Using Acupuncture to help heal Tennis Elbow

So many times, patients come to see me and say "my doctor says I have Tennis Elbow, but I don't even play tennis!" Tennis Elbow is a very common repetitive strain injury that can be caused by tennis, but can have numerous other sources as well.

What is it?

The Western medical term is Lateral Epicondylitis, which is inflammation of the small "bony knob" on the outer elbow and the surrounding tissue. Pain here can cause difficulty with lifting objects with one hand, like when you want to pour milk into your coffee (of course you are pouring coconut milk into your tea, but that's an exploration for another day) and can sometimes interfere with one's ability to twist open jars. In Chinese medical terms, there is Qi and/or Blood Stagnation in the elbow, often due to physical trauma (like overuse), Heat, Dampness, Cold or a combination. When Qi (often translated as energy) is not flowing properly (no matter what the cause), there is pain; by encouraging Qi flow, the pain goes away. Qi stagnation usually has an achy, dull quality to it, whereas Blood stagnation tends to be sharper and more stabbing pain; it is possible to have both simultaneously.

Why does my elbow hurt?

Even though the pain is in the elbow, my experience has found that that is rarely where the problem originates. There is a saying in the bodywork community that "pain is a liar;" the location of the pain is not always it's source. Sometimes people feel pain in their knee but the pain is really coming from their hamstrings, their IT band or sometimes it can be compensation from dysfunction in their foot. In terms of Tennis Elbow, usually the problem comes from tightness and restriction in the rotator cuff muscles (often Subscapularis or Infraspinatus). When you repeatedly hit a tennis ball with a racquet, the movement comes from the torso and shoulder, but the impact is often felt at the weakest joint, in this case, the elbow; the elbow is the "weak link" so that is where the pain refers. Even without the impact of a ball against a racquet, repetitive movements like typing, using a mouse or even lifting something with one hand that is a little too heavy can cause strain in the elbow in the same way.

How can acupuncture help?

When the restriction is released, the elbow pain decreases and disappears. Acupuncture needles work

to release the muscular tension and restriction in the body so that it functions properly. In this case, they go into the body typically in points along the Small Intestine and Large Intestine Meridians to encourage proper Qi and Blood circulation which reduces pain and encourages proper range of motion. "Small Intestine 9," or SI 9, is a point behind the shoulder, that when released often gives significant relief to the elbow. Additionally, acupuncture increases blood circulation. Our blood contains nutrients that help our body heal itself, so by increasing blood flow to the area, acupuncture encourages the body's natural healing process.

What else can help?

Sometimes the elbow can feel really "angry," by which I mean sensitive and irritated, and usually feels worse with movement and massage. In this case, the needles can make the pain worse instead of better, so I choose to treat the elbow with Moxa (read more about Moxa here). Moxa is a less invasive way to treat pain and inflammation. What is interesting is that even though Moxa is a heat therapy, it reduces inflammation, rather than increasing it.

Is there anything I can do on my own that will help?

Ideally you want to be treated by a professional, but between treatments or before you can get started, a tennis ball can be very handy to start working on the rotator cuff tension. Lie down on the floor or lean against a wall or chair back. Place the ball around SI 9 (see image above) and lean into it until you feel a strong sensation. Take some deep slow breaths and try to relax into the ball. Sometimes it helps to lie on your side with your arm extended and place the ball that position, but the sensation can be much more intense. Listen to your body and be kind to it. If you find a tennis ball isn't hard enough, you can use a lacrosse ball, but anything harder than that will only cause bruising and tissue damage. Please don't use the tennis ball on the elbow itself, you won't be happy with the results.

In terms of anti-inflammatories, I believe in using food as medicine. Turmeric (with black pepper), tart cherry juice, pineapple, ginger and anything containing Omega-3 Fatty Acids (chia, flax, hemp, salmon, sardines, walnuts) have anti-inflammatory properties. When taken in high enough doses they can make a huge difference in your pain levels and won't cause damage to your liver or kidneys like NSAIDS can. See your local natural health practitioner (acupuncturist, naturopath, functional medicine doc) for dosage suggestions.

*Picture above from www.natural-health-zone.com.

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To learn more about me and what I do, go to www.integrativetherapeutics.com.