomical structures involved in tennis elbow
(lateral epicondylitis) and golfer's
elbow (medial epicondylitis) are structures located very close to the skin-in
some people only two or three millimeters that traditional treatments such as
physical therapy, heat, ultrasound, and massage should very quickly resolve.
These treatments greatly increase the metabolic
rate in the muscle attachments at these sites, so recovery should be quick and
easy. Because these conditions do not recover quickly, this tells us that the
muscles are not the problem, but the underlying ligaments.
The athlete does not recover because tennis elbow
elbow, known as epicondylitis, are way overrated as a cause of chronic
and tendons are the cause of the problem, Prolotherapy
injections are given. The inherent stability of the elbow,
because of the unique interlocking features of the humerus into the ulna,
cause most orthopedic surgeons, physical therapists, and athletic trainers to
doubt that the ligaments
in the elbow are easily injured. Most believe that elbow instability or ligament
injury in the elbow occurs primarily when the athlete sustains a fracture
to the elbow. One sports
medicine text put it this way, "Elbow instability is an uncommon
clinical concern in sports medicine, except for throwing athletes."
(Tullos, H. Elbow instability. In Baker, C. (ed.), The Hughston Clinic Sports
Medicine Book. Philadelphia, PA. 1995. pp. 317-323.) This is a false notion and
one of the reasons why athletes around the country are not receiving cures for
their chronic elbow pain and injuries.
An orthopedic surgeon will nearly always give a surgical option for the
condition of elbow instability. This is because the only treatment surgeons
have to offer for unstable joints
is surgery. This involves taking a tendon from
the wrist (palmaris longus tendon) and grafting this on the lateral or medial
elbow, depending on which side is unstable. This radical surgery is explained
this way, "The decision to treat valgus instability with surgical
reconstruction depends on the patient's career expectations. Should the patient
have a long-term goal of extending his or her career years, and should he or
she be willing to undergo the one to two year period of healing and
rehabilitation, valgus reconstruction is a reasonable option. Unfortunately,
elbow instability, even if managed optimally, is often a career-altering or
career-ending injury." (Tullos, H. Elbow instability. In Baker, C. (ed.),
The Hughston Clinic Sports Medicine Book. Philadelphia, PA. 1995. pp. 317-323.)
In other words, if an athlete has a ligament injury or a ligament sprain of the
elbow, the orthopedic surgeon is going to cut a tendon out of the wrist and
transplant it into the elbow to maintain an ability to play sports.
The athlete is then supposed to undergo rehabilitation for one to two years.
After all of this, even if it is "optimally" managed, it is often a
career-altering or career-ending injury.
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