Tennis elbow is the pain located on the outside of the elbow most commonly occurring when gripping. It is associated with playing tennis, but can affect activities from doing the house work to shaking hands with a friend. For many people, especially coaches or serious tennis players, tennis elbow can become the bane of your life. I know because I am a tennis coach who had a 12 month battle with tennis elbow and I would like to share my experience with you in the hope of helping other coaches or tennis fanatics overcome the injury.

Tennis elbow is an overuse injury - technically called lateral epicondyle - that affects the tendon on the outside of the elbow. For a tennis player it most commonly occurs due to the constant stress on the tendon from hitting 1000's upon 1000's of balls. This stress can be compounded by mistiming the ball, especially on the one handed backhand. Interestingly the incidence of tennis elbow is far less common in double handed backhands.

In my case it was caused by trialling a stiffer racket - so many of today's modern rackets and strings create a stiffer feel which can place extra stress on the elbow tendon. After just one hour the pain had become extreme and I was to endure it for over twelve months. As a full time tennis coach this was a less than ideal scenario.

With my income on the line I quickly had to get to work treating the problem. As a coach rest was not an option, but I was quickly on the internet - which has a huge amount of data on tennis elbow. In no particular order I undertook the following treatment program:

- Physiotherapy. Once a week massage and manipulation ran into 00's of dollars over time.
- Anti inflammatory drugs. 3 times a day I took ibuprofen with a cup of green tea [which was highly recommended treatment also]
- Strengthening and stretching. 3 times a day I completed a routine which aimed to strengthen and stretch the forearm extensors and triceps surrounding the elbow joint.
- Elbow brace. I trialled several forms of elbow strap which were designed to take the stress away from the elbow tendon.
- Heat and ice. Three times a day I would ice the elbow then put a heat pack on to stimulate the healing process.
- Acupuncture. Once no progress was achieved with physio I took a course of acupuncture each week.
- Rest. After several months of frustration I set aside 1 month where I would play no tennis.
- Changing racket and string combination.

Despite my best efforts I was experiencing no improvement and the injury was in fact deteriorating.

Various invasive procedures like injecting cortisone were the next option, but this procedure had very weak evidence of success. Using my favorite research tool the internet I turned up a procedure which was achieving promising results called an "autologous blood injection." This involves drawing blood from your body and re-injecting into the elbow. The injection is made under CT scan so that it is made at exactly the right point on the elbow tendon.

The theory is that when blood is taken from the body it reacts by releasing its healing agents. When that blood is then re injected into the injured elbow tendon it will speed the healing process. Tendons are notoriously slow healers as they don't have the blood flow that muscles enjoy. The autologous blood injection gives the tendon the "kick along" it needs. The research on the blood injections showed promising results, although often patients need 2 - 3 injections to fully resolve the problem.

I was prepared to try it. The first step was to visit a sports physician who scheduled a scan on my elbow. Sure enough the scan showed a significant tear in the elbow tendon. Next the injection was organized to be performed by a very well regarded surgeon under CT scan. While a local anesthetic was administered the procedure was very painful. This pain however was short lived, and I was quite comfortable 1 - 2 hours after the injection.

The first week I completely rested the arm in a sling to give the procedure the best chance of success. After two weeks the tennis elbow appeared to have gone. For the first time in twelve months I was able to play and coach without pain - I would estimate it has been a 90% recovery and a fantastic result.

Clearly each case of tennis elbow is different - and sufferers should consult their physio and sports physician to get the best possible diagnosis and treatment. My particular injury was a tendonosis, which is a degenerative problem and therefore a candidate for the autologous blood injection. Tendonitis might be treated by more traditional methods.

What I would recommend is that chronic sufferers of tennis elbow consider the autologous blood injection with their doctor if they can't shake the injury. It worked for me after one injection. The pain and frustration of tennis elbow was ruining my tennis career, the blood injection was nothing short of a miracle for which I am very grateful.

Preparing for your first knee replacement surgery in the hospital can be daunting if you are not sure what to expect.

Once a surgery has been scheduled by your orthopedic surgeon and the hospital you will attend has been agreed upon be sure to find out if they conduct a pre-operative class for joint replacement recipients.

These classes will give you some more in depth insight as to how your surgery and follow-up will be conducted during your hospital stay. The old saying " preparation breeds confidence" holds true no matter what the task at hand is.

Generally you are admitted the morning of your scheduled surgery. After some final paperwork is completed and final verification is carried out you are then taken to the back staging area where you will change clothes and placed on a stretcher. There you will pre-medicated for the surgery to relax you then followed by further medication before being taken into the operating room.

The surgery itself can be can be completed in 1 1/2 to 2 hours if there are no complications. In some case depending on the surgeons experience, the surgery is finished quicker. After spending time in the recovery room you will be taken back to your room to recover from the after effects of the anesthesia and monitored further.

Physical therapy is started the following morning. getting you up and out of bed is one of the main objectives. Getting up and moving has been shown over the years to result in less medical complications and, speeds up your recovery.

Your physical therapy while in the hospital will involve two sessions a day. One in the morning and, another in the afternoon. Making sure you are pre-medicated before treatment is a must. Be sure to stay in touch with your nursing staff and therapist to get the timing down with the medication.

it will take oral pain medication about 30 minutes to start doing its job.

Your exercises while in the hospital will consist of a series of isometric exercises. You will be given gentle range of motion exercises to get the knee to bend and extend. This is not the place where aggressive therapy has to be given. Your physical therapists touch and their ability to make you feel at ease with the treatment are a must.

You will be given a walker to start your ambulation or gait training with as you begin walking in your room and in the hallways. You will find out of all the exercises etc.. the walking is the easiest. You should not feel pain when you step down on the operated leg itself. Yes it will be stiff and tight but pain will not be an issue here.

Your stay should be between two and three days in an acute care hospital. Once its determined you are medically stable, you can get out of bed and move around then it will be determined between you, your surgeon and the hospital staff whether you will go directly home or continue with further therapy in a skilled nursing facility.

That decision is made according to your living arrangements, if you have someone at home that can take care of you etc...

Your surgeon will use the hospital that they either have an arrangement with or, one that they feel more comfortable with. Your overall hospital stay will really determine on the quality of its staff. Most hospitals that have a separate orthopedic wing have nurses that are trained extremely well in that area.

Other then the ICU units the orthopedic staff I have found in my career are a close second when it comes to care and observation skills.

Communicating with the medical and rehabilitation staff are vital for a smooth recovery. Make sure when you are placed either in a chair or placed back in bed you have all your communication equipment available. Your telephone and call bell will be your lifelines while there.

Preparation breeds confidence it has been said and knowing what to expect and how the department runs through a pre-operative class will take some of the mystery out of your hospital stay.

Let me start off by explaining what Carpal Tunnel Syndrome is exactly. Carpal Tunnel Syndrome is when a nerve innervating (has control of) the hand becomes trapped or inflamed. When entrapment or inflammation of a nerve innervating the hand occurs it can cause symptoms of numbness, tingling, and weakness in that hand.

The generalized conception about Carpal Tunnel Syndrome is it only occurs at the wrist. This is true for the most part but, it can actually occur in three other spots as well. If you're only treating the wrist and not getting results, then odds are you need to look elsewhere. Where else you might ask?

We need to look at the bigger picture. Where do the nerves to the hand start? If you answered the neck then you're right! It's possible there could be an issue at the neck causing the Carpal Tunnel Syndrome. As you follow the nerve, the next possibility is at the shoulder, then to the elbow, and finally to the wrist again.
Many doctors and physical therapist over look the trail the nerve must travel in order to get the hand. If you only had your wrist treated without luck, don't give up hope just yet. What you need to do is treat the other possibilities. How?

Stretching, stretching, stretching and again I say stretching. Why is stretching so affective? The biggest reason anyone is experiencing Carpal Tunnel Syndrome is because the nerve is under tension. What stretching does is causing the nerve to get stretched/pull back into its original place relieving tension. Look at surgery for instance (not my recommendation) they go in and cut out excess tissue that is causing tension on the nerve.

Stretching isn't the only way to go about treating Carpal Tunnel Syndrome. I have also had good results with distraction of the joint. Let me elaborate on what I mean by distraction. It is no different than when you jam your finger and all you do is pull on it. Of course there are tricks and tips to proper distraction but I'm sure you get the gist of it.

Knowing when to brace is also very key to relieving the symptoms. Many doctors will give you a brace and say I want you to wear this for 2 weeks or for such and such amount of time. I personally don't think this is a great idea. The key to proper bracing is putting it on when you know you're going to perform a task or activity which causes the Carpal Tunnel Syndrome to flare up. Why shouldn't you wear a brace the whole time? Joints were designed to do one thing, move! Allowing joints to move can actually take out some of the inflammation occurring. Not only that, but joints need to move because this is how they get their nutrients to support normal join function.

I know Carpal Tunnel Syndrome isn't an easy thing to live with everyday. I just want you to know there are other options out there besides surgery. Surgery should always be a last resort because once you go under the knife there is no changing the outcome.

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Question : Are you looking for a way to survive your knee pain after you have injured your meniscus?

If you would like free information on how to help reduce this kind of knee pain then read on...

1.) What Your Meniscus Does

Your meniscus is a shock-absorbing cartilage found in your knee. Tears occur most commonly when a person excessively twists or over-flexing their knee joint. Often times it is a sports related injury.

There is a meniscus located in two parts of each of your knees. One provides shock absorption on the outside aspect (also known as the lateral aspect), and the other is located on the medial aspect (inside portion of the knee). It also keeps your femur (thighbone) and tibia (shinbone) from grinding against each other. In other words, if a person was somehow unfortunate enough to be born without their menisci, their weight would fall squarely upon their bones and this would promote boney fractures and a ton of knee joint pain.

Even a very small tear to the meniscus can cause a lot of pain, which is the overall reason why the health of your meniscus is vitally important. If an individual is older and they have brittle cartilage, they can be more prone to a meniscus tear.

2.) Symptoms include:

A popping feeling can occur at the time of injury

Knee joint pain When pressure is applied to the knee joint, knee pain can occur at the space between the bones.

A locking sensation can occur at the knee joint

Recurrent knee-catching

3.) Diagnosis

When you see your physician after a knee injury and you are concerned about a meniscal tear, he/she will look at your history, and can perform a manual test like the Apley's compression test, or the McMurray's test. Your physician may also use an X-ray or MRI determine the severity of your knee injury. Surgery is not always required, unless the damage is extensive.

4.) Treatment

Icing can help reduce knee swelling and reduce knee pain after a meniscal tear. In addition, it is important to stay away from any activity that inflames your knee pain.

5.) A Knee Brace For Support

A well designed knee support can also help patients who have suffered a knee injury, such as a meniscal tear. Excessive side to side movements can be restricted and the support a knee brace can provide can reduce your knee pain.

If you are an active person, you can use knee braces for a prophylactic purpose. When you use a knee support when you are healthy you may help prevent a knee tear. A well designed knee brace can be a very useful adjunct to the health of your knee.

A good physician will tell you that they use surgery as a last resort; telling you that conservative measures should be considered first:

A meniscus repair can be used to help treat your meniscus, but more often a meniscectomy is performed, which removes the damaged part of the meniscus.

If you suffer a meniscal tear once, you are more likely to have further problems, such as arthritis. Prevention is the best method to avoid such an injury. Making lifestyle choices that can help prevent this injury are recommended, such as staying in shape. The extra weight can only be an increased burden upon your meniscii.

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Metal AFOs, Why You Can Benefit From One

1.) Reasons For Using A Metal ankle foot orthosis.

Many patients will turn to a metal AFO for one of two reasons:

A.) History of Edema

The patient who has fluctuating edema (swelling) can need to have room to expand and contract; with respect to volume of their limb. - A metal AFO (ankle foot orthosis) has medial and lateral uprights that go up and down the side of the leg (below the knee) and are attached to a shoe. These uprights are not directly in contact with the skin and this is done for a good reason. - This room on the sides of the leg allows a person with edema to still use the brace when their swelling goes up and down. If this swelling became much more controlled after the provision of this brace, the uprights of the brace could be recontoured and this space could be reduced if requested by the patient.

When you compare this to other thermoplastic AFOs, you will note that a traditional plastic AFO can not allow this same amount of room on the leg and still be effective for a patient. Yes, both thermoplastic and metal AFOs can be adjusted, but it is important to note that a plastic brace needs to be in more total contact with your leg to be effective.

B.) History of Using Metal AFOs

People will typically also turn to the use of a metal AFO when they have used one in the past. This is a second major reason for using a metal ankle foot orthosis. Many people have been burned in the past by trying something that they are unfamiliar with. The same person might also believe that if what they have used a metal AFO in the past and it works, then why change it?

2.) Where To Find A Metal AFO

It is very important to visit a licensed orthotist in your area to get a quality metal AFO. Why? - When you get one of these braces made for you (or one of your patients) then you will want to go with someone that has experience. This is typically an orthotist, aka a professional brace provider. - These braces (as described in this article) typically consist of a leather calf band which is attached to metal uprights. The uprights are connected to ankle joints (which are adjustable) and these ankle joints are connected to a stirrup within the shoe you will use with the brace. - Sounds simple, but if a professional does not make this brace for you, something is bound to go wrong.

3.) Benefits of Metal Ankle Foot Orthoses

These kinds of braces can help to provide needed support to someones ankle and foot. This is important when you have a problem with weakness or instability at the ankle joint. Moreover, it is also important to use a brace (whether metal or plastic) because this can help to provide indirect support at your knee. This can help to limit knee hyperextension or knee buckling.