The old good tennis

Tennis elbow, also called lateral epicondylitis is a very common injury that results from overuse, injury, or strain of the tendon that attaches the forearm muscles to the boney part of the outside of the elbow. Called tennis elbow because tennis players are prone to getting it (50% of tennis players may have this condition), this medical condition is not limited to tennis players. Tennis elbow can occur with any activity that involves repetitive gripping, turning, bending, or extending the wrist backwards.

Symptoms of a Tennis Elbow

The outer part of the elbow is rather painful and tender to touch. Movements of the elbow, and also movements, that involve lifting, with the hand on top, hurt real bad. Any sport, from badminton, to tennis, to golf involves both the massive movement of the wrist and the complete arm. The elbow is one such part which is most often neglected and once affected takes a rather long time to heal.

Tennis elbow appears in different ways. Some people get symptoms after doing the same type of work for several years. While others get the symptoms suddenly soon after starting a new type of work. The main symptom of tennis elbow is the pain on the outside of the elbow. The pain gets aggravated with the movements involving grasping and holding objects. The damage caused by tennis elbow consists of tiny tears in tendon parts and in muscle coverings. Even after the healing of injury, these areas remain susceptible to tear again that leads to hemorrhage and calcium deposits within the surrounding tissues.

Causes

Although the condition is called tennis/golfers elbow there are many causes. Generally damage is done at the point the forearm tendon is anchored to the upper arm bone (humerous) by shock travelling up the arm whist gripping something tightly, for example using a hammer or playing tennis. The result is small tears in the tendon at the anchor point and inflammation occurs. As the forearm muscles are in continual tension due to the opposing action needed by the hand for gripping, the tendon inflammation (tendinitis) has little chance to heal.

Tennis elbow is caused by overuse, strain or injury to the tendon that attaches to the bone on the outside of the elbow (lateral epicondyle). This tendon is attached to the muscle that bends the hand backwards from the wrist. This results in tiny, microscopic tears in the tendon that causes inflammation and pain in the tendon.

Treatment

Rest: This is normally the first thing suggested. If you have a job that involves use of your hands this simple advice could be quite difficult to follow. However if it is possible, it can be effective.

An injection of a steroid into the painful area of the elbow often eases the pain. For some people, the pain never returns after having a steroid injection. However, for others, the relief from pain is only for a short time – perhaps for a few weeks. Also, it is worth bearing in mind the long term outlook before deciding on trying a steroid injection. A large research study looked at long term outlook. It compared those who had a steroid injection with those who did not. In this study, although about 9 in 10 of those who had a steroid injection had good short term pain relief, after one year only about 7 in 10 were free of pain. This compared to about 8 in 10 who were free of pain after one year who had not had a steroid injection.

Almost every person with diabetes should exercise, but there are some serious risks to avoid. Of all the treatments prescribed by doctors for their diabetic patients, one of the very best treatments is exercise. Some people even claim exercise is a “cure” for type 2 diabetes. I won’t go that far, but it is difficult to downplay the terrific improvement and maintenance exercise can play in diabetes management and control.

Increased muscle mass and strength lowers insulin resistance in Type 2 diabetics.  It helps raise “good” cholesterol (HDL) and lower the “bad” (LDL). It is in fact the very best way to increase HDL cholesterol. Exercise will also burn calories and help control weight.  Not to mention the added benefit of looking better and feeling better.   

Before beginning any exercise regimen it is very important to reviews your case with your doctor. Depending on your age and condition, your medical history and so on, there may be several precautions and possible restrictions that your doctor might place on you regarding exercise. It is highly unlikely, however, that you doctor will restrict you from any exercise whatever.   

Once you have established an exerecise regimen, be it walking, swimming, weightlifting, tennis, etc. and have cleared it with your doctor, here are 5 further rules that can help you gain the most benefit from exercise and reduce most of the risks.

Rule # 1

Test your blood sugar before and after exercise.  If your reading is less than 100 mg/dl (5.5 mmol/l) before exercising you should eat a snack with about 15 grams of carbohydrate.  Re-test after twenty minutes.  Don’t exercise until your blood sugar is over 100 mg/dl.

Rule # 2

To be fair, this is more like an extension of rule number 1. But it is significant enough that it gets its own number. Rule number two is: Exercise two hours after you eat.

There are several reasons for this.  One, you will probably be at your carbohydrate peak for energy.  Two, if you inject insulin, it will be several hours since your last injection. You won’t be as liable to have a hypoglycemic episode while exercising.  Three, it will be glucose-testing time anyway, and you should know what your glucose level is before you begin exercising.

Rule # 3

Remember to stretch and warm-up for 10 minutes before and cool down for 10 minutes after exercise, in order to avoid aches, pains and cramps, as well as heart problems or strokes. Failure to do this, especially the cool-down phase, increases the risk of a heart attack. Ten minutes of actively cooling down by walking or other slow and easy activity enables your heart to gradually reduce blood flow to your muscles.

Rule # 4

Carry a quick glucose-raising snack with you. This could be some glucose tablets, a couple rolls of Smarties® (an easy to chew glucose-based candy) or even a small piece of fruit or raisins.

Rule # 5

Take advantage of modern technology. Carry a cell phone with you in case you need to call for help for any reason. And, especially if you inject insulin, always wear a diabetic I.D. bracelet or necklace.  

Check with your doctor and follow these rules and you will reap many healthy benefits and improve your diabetes.