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Ten Common Orthopedic Injuries - Tennis Elbow

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Ten Common Orthopedic Injuries - Tennis Elbow Presented by Dr. Philip R. Lozman, M.D. Dr. Philip R. Lozman, MD, orthopedic surgeon, is a member of the Center for Advanced Orthopedics at Larkin Community Hospital. He is a Diplomat of the American Board of Orthopedic Surgery and Fellow of the American Academy of Orthopedic Surgeons. Dr. Lozman completed his internship in General Surgery and his residency in Orthopedic Surgery at the University Miami, Jackson Memorial Medical Center in Miami, FL where he also obtained his Fellowship in Sports Medicine and Arthroscopy. He partook in a two year Clinical Course in Microsurgery, within the Department of Orthopedics and Rehabilitation. Dr. Lozman received his BS in Biology from the Tulane University of Louisiana, in New Orleans, LA; he then received his medical degree from the University of Miami School of Medicine in Miami, FL.
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TEN COMMON ORTHOPEDIC INJURIES PHILIP R. LOZMAN, M.D., F.A.A.O.S.
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Page 1: Ten Common Orthopedic Injuries - Tennis Elbow

TEN COMMON

ORTHOPEDIC INJURIES

PHILIP R. LOZMAN, M.D., F.A.A.O.S.

Page 2: Ten Common Orthopedic Injuries - Tennis Elbow
Page 3: Ten Common Orthopedic Injuries - Tennis Elbow

TENNIS ELBOW UPDATE 2014

PHILIP R. LOZMAN, M.D., F.A.A.O.S.

Page 4: Ten Common Orthopedic Injuries - Tennis Elbow

TENNIS ELBOW

PAINFUL CONDITION AFFECTING THE OUTSIDE PART

OT THE ELBOW

AKA “LATERAL EPICONDYLITIS”

BONY PART OF THE OUTIDE OF THE ELBOW BECOMES

PAINFUL

Page 5: Ten Common Orthopedic Injuries - Tennis Elbow

ROOT OF THE PROBLEM

MUSCLES

DAMAGE TO THE TENDON THAT JOINS THE

EXTENSOR MUSCLES OF THE FOREARM TO THE

UPPER ARM

Page 6: Ten Common Orthopedic Injuries - Tennis Elbow

TENDON DAMAGE

SINGLE INCIDENT “HARD SHOT”

OVERUSE (MOST COMMON)

Page 7: Ten Common Orthopedic Injuries - Tennis Elbow

CAUSES AND RISKS

STARTING TO PLAY AFTER PROLONGED INACTIVITY

Page 8: Ten Common Orthopedic Injuries - Tennis Elbow

CAUSES AND RISKS

POOR BACKHAND TECHNIQUE

Page 9: Ten Common Orthopedic Injuries - Tennis Elbow

CAUSES AND RISKS

IMPROPER GRIP SIZE

TOO SMALL OR TOO LARGE

Page 10: Ten Common Orthopedic Injuries - Tennis Elbow

CAUSES AND RISKS

MOST PEOPLE ARE NOT TENNIS PLAYERS!

Page 11: Ten Common Orthopedic Injuries - Tennis Elbow

CAUSES AND RISKS

USING SCISSORS OR SHEARS

GARDENING

THROWING SPORTS

SWIMMING

GOLF (MEDIAL EPICONDYLITIS)

Page 12: Ten Common Orthopedic Injuries - Tennis Elbow

CAUSES AND RISKS

WEAKNESS AND INFLEXIBILITY OF FOREARM

MUSCLES

Page 13: Ten Common Orthopedic Injuries - Tennis Elbow

SYMPTOMS

USUALLY AFFECTS DOMINANT ARM

DEVELOPS GRADUALLY

PAIN AND TENDERNESS OUTSIDE OF ELBOW

PAIN MAY BECOME CONSTANT AND DISTURB SLEEP

Page 14: Ten Common Orthopedic Injuries - Tennis Elbow

SYMPTOMS

MORNING STIFFNESS

PAIN TURNING DOOR HANDLES

SHAKING HANDS

CAN CAUSE NECK OR SHOULDER PAIN FROM COMPENSATION

Page 15: Ten Common Orthopedic Injuries - Tennis Elbow

DIAGNOSIS

STRAIGHT FORWARD DIAGNOSIS

X-RAYS MAY BE INDICATED

MRI IN SEVERE CASES

Page 16: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

“ACTIVITY MODIFICATION”

EASY FOR THE RECREATIONAL ATHLETE

DIFFICULT FOR BRICKLAYERS

Page 17: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

INITIALLY TRY HOME TREATMENTS

REST BY CHANGING ACTIVITIES

APPLY ICE PACK FOR 20 MINUTES

OTC NSAIDS – ADVIL OR ALEVE

ARM BRACE

Page 18: Ten Common Orthopedic Injuries - Tennis Elbow

OTHER TREATMENTS

INJECTIONS – CONTROVERSIAL

PHYSICAL THERAPY – ULTRASOUND TO INCREASE

BLOOD FLOW

Page 19: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

REHAB

STRENGTHENING MUSCLES

CHANGING TECHNIQUE

RESISTIVE TRAINING

Page 20: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

COACHING

TENNIS – AVOIND LEADING WITH THE ELBOW

(PRINCIPLE CAUSE)

Page 21: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

TOPICAL MEDICATIONS

BRACING – COUNTER FORCE – REDUCES THE

MAGNITUDE OF MUSCLE CONTRACTIONS

NITROGLYCERIN PATCH

OSSATRON

INJECTIONS

SURGERY

Page 22: Ten Common Orthopedic Injuries - Tennis Elbow

OssaTron DeviceThe OssaTron®

extracorporeal high-energy

single tx shock wave

procedures (Orthotripsy®)

provide a non-invasive

alternative for patients

suffering from chronic

musculoskeletal conditions

Orthotripsy Candidates-

1. Chronic condition for a

minimum of six months

2. Failed Conservative therapy

Page 23: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

OSSATRON

Page 24: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

PLATELET RICH PLASMA (PRP)

INJECTION OF PLASMA WITH A HIGHER

CONCENTRATION OF PLATELETS

DERIVED FROM YOUR OWN BLOOD WHICH IS

CENTRIFUGED

MOST EFFECTIVE IN TENNIS ELBOW

Page 25: Ten Common Orthopedic Injuries - Tennis Elbow

TREATMENT

TOPAZ PROCEDURE

ELECTROTHERMAL TENOTOMY

OPEN SURGICAL REPAIR

Page 26: Ten Common Orthopedic Injuries - Tennis Elbow

PREVENTION

HEAD SIZE – MIDSIZE 95 TO 110 SQUARE INCHES

PREFERRED

STRING TENSION : LOWER END

STRING MATERIAL: NATURAL GUT

GRIP SIZE : NOT TOO LARGE OR SMALL

Page 27: Ten Common Orthopedic Injuries - Tennis Elbow

PREVENTION

EQUIPMENT MODIFICATION

RACQUET MATERIAL

GRAPHITE – CONSIDERED BEST FOR TORSION AND

VIBRATION CONTROL

Page 28: Ten Common Orthopedic Injuries - Tennis Elbow

PREVENTION

WARM UP

STRETCH

COOL DOWN

Page 29: Ten Common Orthopedic Injuries - Tennis Elbow

PREVENTION

EQUIPMENT

TECHNIQUE

FITNESS

RECOVERY

Page 30: Ten Common Orthopedic Injuries - Tennis Elbow

THANK YOU


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