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Left Lateral Epicondilitis

Started by firefighter ontheside, February 25, 2023, 11:48:14 AM

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doc henderson

Mike I appreciate your enthusiasm.  I agree many medical issues could be avoided with lifestyle changes.  Most of the patients get to us after that is no longer preventative and not curative.  The ones that get this advice are still young and healthy, and the majority ignore that advice, or lack the long-term commitment to it.  Again, I know you express your respect for the few docs on the forum, so the word "criminal" implies intent to harm others.  The system is a mess, and we are doing the best we can in that system.  You are for sure entitled to your opinion, but in general, Docs are not meaning to harm anyone. 
Timber king 2000, 277c track loader, PJ 32 foot gooseneck, 1976 F700 state dump truck, JD 850 tractor.  2007 Chevy 3500HD dually, home built log splitter 18 horse 28 gpm with 5 inch cylinder and 32 inch split range with conveyor powered by a 12 volt tarp motor

Dan_Shade

I think I'm suffering a case of this in my right arm.  Hurts to pick anything up that requires a squeeze (like a cup/pitcher/firewood).

I think I caused it by loading firewood into my pickup.  Possibly previously aggrivated by starting a  cranky 660.

Any tips on excercizes?

Woodmizer LT40HDG25 / Stihl 066 alaskan
lots of dull bands and chains

There's a fine line between turning firewood into beautiful things and beautiful things into firewood.

doc henderson

If acute, then ICE.  ice, compression, and elevation.  ibuprofen if you can take it (no stomach or kidney issues, not on blood thinners) and a brace if it continues.  PT if you dr. can refer you.  the latter is for more long standing.  avoid for a while the stuff that makes it hurt, and try stretching. 

Lateral Epicondylitis (Tennis Elbow) | Johns Hopkins Medicine
Timber king 2000, 277c track loader, PJ 32 foot gooseneck, 1976 F700 state dump truck, JD 850 tractor.  2007 Chevy 3500HD dually, home built log splitter 18 horse 28 gpm with 5 inch cylinder and 32 inch split range with conveyor powered by a 12 volt tarp motor

mike_belben

If you experience relief from any sort of over the counter anti inflammatory med, then that proves inflammation is a contribitor. 

To take any of these meds long term as i did, will attack your intestines' protective mucosal epithelial lining over time.  That allows the sewage of pathogenic invaders that your intestines are designed to corral to the toilet, to directly attack your epithelial tight junctions and eventually perforate them on a microscopic level.  Then you have a sieve with holes.. aka "leaky gut"

The next step is that your immune mast cells start picking up distress calls as foreign particles spill out where they dont belong and the immune system launches full scale attacks wherever they may land.  Much suffering and lost wages later you get an autoimmine diagnosis named after whichever weak link in your unique anatomy breaks first, and the cure is no cure at all.. to "manage" it by supressing the immune system that you depend on to keep you alive. So really the cure is a delorian to go back in time and prevent that problem before it started.  Today might not technically be the best day, but today is better than tomorrow to start reversing.  Youre better off putting a truck in park before it rolls down the hill than after.

The moral of the story is to not depend on anti inflammatory meds because not all mucosal barriers are created equal and i think doc is also suggesting that as well.  The studies that look at side effects are hired out by the med manufacturer and are designed specifically to pre exclude from the trial anyone likely to have adverse reaction so the numbers look better.

If inflammation is causing you discomfort, do everything possible to lower it by dietary avoidance of inflammatory stuff and increase of anti inflammatory stuff. You can measure inflammation levels by looking at a host of markers that may or may not be there.

White blood count/ wbc ( most routinely tested)
Pla2 or "plac2" or hp-pla2
ESR
Fibrinogen
Oxidized LDL or oxLDL
CRP or C reactive protein
MPO or myelo peroxidase
SAA or serum amyloid A

Any of these being up is indicative of inflammatory activity.  Inflammation is a neccessary ingredient in most brands of slow death so you wanna spot it early on.


If you give a kid free tires for life he does lots of burnouts.  If you give a carpenter free wood he makes lots of wood stuff.  If you feed your body abundant omega 6 fatty acids he makes lots of inflammation.
Praise The Lord

firefighter ontheside

Dan, if with your arm held straight there is pain from pushing on the area at the bone of the outside of your elbow it is likely tennis elbow.  As Doc said, icing in the evening to help with pain and swelling.  To stretch it, hold your arm out straight, rotate your wrist so that your palm is facing away from your body, then with the other hand flex your hand.  You should feel the stretch right where you need it.  Don't over-do that stretch if it hurts badly.  You can pick up a band at Walgreens that applies pressure on your forearm just distal to your elbow.  That helps to take up some of the strain that is placed on the area of pain.  I've learned to do some of my activities in a way that doesn't require those muscles as much.  When I carry a bucket of water for my goats for instance, I will carry it such that my palm is rotated out instead of in.  That puts the strain on the muscle of the inner forearm instead of outer.  Also, steroid injections can eliminate the pain for a while.  For some, like me, the pain comes back after a few months.  For others it may never come back.

My surgery is in 2 days and I'm ready.  I'm tired of bumping my elbow on things and it hurting so bad.
Woodmizer LT15
Kubota Grand L4200
Stihl 025, MS261 and MS362
2017 F350 Diesel 4WD
Kawasaki Mule 4010
1998 Dodge 3500 Flatbed

doc henderson

good luck.  what are they going to do Bill?
Timber king 2000, 277c track loader, PJ 32 foot gooseneck, 1976 F700 state dump truck, JD 850 tractor.  2007 Chevy 3500HD dually, home built log splitter 18 horse 28 gpm with 5 inch cylinder and 32 inch split range with conveyor powered by a 12 volt tarp motor

firefighter ontheside

I had it done 13 years ago to my other elbow.  The way I understand it, they cut the tendon away from the bone, trim the bad end of the tendon off and then suture the end that is left back to the bone.  The scar tissue that forms is what keeps it attached.  This surgeon mentioned that he does it a little different than how the other one did, but I assume the end result is the same.
Woodmizer LT15
Kubota Grand L4200
Stihl 025, MS261 and MS362
2017 F350 Diesel 4WD
Kawasaki Mule 4010
1998 Dodge 3500 Flatbed

firefighter ontheside

surgery all done.  doctor said my tendon was pretty bad, but surgery was a success.  seems i was in there for 1 1/2 hours.  the nurse was croatian guy and we talked about croatia a bunch.  turns out hes the cousin of another croatian friend of mine.  small world.  bandage comes off in 3 days.  then i have to wear a wrist brace to prevent me from bending wrist, which uses that muscle. 
Woodmizer LT15
Kubota Grand L4200
Stihl 025, MS261 and MS362
2017 F350 Diesel 4WD
Kawasaki Mule 4010
1998 Dodge 3500 Flatbed

thecfarm

Good luck!!!
I hope all goes well.
Model 6020-20hp Manual Thomas bandsaw,TC40A 4wd 40 hp New Holland tractor, 450 Norse Winch, Heatmor 400 OWB,YCC 1978-79

firefighter ontheside

thanks.  some pain started during the night.  seems the nerve block wore off.  nothiung too bad though.
Woodmizer LT15
Kubota Grand L4200
Stihl 025, MS261 and MS362
2017 F350 Diesel 4WD
Kawasaki Mule 4010
1998 Dodge 3500 Flatbed

doctorb

I had that surgery too.  I think about it as an attempt to excise an area of chronic inflammation, which is the attachment of your wrist extensor muscles to the lateral epicondyle of the distal humerus.  This damaged area was not able to be rested enough for the attempted healing to outpace the repetitive injury.  Lifting a pot off the stove.  Twisting a tough doorknob.  Shaking hands.  Lots of daily activities that are extremely difficult to avoid recreate this injury constantly.  Most don't end up needing surgery, but a few of us unlucky ones do.  By cutting out the damaged muscle attachment, normal tissue is left behind and the healing progresses without the constant re-injury of inflamed tissue.
My father once said, "This is my son who wanted to grow up and become a doctor.  So far, he's only become a doctor."

firefighter ontheside

Thanks for that very good description.  I had the same surgery on my right elbow about 15 years ago and it is doing well.  I just came home from my 2 week surgical followup.  They said it is doing well.  I will start setting up therapy next week for twice a week.  At first they will focus on range of motion and wait til later for strength.  What I remember about last time is that I will need a lot of stretching of my arm.  I go back for next followup in 4 weeks.
Woodmizer LT15
Kubota Grand L4200
Stihl 025, MS261 and MS362
2017 F350 Diesel 4WD
Kawasaki Mule 4010
1998 Dodge 3500 Flatbed

thecfarm

Sounds like it's going good!!!!!  
Model 6020-20hp Manual Thomas bandsaw,TC40A 4wd 40 hp New Holland tractor, 450 Norse Winch, Heatmor 400 OWB,YCC 1978-79

firefighter ontheside

I guess I should update this.  I'm doing well in  my recovery.  I'd say I'm about 75%.  I'm gonna be going back to work this week on sort of light duty.  I will have a 25lb weight restriction, which means I can't work on a firetruck, but I can do my main job which is Battalion chief.  After my next doctor appt. I may be cleared for everything in mid April.
Woodmizer LT15
Kubota Grand L4200
Stihl 025, MS261 and MS362
2017 F350 Diesel 4WD
Kawasaki Mule 4010
1998 Dodge 3500 Flatbed

Old Greenhorn

ffcool ffcool ffcool
 Glad to read this Bill! Also glad you got through the recovery period (so far) without doing anything dumb to stretch the recovery out. I know many of us (OK, ME) would have trouble sitting around and waiting without 'just tryin to do a little bit of work because I feel good'. I stretched out a shoulder injury by 3 years doing just that. Don't be like Tom. ffcheesy
Tom Lindtveit, Woodsman Forest Products
Oscar 328 Band Mill, Husky 350, 450, 562, & 372 (Clone), Mule 3010, and too many hand tools. :) Retired and trying to make a living to stay that way. NYLT Certified.
OK, maybe I'm the woodcutter now.
I work with wood, There is a rumor I might be a woodworker.

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