Causes, Symptoms and Treatment for Tennis and Golfer’s Elbow

00:07-06:50Tennis Elbow and the Radial Nerve
06:51-11:37Golfer’s Elbow and the Ulnar Nerve
11:59-19:52Tennis and Golfer’s Elbow X-Ray
19:53-27:40Treating Golfer’s Elbow and Tennis Elbow
27:41-36:13Elbow Pain and the Kinetic Chain: The Throwing Athlete

Tennis Elbow and the Radial Nerve

Dr. Ben Boudreau: [00:00:10] Tennis and golfers elbow. So this is a really cool topic, like probably one of the more common conditions of the elbow. Definitely tennis elbow. We’ve all heard of it. The proper term medical term is lateral epicondylitis or lateral epicondylalgia, whatever you like to call it, it’s a very painful condition that will originate from the outside part of your elbow. And this is when the common extensor tendon. So this large tendon that will attach right on to that bony surface on the outside of your elbow becomes inflamed, usually due to repetitive injury or repetitive motions like at work, or you’re doing a repetitive action over and over again, things like new sports, like tennis. So it’s very common on the backhand. Yeah. A very common condition. And we’ll be talking about this evening.

Dr. Clayton Roach: [00:01:12] Just want to pull here. How many of you from the listeners here have had either golfers or tennis elbow, in other words, paint on the inside or the outside of the elbow or know someone who has had golf or tennis elbow or maybe even had surgery for it is released? They call it. So just give us a little thumbs up if you know of anybody or if your yourself has had tennis or golf resort, go ahead and give us a few thumbs up there.

Dr. Clayton Roach: [00:01:39] The first one we’re going to talk about is going to be lateral epicondylitis let’s show this next slide or before, OK, lateral epicondylitis or tennis elbow. There are two bony prominences on the elbow, one on the inside, one on the outside. They are called epicondyle. So when you feel the elbow, the bump on the inside, and the bump on the outside. Called the epicondyle, when it gets inflamed, we add itis at the end, so Epicondylitis medial inside, lateral outside, inside is golfer’s elbow, outside is tennis elbow. Go ahead, Ben.

Dr. Ben Boudreau: [00:02:21] Yeah. So these types of conditions are very, very, very common. They call them tennis elbow because, during the backhand in tennis, you put pressure on this outside portion of your elbow where this common extensor tendon will need to pull on that bony surface. And what that will cause is little micro-traumas, little micro-tears in that tendon over time, which then leads that inflammation. With golfers elbow, it’s due to this increased pressure on the outside of the elbow pushing in. It’s called a valgus. And so, yeah, go right ahead Clayton Yeah,

Dr. Clayton Roach: [00:03:00] No, no, I was just going to say so the valgus stretch on the inside is when if you took the outside elbow and brought it in the ligament on the inside, it would be stretching. Right. It’s the same thing as a pitcher. When they go back, it opens up the inside part of the elbow. I just want to mention Ben. So for those of you who don’t know, a ligament attaches bone to bone while a tendon attaches the muscle to the bone. This is a condition of the tendon that becomes inflamed. Again, you add itis tendonitis. Golfer and tennis elbow are forms of tendonitis, right?

Dr. Ben Boudreau: [00:03:35] Yeah for sure. And so these are both like overuse muscle strain caused by repeated contraction of the muscle of the forearms. And there, you know, these are caused by the muscles that are used to extend and flex your wrists. Right. And as well as move your elbow from flexion to extension. But more or less, it has to do with the muscles that are active in moving your wrist joint. It’s definitely a very, very common condition and you’ll even have nerve involvement as well. A lot of people as chiropractors definitely look at the nerves. And so some people will present with conditions that are like tennis elbow, like golfers elbow when really you have entrapment of certain nerves.

If we talk about the outside of the elbow, we have to be thinking about the radial nerve because it’ll pass right underneath that common extensor tendon there. And so you have to make sure that that entrapment site is cleared before you come out and make that diagnosis because when you have a pin involvement or radial nerve entrapment, it can really cause symptoms that are symptoms similar. But when you clear it up, the issue can go away pretty quickly. Right.

Dr. Clayton Roach: [00:04:55] So Ben, where would somebody have numbness and tingling if their radial nerve, so the real nerve is right on top of the forearm here. And if there’s a muscle that’s tight enough pinching that real nerve, where will patients feel it on the hand?

Dr. Ben Boudreau: [00:05:08] So they normally will feel it on the top of the hand and they’ll feel it into the first like the thumb, the second, third fingers, and sometimes even wrap around to the kind of the tops of the fingers as well. But you’ll feel it all along the top of your hand and you might feel tightness and tingling and weakness there. So it’s very common in tennis elbow to also have these types of symptomatology as well.

Dr. Clayton Roach: [00:05:35] Yeah. So again, it spares, you know you’re not going to have any in the palm. It’s all going to be on the outside part of the hand. Now that is usually involved and can mimic tennis elbow because it affects the extensors. And if you’re overusing the extensors and some people will get it because they’re mousing a lot. Right, on the computer, because they keep their wrist up if their ergonomics aren’t proper. You get radial nerve entrapment. Now, the radial nerve can also be entrapped at the neck. Here again, as a chiropractor, we have to differentiate is the symptom caused by something that’s starting at the elbow?

Is it caused by something that’s starting at the neck? Many things will kind of lead you down the path for us. Ben and I will take a look, maybe an x-ray. And if there’s a lot of crud on the x-ray and structural damage around where the radial nerve is coming from, then we might have to treat this as a neck problem, even though the pain is presenting at the elbow and many times people will see it. Why are you treating my neck? The pain is that my elbow? I got numbness in my hand. Well, you know, many times the presentation is going to be away from the cause of the issue.

Golfer’s Elbow and the Ulnar Nerve

Dr. Clayton Roach: That is one nerve entrapment. Now, when we flip the hand over on the inside, there’s a nerve here that sometimes people called the funnybone. Right, and people hit their elbow and their whole hand, not the whole hand actually, but the pinky and the ring finger going numb and that nerve there is called the ulnar nerve. Go ahead, Ben.

Dr. Ben Boudreau: [00:07:13] Yeah, the ulnar nerve, so it’s super important because when we talk about golfers elbow right, the issue on the medial side, the middle side of the elbow, these tendons here will get super inflamed and super tight. If they are that tight and this ulnar nerve passes right underneath the medial epicondyle, it can impinge on that nerve, kind of like squeezing on a hose that’s got water coming out of it. What will happen is you get that numbness and tingling down the side of the hand and it’s very common. People with golfers elbow and medial elbow pain have this numbness and tingling.

Some people present and come in, they’ll be like, oh, you know, I’ve got they’ve diagnosed me with golfers elbow, but I’ve got this numbness and tingling down the side of my fingers and I just haven’t been able to get rid of it. Then what we’ll do is during our physical exam will go into the area, will palpate and we’ll go right into this tunnel here, this little groove where that nerve sits and we’ll just tap. If the owner, nervous, inflamed, it’ll cause this referral, this patterning of pain down the forearm and into the pinky finger and half of the ring finger. And so part of the process is a chiropractor is checking, OK, is the entrapment site up in the neck? Right.

Do we have distribution here? Can we work through the neck and clear it there? Or do we have to work down into the extremity to help clear that issue up a little faster? And so that’s one of the big distinguishing factors between, OK, do we have a true golfer’s elbow or do we have a cubital tunnel syndrome? Right. The cubital tunnel is where that nerve travels. It’s that little groove. And so it’s really important.

Dr. Clayton Roach: [00:08:56] Yeah, totally very well explained Ben. So from a bird’s eye view, when you have nerve irritation, there are two sources either in the spine. So spinal nerve irritation or peripheral can be anywhere distal to the spine, shoulder underneath the arm, wherever. And peripheral nerve entrapments are usually caused by muscles that are tight, pinching that nerve as a nerve pierces through that muscle. So over here, I’m going to just basically annotate this. This is where the ulnar nerve passes in what’s called the cubital tunnel, and then it courses over here and supplies these two fingers.

Dr. Clayton Roach: [00:09:38] Ok, and what happens when these flex their muscles over here are really, really overused because of whatever you’re doing, you create inflammation right where I drew the circle here, and now this nerve is irritated. Now, if you recall another Humpday conversation that we had, there was another condition that created numbness and tingling in the pinky in the ring finger. And that condition was called thoracic outlet syndrome. And that is a good example of entrapment that happens closer to the neck where the nerves dive down and go into the arm. So, again, the impingement could be from here.

It could be from here, it could be in the forearm. It could actually be in the wrist as well. So we need to figure out where is the hole being kinked if there is a nerve presentation. Now, that doesn’t happen all the time because many times golfers’ elbow or tennis elbow will just appear as pain in the elbow. My elbow hurts right there. There’s no numbness, there’s no tingling. Those cases tend to be a little bit more direct and easier to diagnose.

Dr. Ben Boudreau: [00:10:49] Yeah, for sure. And definitely even speaking about different entrapment sites as well, making sure that you’re finding that exact point of contact, whether it be in the neck elbow or in this crucially important in and determining recovery. But as always, you know, starting at the neck is the best place to go because you want to be able to get to the source of the nerves and take as much pressure off of it as possible. And the neck is the best place to start. And just switching gears a little bit, the tennis elbow, we’d look at it the same way as Clayton mentioned before, making sure check and clearing the neck, clearing the elbow, clear the wrist, ensuring that we’re getting all of those and sites down to the main source.

Tennis and Golfer’s Elbow X-Ray

Dr. Clayton Roach: [00:11:36] All right. So, guys, give us a thumbs up if you’ve learned something. So far, we’ve only been talking for about ten minutes, but how many of you knew that the Funnybone was actually called the ulnar nerve. And that’s what gives you that that funny feeling where part of your hand goes numb. That’s actually the ulnar nerve. Right. So I hope you guys are enjoying this so far. Give us a little bit of love, either a heart or a thumbs up. All right. So what do you see next? Now, this is going to be far down the road. By the time you see this in the next room, you have endured a lot of pain, a lot of stubbornness, not wanting to get this treated.

Even though your wife said you should see somebody or your husband said you should see something, you say, no, don’t worry about it. And you keep shovelling, you keep doing what you’re doing. And then eventually the tendon starts to ossify a little bit and you’re going to start seeing it on an x-ray. So go ahead, Ben. Let’s just point out what we’re seeing here. Yeah.

Dr. Ben Boudreau: [00:12:33] Yeah. So, I mean, I’d like to just point to the left x-ray first. And these are both just distinguishing factors. And I want to talk a little bit about anatomy here, because these look like two of the same things, like what am I looking at? How can I tell the difference between the two? And so if we could just get a cursor out, I’d like to just talk about the different like the three different bones that we have here. So this is your elbow joint and the top bone.

There’s your humerus and so your humerus runs right from your shoulder joint down to the elbow. It’s the big, long bone there. And then to the side, we have the radius and then on the inside, we have the honour. And so the ulna is kind of this big bone here to form the sharp point of your elbow.

Dr. Clayton Roach: [00:13:27] Ben, You know what I saw the other day? Olecranon bursitis, I don’t know if you’ve ever if anybody has ever had this, put your thumbs up here. I had one that came into the office. It was a baseball on the end of the elbow. There is a bursa there and they used to call it student’s elbow because students study with their elbow on the desk and the bursa gets inflamed. Boy, this guy had this mallet at the end of the elbow and unfortunately, it’s very painful. And many times they have to go in there with a needle and lance it. Right. So that’s yeah, that’s.

Dr. Ben Boudreau: [00:14:04] So that was one of the first that was one of the first conditions that I’d ever seen as part of, like a student doing, you know, like athletic therapy and like first getting a touch into, like medical sciences. That was the first condition I’ve ever seen, like in the in the flesh.

Dr. Clayton Roach: [00:14:21] And coming out of school and coming out of school you think everything is a tumor, a cancer. If you thought that that was something growing, that wasn’t right.

Dr. Ben Boudreau: [00:14:28] Yeah. To return back to this photo. We’ve got humorous, we’ve got the radius and we’ve got the ulna. So the owner again will make that giant bony, sharp part of your elbow here. Right now, if we’re talking about lateral epicondylitis or tennis elbow, we want to look to the lateral side of the elbow. And so the radius is on the lateral aspect of the elbow. And so if we do see calcification in the muscle, we have to look to the radius, the radial head and look just lateral in the muscle belly. Now, Clayton just pointed those out there and you can see little white densities, radial opaque density, just lateral to the humerus and the radial head there.

Dr. Clayton Roach: [00:15:25] And there should be no white in muscles, no white and tendons. It’s soft tissue. It’s not bone. Only bone appears white. So if you’re seen white in muscle, you have bone-in muscle. That is a problem.

Dr. Ben Boudreau: [00:15:39] Yeah, straight up. That is a problem. That’s what we’re seeing there on that image. Calcium deposits in the muscle, in the common extensor tendon, extensor, ECRB, extensor carpi radialis brevis. And so that’s in that particular muscle there. You should not be seeing that. On the lateral side. They say up to 25 percent of patients with tennis elbow will present with calcifying densities in the elbow if it’s not taken care of early enough.

Dr. Clayton Roach: [00:16:15] And as we said, this is a chronic condition. Like this did not happen yesterday because you shovelled gravel and did some landscaping like this has been a chronic condition that went untreated or treated improperly. And there has been so much inflammation and chemicals from the inflammatory process that has infiltrated and what happens to bodybuilders’ bone because if it doesn’t build bone at one point, the actual tendon could detach from the bone. It protects itself. So it actually starts to calcify the tendon in the muscle to make it stronger because you’re constantly pulling on it, you’re not fixing it. Just get it fixed.

Dr. Ben Boudreau: [00:16:55] You know what? This reminds me a lot of the Humpday conversation that we did when we were looking at semispinalis capitis. Splenius capitis.

Dr. Clayton Roach: [00:17:03] Yes.

Dr. Ben Boudreau: [00:17:04] Extreme forward head posture.

Dr. Clayton Roach: [00:17:06] Yeah.

Dr. Ben Boudreau: [00:17:06] And they had those limbus bones, like they had those bones, those calcium densities in the muscles and tendons, right. Yeah, very similar.

Dr. Clayton Roach: [00:17:15] Or even. Yeah. The people that had that that unicorn there on the back of the head. Yes. Is that what were talking about. Right.

Dr. Ben Boudreau: [00:17:22] Yes. Yeah. Same thing as these offices and those giant horns. Right. The body is going to start to try to protect itself. If you’re not moving these structures and this condition is very painful, so this individual must have had this tennis elbow over a little while and not having it taken care of.

Dr. Clayton Roach: [00:17:43] Yeah, so on the right side, on the right side, yes, so this is the medial part of the elbow, so medial means on the inside and on the inside we have the ulna. So this is the ulna to orientate you again. Again, this is the radius and this is the humerus. So over here you can start to see these little. White densities, again, you don’t see any white in soft tissue, white is bone, so now we have bone and muscle, bone and muscle.

No good, there’s a problem there. So this is a condition that we would call golfer’s elbow because it’s on the inside tendonitis or medial epicondylitis, all the same words. This is the epicondyle right there. The tendon comes up and attaches there and it’s become inflamed and now didn’t get resolved. And now there are some bony deposits that have started to form within that tendon.

Dr. Ben Boudreau: [00:18:48] Yeah. And I mean, these conditions can happen you know to anyone who does any sort of repetitive motion, but they’re most common in the 4th and 5th decades of life. Ultrasounds and MRIs are also extremely helpful because that way you can see the soft tissue before it gets to this point before calcium densities start to invade the muscle or the tendons. And so if you are suspecting someone may suspect that you have a severe condition, a severe case of this particular condition, they may send you for an ultrasound to get that quick diagnosis, that quick, quick look.

Dr. Clayton Roach: [00:19:33] Good luck getting a Mri, for tennis elbow. Chances are not likely you’ll get one, But what you would see would be depending on if T1 or T2 you would see the inflammation in that area and you might be able to see the striations or if there’s a little bit of tear tearing there on that on that MRI. So what the heck do you do about this?

Treating Golfer’s Elbow and Tennis Elbow

Dr Ben Boudreau: [00:19:55] Yeah.

Dr Clayton Roach: [00:19:57] What do you do Doc?

Dr. Ben Boudreau: [00:19:58] I mean, I was kind of this condition, this was actually the first condition Dr. Roach that I’ve ever diagnosed. Anyone this tennis elbow was the first condition ever diagnosed because when I was an undergrad at Saint of X, I took a few courses, diagnosis courses with a great athletic therapist over there. We learned, you know, special tests, ways to diagnose, using our hands and putting pressure and touching specific areas. I feel very attached to this condition. It reminds me it takes me right back to when I first started doing this.

But yeah, no, light weights are actually good. Contrary to popular belief controlled contraction of the musculature. And so either eccentric loading of the muscle, which is when you are slow, you’re working on the common extensor or you know, if it does, this is central to loading would be slowly lowering with weight. So you’re lengthening the muscle or you can do slow control concentric exercise where you’re shortening that muscle. So you’d be slowly extending or lifting your wrist.

Dr. Clayton Roach: [00:21:14] So one could simply get a dowel like a wooden dowel and tie a rope to weight. Yeah. And just basically bring your wrists up and down. So that would be a very easy way to create a little bit of an exercise rehab-type program for epicondylitis.

Dr. Ben Boudreau: [00:21:32] Yeah, yeah. And definitely, another easy exercise too would be just to squeeze like a stress ball. Yeah. Just squeeze a stress ball and then flex and extend your wrist at the same time. Right. And a lot of people think, oh, you know, if I’m going to try and fix this issue and I have to do strengthening, weight strengthening, don’t you want me to be moving my elbow? No, actually, contrary to popular belief, it has nothing to do with moving your elbow. It’s these muscles all act on your wrist. And so all you have to do is wrist exercises to help with this condition.

Dr. Clayton Roach: [00:22:09] Yeah. You got to realize that those two muscles, the extensors, the ones that attach to the epicondyle on the flexors they don’t cross the elbow joint. Right. They just attach at the radius or they don’t attach to the humerus. So that’s very important to realize that.

Dr. Ben Boudreau: [00:22:25] Yeah. So the second thing that I would be doing is stretching. Right. As well. So even if you’re loading and working on this, you want to be able to stretch it out. And so one of the stretches that I like to do for if this is a wrist extensor issue for talking about tennis elbow. It’s just bringing the two hands together. We call this reverse surveillance, and so you’re just stretching the top, right? You’re going in the opposite direction. And then if you want to stretch the golfer’s elbow, right, you just do the complete opposite. You’re bringing the hands together as a family. It’s like this just to get a good stretch in on the inside here of that elbow there.

Dr. Clayton Roach: [00:23:08] Yeah, what else? Yeah, so lifting properly, very important, definitely keeping your wrists rigid and using the bigger muscles, just like we always tell people when they’re lifting something heavy to lift their legs and not their lower back using your legs. The muscles are bigger there. Muscles are bigger in the top part of your forearm than what they are at the wrist. So keeping your wrists stable will keep the muscles stable. So you actually can lift with your with your arm, your bicep and your tricep where the muscles are a lot bigger.

Dr. Ben Boudreau: [00:23:44] I’ve also got here nerves, you know, so just like we were talking about earlier, you can’t just look at the muscle. You have to also look at the nerve and make sure that it’s moving properly. We talk about things like nerve flossing. And so this is when you’re actually trying to target and move the nerve back and forth through the tunnel in which it may be entrapped. And so you want to get that mobility in there because if you’re moving the nerve, you’re feeding it with blood flow. Whereas if the nerve stays stagnant, just like a joint, it won’t receive that healing process, that factor.

And then what’ll happen is that continue to get symptoms and they’ll actually get worse. So you have to keep feeding that nerve properly. Some things that you can do with this condition is as well as just do a little bit of trigger point therapy, just go in the muscle and try to get that. If there’s any scar tissue that may have developed, try to break that down a little bit, get that inflammation out of there and encourage that blood flow. And speaking of encouraging blood flow, there’s something that we offer in the clinic as well. That’s really helpful in doing that. And that is the laser.

Dr. Clayton Roach: [00:24:45] Yeah, yeah, the laser is going to basically penetrate the skin and be able to go to a depth that is almost impossible to go to when you do stuff by hand. So one of the things that Ben and I do by hand is called the active release technique. We basically take the muscle, we shorten the muscle. If we’re working top out of the forearm, we take attention to the muscle while the person is actually shortening the muscle and then the person lengthens the muscle as we hold that muscle. The best example I can give you is almost like if you crumble a piece of paper, you put your thumb on it and you pulled the paper. What you’re going to do is you can take the wrinkles out of the paper. That’s what active release is doing.

Many times, though, the condition can be very chronic and there’s a certain amount of information that’s there that if you put your thumb on it, it’s almost like you’re putting pressure on a bruise all the time where it’s not going to heal. Sometimes the chronicity makes it such that you should start care with laser, which is going to basically bring tons of oxygen to the cell, bring new blood flow by causing vasodilation. You’re going to expand the vessel diameter where more blood is going to get to the area and you can supply that area with new blood flow, which has been taken up and couldn’t get there because of the amount of inflammation that was in that elbow.

Dr. Clayton Roach: [00:26:02] So sometimes the laser therapy is called laser is very, very useful to get the condition going. But then we also have to work the soft tissue, because you’ve got to remember the reason the inflammation was there is because there was a muscle problem in that area. And I just wanted to mention that one of the diagnostic tests to figure out if you have carpal tunnel or not, one of them could be just very simple, resisted extension. So when a person has a golfer’s elbow to a test called I think this one’s called Coltons, where you basically resist extension, so you tell the patient, hold strong as you try to bring the waist down and all of a sudden you say, oh, my elbow hurts right on the outside part of the elbow or the other way around.

If they flex their forearm and you try to resist, they try to resist. You bring their wrists down. It’ll hurt on the inside because you’re activating the flexors. And on this one, you’re active in the extensor. So a very simple test that if you’re married, you’re with somebody, you can actually, you know, that you should do that, but maybe try to diagnose yourself and then make a call to the chiropractor.

Dr. Ben Boudreau: [00:27:05] Yeah, for sure. For sure. What else did I write? I said, ice too, you can always try icing the area, right? If you were looking for a quick fix. Right. And reduce the inflammation. Get that stuff

Dr. Clayton Roach: [00:27:16] Out of there. Ever, ever put heat. Okay

Dr. Ben Boudreau: [00:27:21] Yeah. Never, never, ever, ever heat this condition, never

Dr. Clayton Roach: [00:27:28] Steroid injections, we only talked about steroid injections, try to avoid that, connect with your chiropractor, please try to avoid cortical steroid injections in the elbow. All right.

Dr. Ben Boudreau: [00:27:41] Yeah. Did you want to kick this one off, Dr. Roach?

Elbow Pain and the Kinetic Chain: The Throwing Athlete

Dr. Clayton Roach: [00:27:45] Yeah, sure. So basically, there’s research that’s been found that people with weak rotator cuff muscles have a higher propensity to having elbow pain. So rotator cuff muscles are very important because most of them rotate the arm externally. This is inwards, this is external, so there’s research that shows that there is a higher propensity to elbow problems with people that have poor rotator cuff muscles, also young kids that have a rounded back. And, my gosh, we’re starting to see a lot of those because of how much time kids are spending on their video games. I’m not an enemy of video games.

I’m just saying that there has to be moderation. Right. Parents, you got to limit it, OK, we’re starting to see a lack of cervical curves in kids, eight, nine-year-olds, so eight to nine-year-old kids coming in, no cervical curve left in their neck because of how much time they’re spending with their heads down. So what happens? They start to be kyphotic. They start to be rounded. And research also shows that there’s a link between people that are rounded and elbow pain, specifically with baseball. People are throwing go ahead, Ben.

Dr. Ben Boudreau: [00:29:11] Yeah, there are two and a half times more likely to develop an elbow injury if they have this kyphosis or rounded back. You think about it, these muscles aren’t in favourable positions. When the shoulders are rounded forward and in the back is more curved, the muscles have to work much harder to pull the individual into the proper position. So what they’re just going to say is, you know what we’re going to save energy, and instead, we’re just going to keep them in this position.

What happens is ours stabilizes for our shoulders become very weak. Then when it comes to throwing right, if we’re a throwing athlete, all of this force has no stabilization through their shoulder. Where’s the stabilization that I come from, from the elbow. And then the elbow has to work way harder than it usually would produce a nice throw, a nice pass throw. And what ends up happening is we get these elbow injuries at a very, very, very young age.

Dr. Clayton Roach: [00:30:09] So let me just show this. So when you take a look at the cocking phase, that’s basically where the arm is basically creating the most stored energy, right, it’s like a spring, it’s all the way back, ready to be moved forward. Look at the spine here. This is what we call extension. The back is arching backward well, a rounded back cannot do that, right? When the arm is coming back, the spine has to be able to extend backward. If it cannot do that, all the forces, that Ben was saying has to come from the elbow. The elbow reaches further back because the back is not going there.

All of a sudden you have a ligament here called the ulnar collateral ligament, the UCL, that goes. And there is a snap that occurs and the ulnar collateral ligament the ligament on the inside of the elbow right here, tears. Hmm, yeah. If some of you watch baseball. That is called Tommy John surgery, and, you know, they’ve gotten better at doing Tommy John surgery, so it’s not the career breaker that it used to be, but the arm is never the same and definitely could be avoided because we get it all the time. Why should I bring my kid to the chiropractor? Well, here’s a very great example of why?

Dr. Ben Boudreau: [00:31:44] If you improve that thoracic kyphotic angle if you improve that curve and through the mid-back, the results show that there’s three times less, that’s three times less of a chance of suffering an elbow injury if you’re taking care of that kind of the kyphotic angle than if you weren’t taking care of it at all. That’s a beautiful connection between what it is that we do right at the spine and its immediate effects on improvements in mobility at the elbow joint and just something else. This is just food for thought. In baseball players, there’s a crazy association with the amount of hip rotation, internal rotation, and Tommy John surgery. It goes to show that kinetic chain and its importance from ground reaction force all the way at the bottom to the elbow producing force all the way at the top.

Dr. Clayton Roach: [00:32:33] Let’s take it even further. You see his foot right here. That is the big toe, the inability for the big toe to be able to extend. When you’re standing and you take your big toe and you bring it up. Get your partner pull up on the big toe and see how much pliability there is, there is a huge correlation between your ability to extend your big toe or the inability for you to extend your big toe and which is highly prevalent when people get older and get arthritis in that big toe and starts curling in and you got that big lump on the side of the big toe. Your ability to be able to rotate the hip and lower back pain now when all of this is happening, shoulder and elbow become the symptom and not the cause.

Your ability to accept ground force from the ground up needs to happen at every single joint, and if it does not happen, you will have what we call a non-traumatic injury, an elbow. Ulnar collateral ligament injury is not a traumatic injury. All you’re doing is throwing a baseball. Nobody hit you. You then get hit by a car. It’s non-traumatic and it evolves because of things not being corrected. Like your big toe, like your knee, like your hip, low back, all this stuff, all the rotation happens right here after the hip at what’s called your T junction, your T12, L1, all the torso rotates at that area. Well, guess what?

That is a major area, that Ben and I find all the time that isn’t moving well in people. That is a huge thing. So, guys, please give us a thumbs up if you’ve learned something. That is a great way to explain basically all the Humpday conversations that we have done and everything that we’ve talked about on the kinetic chain. Does this make sense? Give us a heart.

Dr. Ben Boudreau: [00:34:31] I love the kinetic chain. Like this is like some of the coolest stuff that I just like I’m such a nerd over, like the minute that I start talking about the kinetic chain and like how this affects that big toe and all the way up to the hand. And then people think that I’m crazy and then I explain it and then they’re just like, well, you’re totally not crazy. That totally makes sense. Well, this is how the body moves. Everything’s connected. But fascial networks and nerves and muscles, I mean, this is like this is really primo crazy stuff.

Dr. Clayton Roach: [00:35:05] By the way, if you think chiropractic is still in Stone Age, this is the reason why every single professional sports team has a chiropractor and most of the top dogs in the sport that are being paid 10, 20, 30 million dollars a year. Whether you like that or not, it is true. A lot of them have their own personal chiropractor because maybe they choose not to see the team chiropractor because they have their own that they trust. Right. So chiropractic is come out of the Stone Age and is by far probably the people that are most effective at making changes in that kinetic chain and increasing performance in professional athletes, so if it’s good enough for them, guess what?

It’s good enough for Mary, who’s forty-seven, working at Bell or working or gardening, or the guy that’s driving a truck. The kinetic chain is a kinetic chain. It doesn’t really matter. We’re all bipedal. We all walk on this planet. We all have you know, we’re forced to accept ground force as soon as we step foot and we all need to have these joints working in hand together. That’s right. This is probably my best Humpday conversation. I love this one altogether.

Dr. Ben Boudreau: [00:36:19] I thought you’d like this one. Even patients who just want to improve their golf game like weekend golfers. I love talking to them about the kinetic chain because they appreciated it so much and said, yeah, like, you know, I’m coming here to my back pain. I didn’t realize now that if I just improve my hip internal rotation on my lead leg, that it could save my back and keep me golfing for like an extra five years if I just improve my hip mobility. So absolutely. It blows me away when I first heard it. But I mean, now that I see it in clinical practice, it’s just like

Dr. Clayton Roach: [00:36:58] And once you explain it and patients are like, well, duh, now I get it right. Yet everybody’s been treating the elbow or everybody has been treating where the fire is. And we’ve got to get away from that, you know, pin the tail on the donkey and just treat where the pain is. We got to take a look at the overall thing. Omega3, very important anti-inflammatory. We talked about inflammation, epicondylitis. It’s an inflammatory condition. Tendons get inflamed.

Omega3 is just a good way where we are replenishing our body with stuff that kills off inflammation because we’re not always perfect. We do stuff we guarded and we do all these things and definitely taking omega three from a great source like these nutritious products, which are fantastic. By the way, regarding the Omega 3, we talked about the. The omega 3s becoming rancid and the reason they become rancid is that they’re all in big barrels and they get exposed to oxygen and because of oxidation, you know, they become rancid. So when you’re burping fish oils, that is not a great product. You should not burp anything. It shouldn’t come back to haunt you. It shouldn’t smell. You should be able to break the capsule open and not have that, you know, fishmeal smell. That’s just not good at all.

Dr. Ben Boudreau: [00:38:21] That was that was a good conversation.

Dr. Clayton Roach: [00:38:24] That was that was the rock on good Humpday conversation. So, guys, let’s do this right now. Let’s have everybody on the count of three-hit that share button right now. This is worthy of being shared. This is some of our best work.

Dr. Ben Boudreau: [00:38:42] This is a great Humpday conversation. I was about to say, you know, even the treatment side alone, like if you have that tool, that treatment side alone is a huge help in reducing the greater than 50 percent of that symptomatology.

Dr. Clayton Roach: [00:38:58] And by the way, chiropractors don’t just adjust vertebrae, they adjust extremities as well. Wrists where there’s a joint a chiropractor can move it. I will say not every chiropractor adjusts extremities Dr. Ben and I do a lot of it, actually. And yeah. So on the count of three, everybody, pressure share. Three, two, one share. All right, if you’re watching this on YouTube, click subscribe. All right. And then I think you can actually share a YouTube video, too.

Dr. Ben Boudreau: [00:39:29] Yeah, you can share a YouTube video. You can also post YouTube videos to Facebook. So there are tons of things you can do with YouTube videos. That is absolutely awesome. As let’s say when we’re talking about special tests earlier. Let’s say we can you know, you can test for tennis elbow by lifting the middle finger. It’s called resisted middle finger extension, because that radial nerve passes right underneath and that pin. Testing for that, so it’s really cool, yeah, yeah, is this the middle finger extension?

Dr. Clayton Roach: [00:40:01] Give us a thumbs up. If you enjoyed this presentation tonight, another hand-up would be great. And we look forward to next week. Again, we’re going to do a few little promos there. We want to have a lot of people live on that Facebook live because any time you bring a guest on, they are doing this for free. They like it when there’s a lot of people on there asking questions, we want to make sure that you guys show up big. OK, so make sure you show up and we will. Make sure that he gets a great welcome East Coast welcome, this guy here is from Texas, so we got to give him a good Maritime welcome next week, nine o’clock Wednesday, Humpday conversation number 29 Ben. Last thoughts, buddy.

Dr. Ben Boudreau: [00:40:48] Thank you guys so much. We had a lot of fun tonight. I hope you guys did two excellent topics. If you guys have any questions, you guys have any future topics that you want to hear about comment below. We definitely want to be able to hear from you guys and have this open dialogue and come ready with your questions next week. Yes, go Habs. Go. Yes, yes. So, yeah, we definitely want to hear from you guys, and let us know. Give us some feedback. We love it, guys.

Dr. Clayton Roach: [00:41:20] Thank you so much. Have a great rest of your weekend. Coming up, apparently going to be nice. Take care. Have a great night from Dr. Ben. And I thank you so much for supporting us and watching these lives all the time. We’ve got people who have been alive for all twenty-eight episodes. Thank you. And we’ll see you next week. Cheers, what’s up? Listen, if you like this episode, you’ll probably like the other ones are pretty good. So here’s what you need to do. You need to like us and follow us on Facebook. Following means, you get notified when these two guys are alive. Next, family, friends, you need to share these episodes because you never know. You might help them because they need this information as well.

Dr. Ben Boudreau: [00:41:56] And guys, if you ever miss an episode, make sure you subscribe to us on YouTube. That way, you can watch the episode over and over and over again.

Dr. Clayton Roach: [00:42:03] Guys, we love you and appreciate you. Take care.