Tennis elbow: Not just for tennis players

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DEAR DR. DONOHUE: I am 57 years old and a female. I have tennis elbow. I had a few cortisone injections, which helped but did not get rid of it. A doctor recommended some exercises, but I haven’t continued them because they aggravated the pain. Will the pain ever go away? Am I destined for surgery? – P.C.

ANSWER: For your and readers’ orientation, let your affected arm hang down with the palm at thigh level and facing forward. With your other hand, feel the little, bony bulge on the far side of your elbow, the side not next to your body. That’s the lateral epicondyle, and it’s the place where many of the forearm muscles attach to the elbow via a wide tendon. Tennis elbow is lateral epicondyle tendinitis. Some don’t like calling it tendinitis because they feel it’s not an inflammation but a degeneration of the tendon attachment.

All agree, however, that damage to the tendon comes from repetitive use with too little rest. It can happen at any age, but it mostly happens to people between the ages of 35 and 50 who play tennis three or more times a week for 30 or more minutes each session. It can happen to others – non-tennis players. Carpenters are often victims.

Rest is important. You don’t have to keep the arm and elbow immobile. You shouldn’t do anything that intensifies the pain, including exercises. A physical therapist can work with you to design exercises and stretches that aren’t painful Warm compresses for 20 minutes, three times a day, are helpful. Anti-inflammatory medicines like naproxen and ibuprofen ease the pain.

Cortisone shots should put an end to the pain if you rest the elbow after the shot. Soundwave therapy is favored by many. Botox, the stuff used to smooth skin wrinkles, is said to stop any muscle spasms that aggravate the pain.

Once the elbow is free of pain, then many find that wearing a forearm brace, obtainable at most sporting-goods stores, prevents a recurrence. The brace slightly changes the angle that the tendon inserts at the elbow, and it absorbs the racket vibrations transmitted to the elbow after hitting a ball. People with tennis elbow should see a tennis pro. The pro can correct your strokes so they aren’t taking a toll on the tendon. A poorly hit backhand is often responsible for tennis elbow. You’re not destined for surgery.

DEAR DR. DONOHUE: I took my waist measurement after reading that women shouldn’t have a waist measurement over 35 inches (89 cm). Mine is 32 inches. I swim for 25 minutes, bike for 15 minutes and run for 10 minutes. In addition, I lift weights for all muscle groups.

I am 47, 5 feet 2 inches tall and weigh 140 pounds.

Am I overdoing it? Am I on the track for burnout? What do I have wrong? What am I doing right? – P.H.

ANSWER: You’re not doing anything wrong. Your waist is great. For men, the waist measurement should not be over 40 inches.

A few symptoms can tell you if you’re overdoing it. One is fatigue that just won’t go away. Another is your early-morning resting pulse. Take your pulse about five minutes after wakening, while you’re still in bed. If it jumps up from what it used to be, that’s an indication you need to back off and take some rest.

Your body mass index, a better indication of body fat than is scale weight, is 25.6. Normal is 18.5 to 24. You are a tad overweight, but it’s nothing to get excited about. Just keep doing what you’re doing.

DEAR DR. DONOHUE: I have a pedometer that measures steps, not miles. How many steps are in 1 mile? Are they still recommending 10,000 steps a day? – J.G.

ANSWER: The number of steps in a mile depends on the length of a person’s stride but, on average, 2,000 steps is a mile. Most people take only 3,000 to 5,000 steps a day. The recommendation is still 10,000 a day. That’s no magic number. Take as many steps as you can.

DEAR DR. DONOHUE: My husband has really bad emphysema. He’s on oxygen, but not all the time. I wonder about a lung transplant for him. I have never read that such a transplant is done for emphysema. Is it? I think it’s the only thing that would make him better. – L.C.

ANSWER: COPD, chronic obstructive pulmonary disease, includes emphysema and chronic bronchitis. COPD is one of the five topmost indications for lung transplantation.

The number of people who have COPD is 16 million in the United States. Due to a shortage of lung donors, only around 1,000 lung transplants are possible each year. That’s one reason you haven’t read about the procedure.

In addition, there are guidelines for selection that often exclude many potential lung transplant patients. For a two-lung transplant, people under 60 are usually chosen, and for a single-lung transplant, people under 65 are candidates.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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