Tennis Elbow: Symptoms, Causes and Treatment.

Tennis elbow is the condition in which the outer part of the elbow becomes sore and tender. The origin of forearm muscles and tendons become damaged with the repetitive use of the wrist which causes an extreme pain. The pain initially starts on the outside of the elbow. 


The symptoms of Tennis Elbow include pain in the outer elbow. Pain increases while gripping or holding anything.

Symptoms may also include:

  • Difficulty in shaking hands.
  • Difficulty in turning the doorknob.
  • Difficulty in holding small objects like a cup.


Tennis elbow is caused by the overuse of wrist and arms. The repeated motion and stress results in tennis elbow. As the name suggests it is commonly seen in racquet sports players but they are not the only one who goes through this condition. It commonly occurs in IT professionals who have constant and repetitive use of computer mouse and keyboard & housewives, who repetitively twist clothes to dry and use circular wrist movements for cooking. 


  • Essentially the mainstay of treatment is rest and to avoid chronic repetitive stressful wrist movements.
  • Analgesics and anti-inflammatory medications will help muscles and tendons to recover from the damage.
  • Tennis Elbow Brace is a circular band, which helps in off-loading the point of origin of muscles. Must be used while playing racquet sports, use of computers or while cooking/working.
  • Physiotherapy using ultrasound massage and exercises gives excellent relief from pain and helps in building strength.
  • Local infiltrations of steroid are reserved for resistant or recurrent cases. Local infiltration of PRP (Platelet Rich Plasma) is gaining popularity over steroid injections as PRP is natural and uses patient’s own blood.
  • Surgical releases are seldom necessary and reserved for resistant cases wherein all the above methods of treatment have failed.

How to Avoid Tennis Elbow:

1. Correct posture.

2. ‎Correct grip or padding. 

3. Correct strength.

4. ‎Exercise your wrist and fingers.

5. ‎Take frequent breaks.

Precautions to be followed in Lower Back Pain.

The marvelous strength and flexibility that’s engineered into your lower back also make it susceptible to developing lot of problems and one of the most significant orthopedic health problems today is low back pain.

Most episodes of low back pain are caused by damage to the soft tissues supporting the lower spine, including muscles, tendons, and ligaments. The lower spine, also called the lumbar spine, depends on these soft tissues to help hold the body upright and support weight from the upper body. If put under too much stress, the low back muscles or soft tissues can become injured and painful.  

About 90 percent of the time, low back pain is short-lived and goes away within a few days or weeks without much fuss. A minority of patients, though, go on to have sub acute back pain (lasting between four and 12 weeks) or chronic back pain (lasting 12 or more weeks). If the pain worsens at night and while lying flat, if it’s associated with weight loss and fever, or if you’ve recently fallen or have osteoporosis or experience shooting pain down one or both legs, suddenly crooked posture, an inability to stand up straight, or holding your breath when changing position, you should immediately see a doctor.

Doctors Tips to prevent lower back pain

Exercise your core. Strong core muscles are important to provide support for the lower back and avoid injury. Low-impact cardiovascular exercise—like walking—increases blood flow to the spine, which supplies healing nutrients and hydration to the structures in your lower back.

Correct your posture. Poor posture places pressure on your back and can cause degenerated discs to become more painful. Support the natural curve in your lower spine by using an ergonomic chair. Make sure to get up and walk around at least once an hour if you sit most of the day. 

Lift heavy objects correctly. Even if you’re young and strong, you can still injure your lower back if you lift a heavy object incorrectly. Bend your knees first to lift an object rather than bending your spine.

Improve your overall physical health. The spine reflects the overall health of your body. Anything you can do to improve your overall physical fitness and general health will benefit your lumbar spine as well—including drinking lots of water, minimizing/not drinking alcohol and stopping smoking/avoiding any nicotine intake. It is also important to get enough deep, restorative sleep, as too little sleep can lead to back pain and/or worsen an existing back condition.

Stretch your hamstrings. A little-known cause of low back pain is tight hamstrings. Simple hamstring stretching exercises can help decrease the pressure on your pelvis and provide relief across your low back. Not all hamstring stretching approaches are good for all types of back conditions, though, so check with your physical therapist or doctor first.

Loose any excess weightYou can use the body mass index BMI calculator to find out whether you are a healthy weight for your height

Wear flat shoes with cushioned soles These can reduce the stress on your back

Avoid sudden / jerky movements.

Try to reduce any stress,anxiety and tension. Yoga May Help Patients with Chronic Nonspecific Low Back Pain. Try “non-drug therapies” such as exercise, swimming, yoga.

I recommend low resistance, high repetition exercise programs, alongwith a healthy lifestyle and encourage consistency, as an irregular program will not be helpful.

“Back pain affects us all; the best treatment is avoidance and the best way to avoid is with an active and healthy lifestyle.”


Tendinitis is a discomfort of the tendon. It results in pain outside the joint. There are many tendons in the body, but this condition is mainly witnessed in wrists, heels, shoulders and elbows. Some frequently used names for different kinds of tendinitis includes pitcher’s shoulder, tennis elbow, jumper’s knee, golfer’s elbow and swimmer’s shoulder.

Symptoms of tendinitis:

Symptoms of tendinitis are witnessed at the point of contact between bone and the muscle. Some of the signs of tendinitis are tenderness, swelling and a dull ache while moving the affected joint. Even constant pain can be felt in some cases.

What are the causes of tendinitis?

Tendinitis is frequently observed among athletes. If a job involves repetitive motion of a particular joint, the stress on the tendons can result in tendinitis. It is therefore very important for athletes to use the right technique in order to refrain from tendon related problems. Trauma can also result in an injury to the tendon.

Risk factor of tendinitis:

Risk factors for this condition include job, occupation, and sports. As a person gets older, tendons tend to lose their flexibility, which can lead to an injury of the tendon. If the job of a person involves frequent reaching of the overhead, vibration, repetitive motion and forceful exertion, he might face an injury to the tendon resulting in tendinitis. Last but not the least, tendinitis is very common among players who are involved in sports such as basketball, tennis, golf, baseball, running, cricket and bowling.

What are the complications involved?

Tendinitis can aggravate to tendon rupture of proper treatment is not done on time. Tendon rupture needs a surgical procedure to fix. If tendon pain lasts for few weeks at stretch, there is a good chance that the condition has turned into tendinitis.


Diagnosis of tendinitis can be done with the physical exam itself. A doctor might want to look at an X-ray scan to negate other condition that might be causing the pain.


Treatment includes the prescription of pain relievers. Topical creams can also be prescribed to relieve the pain. Doctors often suggest corticosteroids be injected along the tendon in order to relieve tendinitis. If the condition is not very serious, a doctor might suggest specific exercise such as eccentric strengthening to fix the condition.

If the condition is severe, the doctor might want to go for a surgical procedure to fix tendinitis. Especially in conditions where there is a tear in the tendon. Another invasive technique to treat tendinitis is the needling of scar tissue. This procedure is performed under anesthesia thereby causing less pain to the patient.

Post Knee Replacement Protocol

If you are about to undergo a knee replacement surgery, it is important to know the extent of pain that it involves, and the recovery period that follows. A knee replacement surgery is a major surgery, and a patient needs time to adjust to the replacement of his/her knee. The time of recovery depends on the patient.

The steps of recovery after a knee replacement surgery are as follows:

After surgery
  • After the surgery, you will be given painkillers, which can be self-administered. You may require crutches and should walk within a frame. The ability to get back to walking without any help depends on the patient.
  • You will be taught exercises for strengthening your knees in the hospital by a physiotherapist.
  • It is likely for you to experience some initial discomfort during exercising and walking, as your legs may become swollen.
  • It is likely for you to spend a period of four to six days in the hospital, based on your condition and its progress.
  • An enhanced recovery program may be suggested by your surgeon in which you may start walking from the next day of surgery.
Recovery at home
  • It is normal for you to feel tired and fatigued at home in the beginning. A knee replacement surgery is a major surgery, and the tissues and muscles around your knee require time to heal properly.
  • You should arrange for a person who would help you while you go out for a few weeks after the surgery.
  • It is very important for you to practice the exercises prescribed by your physiotherapist. This is a vital part of speedy recovery and you should not avoid them.
  • You should be able to stop depending on crutches or walking frames and go back to your regular activities and schedule in approximately six weeks after the surgery.

The recovery process usually continues for about a year after undergoing the surgery. During this period, scar tissue heals and your muscles get restored through exercises. It is recommended for you to avoid any kind of extreme sports or movements in which there is a risk of falling.

Heel Pain: Common Myths Busted


Heel pain is one of the commonest conditions for which patient visits doctor especially orthopedic surgeons. There are various causes for this and the most common condition is:


This is basically swelling of a thick layer of soft tissue under the sole of the foot, which spreads to entire foot starting from the underside of the heel. This occurs commonly because of overuse and seen in the population who stand for long durations like teachers, policemen, athletes, improper footwear. This can increase in intensity in cases with weak bones like vitamin D deficiency, high uric acid levels, low thyroid level patients etc. Rarely this can arise from nerve entrapment. 

The other heel pain condition is back-sided heel pain, which is commonly referred to as:


This also is an overuse injury caused by the pull of one tough muscle attachment to the bone called ACHILLES. Causes will be from bony bump over the heel bone called HAGLUND DEFORMITY. More or less the other causes remain the same as described in the earlier paragraphs.

One should always be confident that these are common conditions and definitely treatable. Most of them can be managed by non-operative means like the modification of footwear like:

  • Custom Insoles
  • Silicone Heel Cups
  • Insoles
  • Also some exercises, which include plantar fascia stretching, calf stretching.

If the pain is not coming down injections are given which include steroid+local anaesthetic or stem cell injections like PLATELET-RICH PLASMA are also being administered with high success rate. 

Surgical intervention is very rare especially in plantar fasciitis, rarely in less than 1% may need calf muscle release for reducing the tight heel cord muscle. Surgery is done for backside heel pain with a bump over it when the heel cord (ACHILLES) is torn or weak where the bone bump is removed and heel cord is reattached to the bone.

Following the doctor orders and systematically treated by trained doctors will relieve the patient problem.