What is Tennis Elbow and How Can Physical Therapy Help?

By Nick Mazzone, PT, DPT, CSCS

What does tennis elbow mean?

“Tennis elbow” is the nickname given to a condition known to the medical community as lateral epicondylitis (also seen ending in -osis or -algia). This name describes the region from which the pain originates on the outside of the elbow. The lateral epicondyle is the part of the upper arm bone that serves as the origin for all of the muscles that extend the wrist.

What causes tennis elbow?

Tennis elbow is considered an overuse injury. It typically occurs after repetitive stress to the involved region over time, however one traumatic incident such as a fall or work accident may also cause inflammation in this region. Tennis elbow got its name because it is a common overuse injury seen in those who play the sport. Tennis players tend to hold a tight grip on their racquets while producing powerful forces with their wrist extensor muscles. In certain cases, this may be a recipe for inflammation. Another common population that tends to get tennis elbow is the office worker. Being in a position of wrist extension while typing for prolonged periods may cause repetitive stress to the outside of the elbow.

Here is an example of what your posture should look like while in front of your computer:

How Will Physical Therapy help me?

Your physical therapist will design a specific treatment plan tailored to your needs based on your background and activity level. The program will consist of soft tissue mobilization to assist in the healing process, stretching/mobility training, functional strengthening of eccentrics (the muscle’s ability to control movement from wrist extension to wrist flexion) and grip strengthening, training of ergonomics and posture, and education on how to prevent the condition from reoccurring.

Your specific program will depend on how you acquired the condition in the first place. An office worker will be trained to alter their desk setup in order to decrease the stress on the wrist extensors. A tennis player may be prompted to consider changing the thickness of their racquet handle or the tightness of the strings. Both of these variables may help contribute to the repetitive stress that occurs during the sport since more force production is necessary to produce the desired effect when these conditions are not optimal.

This picture shows one way to stretch the wrist extensor muscles.

Click here to find out more information about physical therapy for tennis elbow

Check out this video for 3 simple exercises to help with your tennis elbow:

About-

Nick Mazzone received his Doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn, NY. To view some of his other content, visit drnickmazzonedpt.wordpress.com.

Resources 

Main photo retrieved from https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987

Photo of bones of arm retrieved from http://cruxcrush.com/2014/06/26/climber-problems-elbow-injury/

Picture of wrist and finger extension retrieved from http://www.militarydisabilitymadeeasy.com/images/handmuscles/

Picture of ideal desk posture retrieved from xhttps://www.microsoft.com/accessories/en-us/support/ergonomic-comfort

Photo of wrist extensor stretch retrieved from https://www.therapeuticassociates.com/athletic-performance/golf/stretching-for-golfers/

How Can PT Help My Spinal Stenosis?

By Nick Mazzone, PT, DPT, CSCS

Spinal stenosis is one of the most commonly diagnosed conditions that affects the lumbar spine (lower back). It is common for people with stenosis to feel tightness and pain that radiates from the low back and buttocks down into both legs.

It is estimated that only about 5% of people with spinal disorders actually require surgery (Eidelson, 2018). So, what are the other 95% of people expected to do? This is where physical therapy comes into play. There are many methods your PT will use in order to help address the issue causing your pain and discomfort. This includes but is not limited to therapeutic exercise, soft tissue mobilization, manual stretching of the hips and spine, and postural re-education.

What is spinal stenosis of the lumbar region?

As you can see from the picture above, stenosis of the spine involves a narrowing of the canal in which the spinal cord sits. This leads to increased pressure on the spinal cord as well as the nerves that branch from it. This is the reason why people feel pain in the buttocks and legs; the region of pain stems from a specific section of the spinal cord that is under pressure. For this reason, two people with the same condition will present with different symptoms.

How can physical therapy help with this problem?

The treatment plan will be specifically tailored to each patient with stenosis. The main objective is to help decompress the spinal cord and its nerve branches by using techniques that create more space in the spinal canal. Bending backward, also known as extension of the lumbar spine, will decrease the space in the spinal canal due to the way the joints of the spine are oriented. This may increase pain and symptoms in a person with spinal stenosis. For this reason, the treatment plan will be focused on utilizing and improving spinal flexion, more commonly known as bending forward. This will help to widen the canal and decompress the inflamed structures, effectively providing relief of symptoms.

A comprehensive treatment plan will help you find positions of maximal comfort and give you more drug-free and surgery-free options for taking care of your lumbar spine and preventing pain in the future.

Please check out this brief video that provides 3 simple exercises to help decrease symptoms due to lumbar spinal stenosis, or click here to find out more information about physical therapy for spinal stenosis.

Resources

Eidelson, S. G., & An, H. S. (February 2018). Spinal Stenosis Center | Lumbar, Cervical, Symptoms, Exercise, Surgery. Retrieved March 18, 2018, from https://www.spineuniverse.com/conditions/spinal-stenosis

Picture of person with low back pain retrieved from http://www.omegapainclinic.com/spinal-stenosis-pain-treatment-utah

Pictures of stenosis in lumbar region retrieved from https://www.spineuniverse.com/conditions/spinal-stenosis

Nick Mazzone received his doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn.

How Can Physical Therapy Help My Arthritis?

By Nick Mazzone, PT, DPT, CSCS

What is Osteoarthritis?

Osteoarthritis is a major cause of chronic pain and disability in our society today. People with arthritis typically report deep, aching pain in the joints affected as well as stiffness and inability to get up and get right out of bed in the morning. The most common treatments for this painful condition include cortisone injections aimed at decreasing inflammation, over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs), and knee replacement surgery once the condition significantly worsens.

What is going on in my joints that causes this pain?

Osteoarthritis is a degenerative condition that leads to wearing away of the outer layers of cartilage and bone as you can see in the image above. This causes an inflammatory process to be induced by the body which leads to swelling, increased sensitivity to touch and pressure, and pain. On an X-ray, you will see decreased space between the bones and potentially bone spurs, which the body lays down in response to excess pressure in the area. This inflammatory condition typically leads to inactivity, which then leads to decreased range of motion along with muscle weakness.

What will physical therapy accomplish?

The hallmarks of arthritis include joint stiffness, swelling, muscular weakness, and pain. In physical therapy, your therapist will prescribe specific exercises that will help improve range of motion, and therefore, stiffness, as well as exercises for strengthening the surrounding muscle groups. These exercises will also act to help decrease the central nervous system’s hypersensitivity to pressure and touch, which will allow you to perform your daily tasks with much greater ease. Your therapist will also work on improving your patterns of movement in order to ensure that you are decreasing the pressure on your arthritic joints and using the most efficient pattern available to your body. There are also modalities and other methods used that will help to decrease the amount of swelling in the joint, which then leads to decreased pain.

Great. Stronger muscles, improved range of motion. How exactly is this helping my condition?

Good question. I would like to start by saying that there is currently no way to reverse the arthritic condition. That being said, I would like you to consider this example. Think about a stiff and swollen knee joint. When a person bends their knee, the stiffness in the muscles and fibers of the joint force the bones to glide along a smaller surface area. This will eventually lead to more breakdown of the cartilage and outer layers of bone, which means progression of the osteoarthritis. Now imagine we have a knee joint that has been sufficiently stretched and has less swelling. These bones glide in a smoother manner across a larger surface area (due to less range of motion restrictions). Now that the force can be spread evenly across the bony surfaces, there is a much less chance of increasing breakdown of the cartilage and bone.

Strengthening the muscles helps to ensure that while walking or performing other functional daily tasks, the joint is kept in a position that ensures proper alignment and efficiency of muscle function. This formula along with a prescribed home exercise program will prevent progression of the condition and assist in avoiding knee replacement surgery.

Check out this brief video which shows how to utilize a “hip-first pattern” to help offset pressure on the knee joint when bending down and squatting.

For more information or any questions, give us a call at 718-258-3300 or contact us today!

or click here to find out more about physical therapy for arthritis

Nick Mazzone received his doctorate in Physical Therapy from Stony Brook University. He has a strong background in strength and conditioning and aims to bridge the gap between strength training and physical therapy. Nick believes that a lifestyle centered around physical fitness and mental well-being are vital to one’s successes and happiness. For this reason, he educates his patients on pain science and helps empower them and motivate them to reach their goals every day. You can find him at Evolve Physical Therapy in Mill Basin, Brooklyn.