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HomeHomeDiscussionsDiscussionsFORUM OF MEDICA...FORUM OF MEDICA...Tennis Elbow- Cortisone gone bad?Tennis Elbow- Cortisone gone bad?
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6/20/2013 6:07 PM
 

I had a new client come in today with Tennis Elbow.  Being new to Medical Massage, I was not yet familiar with any of the tests under the tennis elbow category; however, she did test negative for nerve irritation from the anterior scalenes and pec minor.

July 2012 she received her first cortisone shot which provided 6 months of relief.  Dec 2012 she had another cortisone shot, but this time the skin around the lateral epicondyle turned black and green.  The skin in that area now appears much thinner when compared to the other elbow (the bone on the affected side is much more prominent which she states was not the case prior to the 2nd shot).  The area is extremely painful to the slightest touch.

Her doctor has been talking to her about plasma injections and she is also considering acupuncture (thoughts?).  I did not want to proceed with the protocol and PM without consultation given the state of the tissue in that area after the cortisone.

 

Thank you,

Shea D.

 
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6/23/2013 11:23 PM
 

Dear Shea

 

Your client has soft tissue atrophy as a result of repetitive steroid injection. This is a frequent complication. Considering the complicated situation I think that you should ask her to talk with her physican to do elbow MRI and rule out the severe tear of tendons at the insertion into the epicondyle. If there is no significant tear you may proceed with protocol for the Tennis Elbow but instead of periostal massage use cross fiber friction (Cyrax's friction) to build up resistance of the tissue especially skin. Be careful and increase intensity and duration slowly. Only after the skin recovers (and it will) you may start PM

 

Dr.Ross Turchaninov

 
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7/3/2013 10:57 AM
 

Thank you.  Her doctor did not want to order the MRI, as he says he is certain there is significant damage to the tendon.  He is suggesting the plasma injections, but the client is still very interested in massage.  If there is a lot of damage to the tendon, can I still help or should she seek other therapies?

 

Thank you, 

Shea

 
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7/8/2013 11:42 PM
 

Damage to the tendon isn't the contraindication to your therapy. You need to let your client at the very beginning that if there is a lot of damage (presumably) your treatment has less chances to be successful. I will try it anyway since without MRI no one for sure can rule damage in or out.

 

Dr. Ross Turchaninov

 
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7/18/2013 8:39 AM
 
Question for Ross:
Is there any possibility for med massage practitioners ordering their own MRI's?
Rabel M
 
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HomeHomeDiscussionsDiscussionsFORUM OF MEDICA...FORUM OF MEDICA...Tennis Elbow- Cortisone gone bad?Tennis Elbow- Cortisone gone bad?