Injury blog: Student’s elbow

G’day readers, it’s blog o’clock! This month's blog is about a common elbow injury. Ever heard of student’s elbow? “But I’m not a student!” we hear you say. Well you don’t have to be to fall victim to this condition. Students elbow, or ‘Olecranon Bursitis’ is a condition where a small sack of tissue over the tip of your elbow becomes inflamed and swollen. The pointy bit of bone at the end of your elbow is called the ‘olecranon’ and the small sack which sits between the bone and the skin is called a ‘bursa’. The ‘itis’ part of bursitis simply refers to inflammation of that bursa.

What are the causes?

The most common way to develop student’s elbow is repetitive trauma to the tip of the elbow which slowly irritates the bursa and causes inflammation over time. Think of a student who sits for hours, day after day writing at a desk with their elbow resting on the table. The constant pressure on the tip of the elbow could be enough to kick things off. Anyone whose elbows are subject to repetitive pressure could develop this problem; plumbers and office workers are other good examples.

Other causes include:

•           A single blunt force trauma or fall onto the tip of the elbow

•           Infection

•           Having an olecranon spur (an extra small bony growth which rubs against the bursa)

•           Having an extra pointy olecranon (some peoples skeletons are just a bit different)

This condition may also develop as part of having another medical condition, such as Diabetes Mellitus, Gout, Rheumatoid Arthritis, HIV or alcoholism.

Signs and symptoms

So, what does student’s elbow look like? Signs and symptoms include:

•           A painful or (often) non-painful swelling on the end of your elbow

•           Pain with leaning on your elbow

•           Painful elbow movement

•           Restricted elbow movement (although this is often unaffected)

•           Redness, warmth and a fever (if associated with infection)

Will I need to have any tests done?

Possibly. As with all lumps on the body, your practitioner will want to rule out anything serious going on first. We ask lots of questions so we can paint a picture of what’s going on in our clinical head. Depending on your signs and symptoms, if you have a history of cancer or if infection is suspected, you may be directed to your GP for tests. This is to make sure you are receiving the best treatment in the best time frame. Your doctor may need to take a sample of the fluid inside the swelling to be sent off for lab testing. This will be able to tell us if infection is playing a part or not.

Treatment

The treatment of bursitis is very much dependent on the cause. If the cause is infection, then your GP will start you on a course of antibiotics and anti-inflammatories to fight it off and control the pain. Other treatment may include the use of ice or contrasting hot/cold bathing to help reduce the swelling. In severe cases, your elbow may need to be splinted or elevated in a sling. Elbow pads and changes to your general activities may also help to protect the elbow from further injury. Your GP may offer to drain the swelling (this is called ‘aspiration’ and requires a needle to remove the fluid), and this can help to provide relief by reducing pressure around the elbow.

Once clear of infection, or if you have a non-infective bursitis, then your superhero osteo can step in and work their magic. Abracadabra!

During the inflammatory process, swelling and pain may have affected how you use your arm. With pain, people often stop using that part of the body and swelling can affect the joint's ability to move smoothly through its range of motion. This can have a knock-on effect on the muscles and other tissues which surround the elbow joint. Many muscles which cross the elbow and are involved in elbow movement also cross the shoulder and wrist to aid in their function. So, you can see how a problem at the elbow could affect the whole limb (and beyond).

Here at Holistic Hands Osteopathy we will get to work at restoring full function to the shoulder, elbow and wrist. We will look at your spinal movements too to see if they have been affected. You can expect to be mobilised and massaged and we may also perform some lymphatic drainage techniques to help restore fluid movement through the limb (which may have stagnated during the injury process). Your biceps, triceps and other arm/forearm muscles may have shortened over time so we may perform some stretching techniques and will give you some exercises to do at home to back up what they do in the clinic room. If necessary, strengthening exercises may be given to reduce the risk of future episodes.

If your bursitis doesn’t resolve with the above treatments or keeps coming back, a decision may need to be made on whether the bursa should be removed surgically. This is called a ‘bursectomy’ and is usually a last resort. Extra pointy olecranons or spurs can also be treated surgically if needed.

Back to school… And work!

Now that the festive season is over, the kids will be back to school and the parents back to work. Normality resumes. Keep an eye on those elbows people! If you think you are developing an elbow problem (or any body part for that matter) then please call us on 0439379847 and we’ll get working on it straight away.

Exercises to try in the New Year

We know many of you will be entering 2020 with the goal of getting fit and we salute you. It is never too late to do more for your health and there is no better time than a new year to make a fresh start. As part of your osteopathic treatment, we offer advice on how you can use exercise to better yourself, so we thought a short email on different exercises you could try this new year would be a worthwhile read. Now go and get your gym gear out, you’re going to need it!

Something aerobic

The word ‘aerobic’ in an exercise sense relates to the need of oxygen to make energy for the body when exercising. You might hear some people refer to aerobic exercise as ‘cardio’ and this relates to the benefits on the cardiovascular system as a result of doing aerobic exercise. In other words, it’s good for the heart and lungs. Examples of aerobic exercise include walking, jogging, running, cycling and swimming. If you are looking to improve your cardiovascular health or ‘aerobic’ fitness, then trying one of the above options would be ideal. If you’ve never run before, but you’d like to give it a go, then start small. Try a light jog over a short distance to get the heart pumping and build from there. It’s not ideal to try running a 10k from the get-go! Cycling could be on either a push bike or a static exercise bike in the gym. You’ll benefit from both, but we think going out on a push bike is much nicer. Think of all the fresh air and beautiful views you can take in by opting for an outdoor ride. Have your helmet ready and ride safe :)

Something stretchy

If you’re not feeling the cardio side of things and would like to try something a little gentler, then stretching could be a good fit for you. The benefits of stretching include:

•           Improving or maintaining muscle flexibility

•           Reducing the risk of injury due to tight or short muscles

•           Allowing you to maintain good posture and movement to be able to perform everyday tasks efficiently

•           Allowing you to exert yourself to higher levels without the worry of injury

•           Improving fluid movement throughout the body

If you’re looking for guidance on a stretching regime, speak to us next time you’re in the clinic. We will be able to tailor one to your needs and abilities. You may also want to consider taking part in a local yoga class. Yoga is fantastic for helping you stay flexible, as well as a whole host of other benefits including increased strength, balance and energy levels.

Or maybe strengthening?

If you’re still looking for something else, then some strength training could be the right fit for you. If you don’t already have a gym membership, then get to your local gym and see what they have to offer. You can often try the facilities out first before signing up. Or if you don’t like the gym setting (and many people don’t), you could always look into getting your own equipment to use at home. Strength or ‘resistance’ training helps to increase the strength of your muscles which improves support for your joints and skeleton. You can also expect to see other benefits such as weight loss, improved posture, reduced risk of injury, and improved mood and self-esteem (and so much more!). Check out your local Pilates classes (we can help direct you to a good place), as this is a great way of increasing strength and flexibility for your whole body.

It is a good idea to have a mixture of all types of exercise to keep your body functioning to its best. One step at a time though. If you need advice, please call us on 0439379847 and we’ll be happy to book you in for a chat and run through some ideas. Let’s make the new year our chance to try new things!

Lumbar disc prolapse: Symptoms and treatment

It’s moving day and you’ve been running around packing, unpacking, lifting boxes and awkward furniture all day. You can’t stop though because there’s still more to do. It’s onwards and upwards with another load in the back of the Ute. You bend down to pick up the umpteenth box of the day and bang and you’re hit with excruciating low back pain and a shooting pain down the back of your leg. It’s crippling and you’re struggling to catch your breath and stand up straight. It’s a scenario unfortunately a lot of us are familiar with, but what has caused this searing pain? One possible and relatively common cause for such pain is a lumbar disc prolapse. Sit back with a coffee and let us take you through the ins and outs.

What is a disc and what just happened when I bent down?

Your spine is made up of many vertebrae spanning from the neck all the way down to the tailbone. Between each vertebra sits an elastic-like structure called a disc. The disc is made up of a tough outer section called the 'annulus fibrosus’, and a gel-like inner section called the ‘nucleus pulposus’. The discs work to separate the vertebrae to allow movement, as well as provide shock absorption to forces acting on the spine during movement.

Common causes of disc prolapse include trauma and degeneration of the disc tissue as a result of poor posture (for example lots of slouching or slumping) and repetitive bending movements. When we bend forward, particularly when we bend forward under load (like with our house mover above who had been repetitively picking up and putting down heavy boxes), the forces acting on the discs, and especially the inner nucleus, increase drastically. Over time these repetitive movements may cause small micro-tears in the layers of the outer annulus, which weakens the overall structure of the disc. Slowly, the nucleus gets forced out and a small bulge may occur (there is often no pain at all at this stage). If these movements continue, or if you go to pick up that box which is just too heavy for you, the force is too much and the bulge can progress into a larger protrusion. Like with any injury, the initial response of the body is inflammation. The presence of inflammatory chemicals alone can cause irritation to the surrounding nerve tissue as it exits the spine, or you may get actual contact of the disc on to the nerve itself, causing impingement. This is when you feel pain and know that all is not well.

What should I expect to feel when this happens?

The signs and symptoms of a disc prolapse can vary greatly depending on the type and severity of the prolapse, and where the spine is affected. A prolapse may happen slightly out to one side of the disc affecting only the nerves on that side of the body (this is most common). Or it may occur in a backwards direction, potentially affecting nerves on both sides of the body. A small bulge may only yield mild symptoms, whereas a large prolapse may cause more severe symptoms. Interestingly, this is not always the case though.

Some of the symptoms you may experience include:

•   Low back pain

•   Pain running down the front, side or back of the leg

•   Pins and needles or tingling down the leg

•   Numbness down the leg

•   Muscle weakness (this may manifest as losing the ability to lift your foot)

The most common disc prolapse affects the L5/S1 disc (the lowest disc in the spine) and will give symptoms down the side and back of the leg. Your practitioner will ask you lots of questions and do lots of tests to determine exactly what area is being affected.

How do we treat disc prolapses?

Initially you may be in a lot of pain and simple movements may be very difficult to perform, like standing up straight, for example. This is because the body is trying to protect you from doing further damage. Once inflammation occurs, the body needs a few days to deal with what has happened. So, if you come to see your Osteo straight away, don’t expect to feel better after one visit. In fact, it is quite possible you will feel worse in the coming days before you start to feel better. The advantage of seeing your Osteo early on is that they can educate you on the do’s and don’ts, tell you what to look out for and inform you what to expect going forward. Often the unknown is scary, but your Osteo will be able to ease your mind, even if not the pain immediately. Us Osteos like inflammation. It’s the body’s way of protecting the injury and getting organised for repair. So, although it may be painful, it is good to see it through without intervening too much.

Early on, we’ll get you moving better. We will also give you breathing, relaxation and core activation exercises to help the body better cope with the pain. A disc will often prolapse because of poor core stability, so getting you on the path to rehabilitating your core is good early on. When it is possible, we will relax the tight muscles and reinstate movement to joints that may have seized up and become restricted following the injury. Our focus is to ensure the fluids of the body (i.e. blood, joint fluid, and lymphatic fluid) are moving freely around the body. When injury occurs, these fluids can become congested and a bit stuck around the area, and sometimes need a little help to get moving again. This will ensure a speedier recovery. The injury site will need lots of fresh blood to the area, while the lymphatic system will need to be flushed – ridding the area of all the bad stuff. Depending on the severity, discs generally take around 3-6 months to fully recover.

Your Osteo is trained to help you through the injury process, so you can rest assured you are in safe hands. We know when and how to treat and know what to look for to ensure you are seen by the right people if it’s required (this might include your GP or a specialist if necessary). If you think you have a disc prolapse or have previously been diagnosed with one and need help managing it, then look no further. Call us today to book your appointment.