In the traditional medical view, tennis elbow (lateral epicondylitis) and golfer’s elbow are forms of tendinitis. The presumption is that the tendons around your elbow have suffered microscopic tears through injury or overuse.
Unfortunately, the term “tendinitis” has become a virtual synonym for pain. Even an official medical diagnosis of tendinitis or epicondylitis is often based on no more evidence than your statement that your elbow hurts.
A Contrary View
This long-standing conventional medical mindset is disputed by Doctors Janet Travell and David Simons in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual.
Extensive research by Travell and Simons has shown that myofascial trigger points (tiny contraction knots) in overworked or traumatized forearm muscles, not tendinitis, are the primary cause of pain in the elbow.
When Treatment Fails
The usual prescriptions for tennis elbow include anti-inflammatory medications, painkillers, steroid shots, electro-stimulation, stretching exercises, and rest. These treatments fail, however, when trigger points are the cause of the problem, because trigger points need to be addressed directly and specifically.
Rest is always recommended for tennis elbow, but it’s not the best therapy when trigger points are the cause of the pain.
Rest may lull trigger points into a quiet, latent state, but it doesn’t get rid of them. When you resume whatever activity caused the tennis elbow in the first place, the pain comes right back, rarely diminished in the least.
Elbow splints or braces inactivate the elbow and give relief while they’re in place, but they only serve as a short-term solution. Immobility can actually make trigger points worse and ultimately increase your pain.
On the other hand, activity can be just as bad for tennis elbow if it involves overuse of the arms, hands, and fingers. Physical therapy can even have a bad outcome if exercising and stretching are prescribed.
Conventional stretching tends to irritate trigger points and can very quickly make your pain worse. Stretching can be useful, but only after the trigger points are gone.
A painful elbow can also appear to be weak, but exercising for the purpose of strengthening it is not only ineffective, but unnecessary.
Myofascial trigger points temporarily weaken muscles that are associated with the elbow as a means of protection from further overuse or abuse. There is no atrophy. Full strength ordinarily returns with normal activity within a short time after trigger points are deactivated.
Muscle attachments at the elbow can be irritated by the unrelieved tension that trigger points produce in muscles. This can be the direct cause of any inflammation and degenerative changes that develop in the elbow.
Even when inflammation is proven to exist, trigger point therapy is the most appropriate treatment, because it goes to the source of the trouble.
Seven muscles in the shoulder, upper arm and forearm can have trigger points that send pain to the outer elbow. Inner elbow pain (golfer’s elbow) can come from any one of five muscles in the chest, upper back and upper arm. There are ways to self-treat trigger points in any of these muscles quite effectively. The following is a sample from the book:
The illustration shows a trigger point in the extensor carpi radialis longus muscle. This is the most common cause of pain in the outer elbow, commonly called tennis elbow, elbow tendinitis, or lateral epicondylitis.
Trigger points in other forearm muscles cause numbness, tingling, burning, swelling, weakness, and stiffness in the wrists, hands, and fingers.
The illustration shows massage of the outer forearm with a tennis ball or lacrosse ball against a wall. Lean your body against your arm to apply pressure.
Begin 3 or 4 inches below the elbow and roll the ball repeatedly all the way up to the elbow. Six to twelve strokes make a treatment, but treat several times a day. See The Trigger Point Therapy Workbook to learn about the many other trigger points that can cause elbow pain.
In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies has simplified Travell and Simons’s extensive research into myofascial pain and made it accessible to the layman. His innovative methods of self-applied trigger point massage will relieve tennis elbow and golfer's elbow when trigger points are the cause.
To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.