THIS IS WHAT OFFSHORE WROTE ON BKSA:
every one seems to be complaining of "tennis elbow" type symptoms
what i have decied to do is write a bit on what it is, how to treat it, how to prevent it, who to see and maybe shoulder surgery (if i get time).
(sorry it was not done the other day)
it is meant as a guide and not to be exhaustative so don't grumble at me
tennis elbow- medical term Lateral epicondylitis, this means inflammation of the lateral epicondyle (which is the nobbly bit on the out side of your arm bone, above your elbow (Humerous). the reason this area of bone becomes a problem is that all the muscles that extend your wrist and fingers have a common origin from this segment of bone ,tendons are the extension of muscles that attach to bone, this means that this area of bone can be exposed to high degrees of stress.
the actual dysfunction(problem) may occur in 3 different areas :1/ the muscle tendon junction (MTJ), mid tendon, or the teno-osseous juntion (TOJ= the area the bone and tendon meet). the TOJ is the real problem area as there is a poor blood supply and it takes a long time to heal 8-10 weeks, whereas the MTJ may take 4-6 weeks (with the right treatment)
Recent research has shown that when actually studying the tendon and its attaachment the problem is not normally inflammation but one of degeneration, so the term tendiosis is better (degeneration of the tendon) occassionally the term tendionpathy may be used (means tendon problem). many doctors will still argue it is inflammatory but this is very rarely the case.
to explain why it is degenerative one must first understand what our body is doing- normally our body is constantly repairing tissue whilst we damage/wear tissue. this process is normally in balance, however add more things that wear tissue (such as kiting) then our body actually falls out of balance, and the rate of damage/wear exceeds the rate of repair.
this is shown in most cases of people complaining of these symptoms on here as they say they had a "massive session" or "3 days worth of kiting". this is excessive load for your tendon and will therefore causes pain. given rest this will normally settle.
this is commonly a factor in high level athletes who experiance recurrent injurys and is due to a combination of over training, poor diet, dehydration (common for me when kiting) or other health problems (Diabetes), lack of sleep etc.
with continued trainng at the right level your tendons will alter their structure to take the stress placed upon it- like muscle, this can however take longer and you must consider it as taking months not weeks. aslong as you have other things that don't effect this- poor diet, lack of sleep, other health problems, dehydration etc
alternatively you may experiance post exercise muscle soreness as a result of training (kiting) , think of plaaying football/going to the gym after not going for a while- you are often very sore for several days after with the second day being the worst. this pain may be very severe and cause problems with activity- i have found it difficult to cough due to abdominal soreness after having a kiting session for up to 5 days, the reason you suffer this is due to small microtears to muscles and is experianced in the
in .Muscle belly not the tendon.
Inflammatory phases problems will be acute so less than 2-3 months, pain will be worse in the morning after chemical irritants have accumlated in the tissue over night, activity will often be sore, but after a while the pain dies down after resting after exercise the pain will increase due to the chemical irritants associated with inflammation. inflammatory cases may present after a injury such as a crash when kiting with all the weight on the arms. at present the term has been changed but many doctors still call it lateral epicondylitis so don't get too boged down.
many other problems may mimic this condition so if you suffer with sympoms for a while then i would recommend seeing a very good physiotherapist either privately or on the NHS (whichever country) but like every one you may end up seeing a crap one. (problems mimicing this condition- neck problems may just cause arm pain, or vascular (blood supply) problems amongst others)
since most problems appear degenerative treatment differs from the inflammatory problems when you may take anti-inflammatories, rest, gentle exercise, ice etc.
so best treatment may involve tranverse friction massages to the tendon- ,this actually damages the tendon further but should cause the normal healing process to occur after. stretches to restore normal tissue flexibility, other arm exercises not involving the tendon,
but the best thing is a special exercise where instead of shortening the muscle under contraction you lengthen it.! example a bicep curl, as you pull the wieght up so your hand comes up to your shoulder the muscle shortens, as you lower the wieght the same muscle lengthens, so the principle of the exercises is to lengthen under contraction but not shorten the muscle, how do you do this??
well- you sit next to a table place your arm on it , palm down, with your wrist over the edge, hold a small wieght (tin of beans) , now use your other arm /hand to pull your wrist in to an extended position (bring the back of the hand up towards your arm) let go with your other hand and slowly lower the wieght so your wrist goes into flexion (bringing the palm towards the floor and forarm), now again use the other arm to lift the wieght back up (do not use the arm you are exercising) and repeat 15 times , 3 sets twice a day for 2-3 months and a chronic "tennis elbow" should resolve.
what does this exercise do? 2 theories! 1/ eccentric exercises really stress the muscle/tendon so may cause minor trauma leading to a normal healing pattern (like the massage), 2/ eccentric exercises stress the tendon/muscle causing an increase in tensile strength, an increase in muscle stress means the tendon takes less force as the muscle absorbs more,so problems don't develope. this principle has been shown to work with chronic tendoachilles dysfucntion (which also is degenerative not normally inflammatory)
cross training may help- going to the gym,swimming,climbing etc where you don't rely on this muscle for long lengths of time
what can you do with kiting- ensure good hydration,diet (vitamins/protein), sleep/rest, training, cross training, some people say glucosamine suplhate- this is a naturally occuring substance injoints and tissue fluid, it provides lubrication, without it heat or excessive forces may occur so tablets may increase the levels of this. no medical randomized controlled trials hav confirmed this, and people may get pain due to other causes not just reduced tissue fluid (also effected by hydration), the increase force thorugh the muscle as already stated may be due to shortening, muscle weakness
actual kiting -reduce tension/force needed to to turn the kite, fly hooked in , use the pig tails on your kite to make it turn quicker, use powerlock type bars, let the harness take the load, you may increase or decrease the thickness of your bar, turn your hands over palp up instead of down, hold your bar at the ends not in the middle (less force) use a longer bar (less force), don't fly in an over
stretched position or with your bar really close, if changing/upgrading kites buy some that require less force to turn.
changing your kiting style by not gripping the bar for dear life may help, treat it like you treat your tadger , with firm but yet soft grip(or like you hold a golf club)
reduce intensity/frequency of kiting- self explanatory
if problems occur after changing bar/kite then change back, slowly graduate the change from old bar/kite to new bar/kite, this allows the tissue to adapt.
sh*t i have missed loads but i will be here all day otherwise, keep trying to do this between patients! bad choice,
why should you believe me? because you just should , ok! the bloody server timed me out since it took so long, so i have just had to paste here.
there are loads of other bits that relate to this ,but i wanted to give an overview- hope it helps
offshore? no really??