She started complaining of elbow pain after playing tennis.
A woman living in Kannai came to the clinic after injuring her right elbow while practicing tennis.
She started taking tennis lessons twice a week a year ago. About a month ago, she noticed discomfort in her right elbow during a doubles match. The pain got worse during the game, but she didn’t want to let her partner down, so she kept playing. By the end of the match, her elbow hurt quite a bit. When she got home, she applied ice, which helped ease the pain somewhat, but the discomfort didn’t fully go away and started affecting her daily life. A few days later, she saw an orthopedic doctor near her workplace, who said, ‘Ah, this is tennis elbow,’ and prescribed painkillers, a pain-relief patch, and weekly electrical therapy. She followed this treatment for three weeks, but saw no improvement. Searching for alternative treatments, she found Spine Chiropractic in Bashamichi online, where ‘tennis elbow’ was listed as a treatable condition, so she decided to visit my clinic.
[Initial Symptoms]
Interview:
In the days following the injury, she experienced a throbbing pain and managed it with painkillers and ice therapy whenever it flared up. As a result, the throbbing pain subsided, but she began to feel a sharp, momentary pain when performing movements that involved using her hand, specifically twisting motions of the elbow.
Wanting to avoid taking medication as much as possible, she opted not to receive painkiller prescriptions when visiting the hospital and instead attended weekly electrical therapy sessions. However, as she did not notice any improvement, she decided to seek treatment at my clinic.
Visual Inspection:There were no noticeable issues during the visual inspection, and no swelling, redness, or warmth that I expected with inflammation (depending on the location).
Static Palpation:When touched, she had localized pain on the outside of the elbow (with her palm facing forward).
Motion Palpation:The bending and straightening movements of the elbow were fine with no problems. But turning the elbow outward (with the thumb pointing outward) caused intense pain, making it hard to put any strength into it. Even when the practitioner rotated her elbow while she kept it relaxed, there was still some pain, though less than when she did it herself.
Orthopedic Tests:
Thomson Test: Positive
Chair Test: Positive
Muscle Strength Examination:
Forearm flexors: There’s some pain, but strength is 5/5.
Forearm extensors: Can’t put strength due to pain.
Forearm pronators: A bit of pain, but strength is 4/5.
Forearm supinators: Can’t exert strength because of the pain.
[Treatment Content]
Based on the localized pain on the outside of the elbow and the test results, I determined it to be a typical case of tennis elbow (lateral epicondylitis). Since it had been a month since the injury, the inflammation phase was over, but there was ongoing stress on the tendons connected to the muscles at the lateral epicondyle. Key muscles like the extensor carpi radialis longus, extensor carpi radialis brevis, and extensor digitorum showed uneven tension, making it easier for stress to build up at their attachment point. So, I used fascial release to reduce muscle tension and adjusted the proximal radioulnar joint where these muscles attach.
After treatment, I had the patient perform the movement that caused pain again. The pain was still there, but it had decreased to about a 5 out of 10, compared to the original pain level of 10. With this progress, we ended the first session and planned a follow-up five days later.
[Prognosis]
Second Visit:
When I asked about her progress after the first treatment, she shared, “For about two days, the pain was less, and I felt it less often during daily tasks. But by the third day, it was back to its usual level.” Since her condition had been chronic for a month, it was expected that one session wouldn’t bring lasting relief. We repeated the initial treatment and planned to check again after a week.
Third Visit:
A week later, she reported that while not fully pain-free, the discomfort was about half as bad. Using the same treatment plan, I also added ultrasound therapy to the proximal radioulnar joint. We scheduled the next appointment for ten days later.
Fourth Visit:
Over the ten-day interval, she reported almost no pain and was visibly happy about the progress. At this session, I determined that her symptoms were fully resolved.
She expressed interest in regular maintenance treatments for chronic issues like shoulder stiffness and lower back pain, so we moved to a monthly maintenance schedule.
[Practitioner’s Opinion]
As mentioned earlier, this patient’s condition was a classic case of tennis elbow (lateral epicondylitis). Since the inflammation phase was over, deciding on a treatment approach wasn’t too challenging. However, tracking how the progress would unfold needed careful attention due to individual differences. (Some people improve quickly, while others take more time to see results.)
I based the treatment approach on experience with similar cases, and it turned out to fit the typical course, so fewer sessions were needed for improvement. Using ultrasound therapy at the end really helped ease the symptoms even further, and it was a case where I felt it could have been used from the start as well.
If you or someone you know is experiencing similar symptoms, please visit my clinic, Spine Chiropractic, located just one minute from Bashamichi Station, eight minutes from Nihon Odori Station, seven minutes from Kannai Station, and twelve minutes from Sakuragicho Station. I will provide dedicated and sincere care.