925.999.8757 rnassab@comcast.net

Dr. Nassab’s Clinical Discussions:

I. Findings
Tennis elbow is an inflammation of several structures of the elbow. These include muscles, tendons, bursa, periosteum, and epicondyle (bony projections on the outside and inside of the elbow, where muscles of the forearm attach to the bone of the upper arm).
The classic tennis elbow is caused by repeated forceful contractions of wrist muscles located on the outer forearm. The stress, created at a common muscle origin, causes microscopic tears leading to inflammation. This is a relatively small surface area located at the outer portion of the elbow (the lateral epicondyle). Medial tennis elbow, or medial epicondylitis, is caused by forceful, repetitive contractions from muscles located on the inside of the forearm. All of the forearm muscles are involved in tennis serves, when combined motions of the elbow and wrist are employed. This is an overuse injury is common with men and women alike.

This is such a common injury( Subluxation) in my practice. I thought I may share a patient that is currently a mechanic that basically relies on getting adjusted to maintain his lively hood. He is in his late 30’s and very busy. First began feeling his elbow pain while wrenching on a frozen bolt. It required he pull and finally free this bolt. Interestingly enough, there was no pain for weeks, even possibly months. Pain began one morning when he first awoke and persisted for days until he decided to have it looked at.

II. Treatment
Treatment was very unique for this patient as he continued to work throughout the course of care. I was amazed that he did not take time off and was only good with rehab, his adjustments, and coming and going to work. We began with the x-ray revealing mild to moderate arthritis in his elbow. The elbow consists of two joints; the radial ulna joint and the humeral ulna joint. Each joint has its unique way of articulating and functioning. We used ice, adjustment to the elbow, adjustment to the spine, and taping initially. We were fortunate not to need a brace.
III. Prognosis and Outcome
His prognosis was good in that, he was able to work, pain was tolerable during the healing process, and the strength in his elbow and hands returned fully. As with any extremity, time is of essence. He took more time than expected as he was unable to rest, but ultimately he recovered

IV. Dr. Nassab’s Discussion

I thought this was a good topic because this particular Subluxation pattern is occurring more frequently. Not everyone is a mechanic but, anyone doing any repetitive type work or activity is susceptible to this Subluxation pattern. Pattern is the key as we look at why the individual gets to this point.
Finally, almost always, if the spinal Subluxation is not addressed and rehab is sporadic; almost always we are looking at surgery. Good or bad that is usually the process.

This is an informational discussion for you and to present share with your family and friends.
If you have any feedback, questions, or concerns, please email, text, or call.
Yours in health,
Richard G. Nassab, D.