I am having a tennis elbow issue for 1 year +, have been visiting TCM and did some dry needle, but still the pain is still there.

I went to scan for MRI, show that my muscle was torn, injected PRP X 3, also cannot recover.

any Sensei here got this issue or can recommend a good Doctor or any method to heal it ?

Thank you.

you live at where ?

if in JB, https://www.kpjhealth.com.my/johor/doctor/dr-bea-kia-chuang

You can go to your local GP clinic and ask them to write you a referral letter for the right specialist that you need.

Just explain to him to your chief complaint and history of presenting illness clearly and he should be able to help you with the referral.

my batch uni mate now sports physician at princecourt. very prolific nationwide.

ooh... I stay in Subang Jaya...

I did walk in to those specialist in Hospital, but still couldnt heal my problem...
so see whether got ant experience doctor to recommend or not ...hehehe


got contact ma ? mind to share ?

I got tennis elbow too.

I'm sorry that you got scammed by TCM.

What you need is surgery and physiotherapy, not TCM scam.

I recommend Dr dato Shahrulazua, and regen physio at PJ

@hksgmy
How do I tag people on lowyat? But this lowyat user is an orthopaedic doctor i think

This post has been edited by chromatino_hex: Jan 4 2024, 11:12 AM

Went mri and injected PRP, itu tulen bukan scam

Maybe TS shud go visit hand surgeon instead

The scam is the TCM, not mri

since your muscle is torn, you may need surgery. Did they say why they only gave you an injection?

avangelice - he’s an orthopaedic surgeon if I’m not mistaken

KLSMC. I heard some athletes go there for treatment. Many people come from overseas for treatment there as well.

Go princecourt website search. Speciality choose sports medicine.

Only got one.

Kuala Lumpur Sports Medicine Centre (KLSMC HOSPITAL)

Thank you hksgmy for highlighting this

Op. No you do not need surgery as per what others are saying as your tendinitis is brought on by trauma at the insertion point on the elbow and I got a suspicion that the tsm may have effected the healing process.

What you need now it not needling or ppr injection. What to need is to start focusing on the area I have drawn out for you. In my experience with tennis elbow, alot of patients fail to get better is because every Tom dick and Harry is focus on the tendon but I would suggest releasing this part I highlighted either via a physical therapist or via a extracorporal Shockwave therapy (eswt).

Someone highlighted klsmc and yes they are known to be knowledgeable in fixing this issue.

If you don't believe me, try massaging that part I highlighted by applying pressure on the area for a few mins and finished off with a stretching

TS no mentioned physiotherapist or deep tissue massage?

Can try that also probably the those people there will understand more on ur situation for your problem

I’m very impressed. That’s a very well explained answer and TS essentially got it for free.

Much appreciated bro!

what type of doctor are you again?

Not my first rodeo with a free consult here on lowyat. 😅😅

It’s ok bro. Some things are better left to the imagination. Singapore’s too small and I’d rather like to be able to enjoy my time here in relative obscurity

so how is ur issue, recovered d ?


the doctor ask me to try PRP first, if cant be cure, the last step is surgery , but I wanna try other method first b4 taking this last step of surgery...
takuuttt~~~~

thank for bringing a gem to this post..
haha..



great for your info sharing. Can I know where is your workplace, can I go visit you ?

I'm in sarawak bro. Lol

Currently I just rest, and so lighter weights.

Cant fully recover. Just wear strap and continue. If pain, stop.

Yours sounds more serious. I put steroids 2 rounds already, maximum is 3, any more it becomes harmful to my tendons

duh

oHhhH nOoooOoO

seem like we have to carry this pain forever d if without go for surgery..

aiskzzz

For your case, yeah. What causes it? What sports do you play?

Try to get a theraband bar, it ain't cheap, but good to try.

Go exercise your forearms and extensors with it, using light weight first

I play badminton, use the wrong muscle, also with a heavy racket..

then gg d..
hahahahah

Hahaha, gotta stop bro, and focus on rehab. Try a different sport for now.

Until you're recovereddo you use a strap?

MRI and PRP injection also does not work. So not scam?

A bit bias no?

MRI is a scanner. What u want that to work?

And PRP is experimental medicine, so you even know what's PRP? And it's success rate?

PRP speeds up healing, not instantly make tendon heal.
Maybe TS can give it more time for the growth factors in the PRP to do its work. Most tendon injuries take up to 6 months to recover.
In the mean time, can use TCM acupuncture to help with treating trigger points, reducing muscle tension which put less stress on the extensor tendon and physio to help with active recovery, such as stretching, muscle strengthening to aid in the tendon remodeling phase, prevent scar tissue formation which cause chronic pain.

But if MRI already show tear (not sure the extend of the tear, partial or complete) maybe surgery is indicated?
Even after surgery, also need months to rest and down time from any sports.

btw, PRP is not FDA approved and many medical insurance don't cover. Most likely need to pay out of pocket.

I'm aware that PRP is experimental and not covered under insurance.

OP went to TCM too, didn't work. So how? Nothing works?

I have a feeling he is just not resting enough and doing his rehab.

Do not need to go sport orthopedic. Your problem is small issue. Just need to find correct approach. My partner regular tennis player also having same issue. After helping him, few days slowly recovered.

I kena this tennis elbow in around June - July 2022 like that, at that time I didnt know what is tennis elbow, I just tot my elbow muscle soreness and normal aching only.

So I just ignore it, and continue to play badminton until Dec 2022.

Until I realized that the soreness is still there, so i stop playing badminton from Jan 23 until now, and I went to few TCM , massage and dry needling to that elbow area from Jan 23 - Mar 23, but still the pain didnt reduce at all.

So I decide to have a MRI scan, and the specialist doctor suggest me to take PRP first, since the MRI shown it was just a small muscle torn.

After I have tried 3 PRP, from May 23 - Oct 23, the pain was just reduce from 100% to 95% only.

I got wear the elbow strap everyday.

Until now , the pain is still there, then I really out of idea what can I do already...
unless just go for surgery, but this will be my last last last option.

ooohh...
mind to share ur partner experience of curing it ?

Need to try whatever method I can to kill this tennis elbow..

try shockwave therapy?

Need to know which part. Pain? Numb? Better draw easier

Op have u tried visiting institute Sukan Negara (ISN) in Bkt Jalil?

They’re specialist in sports injuries too since they are taking care a lot of our national athletes

What’s the procedure? Finding GP to give referral letter?

the red pen is the area i feel pain, when I straighten my hand, and clenched my fist, then the red pen area will pain ..





then when I bend my elbow, the bone nearby there also pain (I have done the x ray for my bone, all ok)


This post has been edited by timesquare.net: Jan 5 2024, 02:04 PM

hmmm...not yet...because didnt know the specialist ISN..
haahaha

I know your pains, and they were in the same places as you indicated in your photos. It took approx 7-8 months for my left arm to recover. No docs, no medications, not even a panadol; just self-massaging and going easy with what i carry. Now i'm going thru the same process with my right arm and elbow which seems to be healing faster....estimate 70-80% healed already. It's frustrating to limit the load on the arms, but that has to be done in order for healing to happen. I won't be hefting 2 x 50kg sacks of fertilizer anytime soon. Be well soon, TS.

Dr Ranjit Singh at Colombia Asia Bkt Jelutong

for ankle injury, you have to do RICE and follow a true physiologist expert, there isn't many out there who can do true physio, of course there would be a lot of pain during the recovery, the faster you do RICE the better for you. Dont believe any medicine that can help you repair muscle without pain, your muscle is continually adapting to the forces that we put through it – So if you put the right controlled forces though your injured ankld, it will get stronger and stronger. obviously the more you wait and rest and dont do RICE your muscle would eventually and gradually reduce to the strength of a little kid! That is why doctor keep telling you your ligament begin to torn, muscle torn, soft tissues torn etc!

I have already informed you what needs to be done and someone did say something good which is stop exercising yet here we are still diddling over this. Alot of people I see get this sorted within a visit of consult. No injection. No surgery. Just rest and stretch.

Tsk

Thanks for the tip, I will try incorporating this to my routine

I also have tennis elbow for the last 7 months

Got it from lifting. For TS you prob need to stop badminton for a couple of months till it heals

For me I started using lifting straps for my pulling exercises. I find it helps since i'm no longer using my forearms and focus more on back

I also need rehab exercises 2-3x a week

Wrist curls/wrist extensions palms down with light weight 3x20
TS can use a mineral water bottle filled. Use yr other hand to help with the concentric(lifting) and just do the eccentric (lowering)

Forearm rotation with a hammer 3x20

Or you can get a theraband and use that

Learn to sleep on your back. I find sleeping on my side irritates my elbow. It also interferes with bloodflow hence healing if you sleep on the affected elbow

It has nothing to do with bone. Dont waste time and money on xray ct scan. Understand your problem. Find the root cause. Your problem is due to nerves.

Ask someone to follow the picture below. Technique must be correct and the strength must be accurate. This is just one correct method. If you follow correctly immediately you will notice the result. Keep repeating few days will recover. Need to charge you consultation😂

watzisname

Thanks.. been doing some of the rehab exercises like wrist curls

Hows the teraband flexbar exercises ?

i still havent got it from shopee.... been 2 weeks. parcel stuck due to new years holidays

Oof..

I think using lifting straps for my pulling exercises helped me recover faster.

im not too sure. maybe u can give them a call to confirm.

Today is a memorable day. The pain in my right elbow and forearm has dropped from an estimated 6/10 to less than 1/10, and I had refrained from taking any Panadol Extend

The healing (approx 5 months) was way much faster than my left elbow (7-8 months), I think mainly because this time I massaged and stretched it more often and consistently. I also took great care not to strain it, using left arm for lifting.

Take heart TS, and be strong. You WILL get thru this

Good for u man.. its been 8 months for me.. still discomfort in right elbow

I KNEW i forgot to do something!! and what I forgot to do was to share with u this exercise. Hope it helps!

How is your condition thus far? Confirm not so pain

Prof Ng Wuey Ming SJMC or sunway

The best sports orthopedic sifu in Msia.

As avangelice said usually thats sufficient. Refractory cases with uncontrollable pain despite analgesics may need MRI to rule out loose bodies and look at other causes. In severe cases diagnostic arthroscopy after mri will rectify.

But usually symptons will subside

This post has been edited by Jedi: Jan 13 2024, 08:29 PM

Thanks!

肌肉萎缩的原因及训练方法（器材辅助）
肌肉萎缩是伤后和术后非常普遍的问题，做完手术后，你的腿变细了，没有力量了，不能支撑身体了，不能正常走路了。。很多叉友咨询我“我一直认真锻炼，但肌肉就是不长”的困惑和经历。如果长时间得不到改善，还会出现大腿发不上力、打软腿、上下楼吃力、不稳甚至疼痛等症状。肌肉萎缩如此顽固，那么如何提高肌力才是最有效的呢？
一、肌肉为什么那么容易萎缩?

运动损伤或术后,我们出于制动的考虑减少了负重和活动,肌肉不收缩了,结果会快速出现废用性肌肉萎缩。这种肌萎缩是手术后的普遍现象,所谓废用,就是停止不用。病理改变就会表现为肌纤维的横截面积缩小(肉眼可见的肌肉体积缩小),还有肌纤维在纵向上的挛缩,大大影响肌肉的延展性,肌肉弹性变差。万幸的是,早期的废用性肌肉萎缩是可逆的,但康复训练必须尽早介入,如果肌肉纤维化之后再想练回来就太难啦！


二、为什么萎缩的肌肉很难练起来？

如果仅仅是肌肉萎缩还能训练,但术后常常伴随着关节源性肌肉抑制,这才是肌肉萎缩难练的根源。它是一种条件反射反应,当关节发生疼痛、炎症或者损伤时,大脑出于保护就会减少向损伤的肌肉和软组织放电,同时下达一个“限制活动,勒令休息”的命令。接收到命令的损伤肌肉就会开启保护机制,拒绝相关肌肉收缩的信号,导致萎缩的肌肉怎么也练不起来,因为训练时大脑发出的电信号难以抵达受抑制的肌群。


上图分别说明疼痛和肿胀刺激会明显抑制肌肉收缩活动
三、肌肉萎缩怎么办？

首先，针对废用性肌肉萎缩，我们就一个字“练”，真男人就是干～！

其次，针对关节源性肌肉抑制，我门就要打破抑制。从新获取对我们自己肌肉的控制权。


四、肌肉萎缩及时康复是可以恢复的（案例小分享）

我们先来看一个术后早期就到专业的运动康复中心并且使用Compex去训练的一个叉友的案例。


再看一个没及时康复，前期康复曲折且肌肉严重萎缩，然后到专业的运动康复中心实现康复的案例：


所以我门在术后，一定一定要及时的到专业的运动康复中心进行专业系统的康复。如果实在没有办法到专业的运动康复中心进行康复，一定要认真学习我的主页里面的康复教学，有条件的话，可以购买一台compex，它对于肌肉萎缩的训练效果还是非常棒的。

五、如何有效应对关节术后的肌肉萎缩？

废用性肌肉萎缩是可逆的，可通过持续进阶的康复训练来恢复。但是康复训练介入不及时、训练方法错误会大大降低肌力恢复的效率，此时要激活废用肌肉需要一些科学手段。人体神经组织之间通过生物电传递信息，只要对休眠的肌肉神经施加相应频率的电刺激，就能够控制肌肉收缩，这种治疗方式叫做神经肌肉电刺激。

那在训练之前，我门要先了解一下肌肉是如何训练起来的

健康的人在训练时，是大脑发出电信号，肌肉收到电信号，开始收缩，从而达到训练效果。受伤之后，由于存在关节元性肌肉抑制，大脑发出的电信号到达不了目标肌肉，这时，我门可以借助电刺激，跳过肌肉抑制，模仿大脑发出的电信号，直接作用在萎缩肌肉上，从而达到训练效果。提高肌肉体积和力量。


先利用外界让肌肉动起来，然后增强肌肉募集能力
六、文献中关于神经肌肉电刺激的描述

1、《诺伊斯膝关节功能紊乱——手术、康复及临床疗效》

EMS（肌肉电刺激）促进股四头肌收缩的模式应根据股四头肌和股内侧肌的评估情况进行调整。一般可将一个电极置于体表对应于股内侧肌的位置，而另一个电极则置于股四头肌肌腹中外侧面的上三分之一处。此治疗的持续时间为每次20min，并嘱咐患者在机器刺激的同时进行主动给的股四头肌收缩。
如果患者的肌肉情况不佳，还可能需要使用便携式肌肉电刺激治疗仪进行家庭康复。肌肉电刺激治疗应持续到患者的肌肉评分恢复至良好程度为止。——P307-P315
2、《骨科运动康复》

肌力训练方法选择的原则：具体训练方法的选择应根据患者现有肌力水平选择合适的肌力训练方法。
1、肌力为0级时，宜选择电刺激疗法，被动运动训练和传递神经冲动训练（即患者主观用力，试图引起瘫痪肌肉的主动收缩活动）。传递神经冲动的训练与被动运动结合进行，效果更好。
2、肌力为1级或2级时，宜进行电刺激疗法或肌电生物反馈疗法。同时配合助力主动运动训练效果更好。
3、肌力为3或4级时，宜进行徒手抗阻训练和各种器械的抗阻训练。——P39
3、《骨科术后康复》

Hopkins等发现：经皮神经肌肉电刺激可以控制疼痛和肿胀。
Jaris等发现家庭中有效的干预措施可以帮助或者减轻肿胀和疼痛，同时提高术后关节活动度。但是，经皮神经肌肉电刺激的时间参数需要每天30分钟，并且干扰电治疗每日3次，每次28分钟。患者与物理治疗师之间可以就治疗次数进行讨论。

膝关节术后的肌肉萎缩的应对策略，我们分为4步走：

just walk in to any physio , i believe they can help

肌肉萎缩的原因、预防与逆转方法建议

4 个月前

什么是肌肉萎缩？
肌肉萎缩是指肌肉组织的损失或变薄。如果肌肉萎缩，肌肉质量和力量都会下降。肌肉萎缩时，你的肌肉看起来比正常人要小。发生肌肉萎缩的原因可能是营养不良、年龄、遗传、缺乏运动或某些疾病。当你对肌肉的使用不够时，就会出现废用性（生理性）萎缩。神经源性萎缩是由于神经问题或疾病引起的。


肌肉萎缩有哪些症状？
肌肉萎缩的症状因病因而异。肌肉萎缩最明显的症状是肌肉质量下降。肌肉萎缩的其他迹象可能包括


一只手臂或一条腿比另一只小。
一只手臂或一条腿无力。
手臂和腿麻木或刺痛。
行走或平衡困难。
吞咽或说话困难。
面部无力。
逐渐丧失记忆。


肌肉萎缩是什么感觉？
如果四肢肌肉萎缩，你可能会感到手脚刺痛、麻木或无力。如果面部或喉咙肌肉萎缩，面部肌肉可能会开始感觉无力，说话或吞咽也会变得困难。


常见问题解答


肌肉萎缩与肌肉萎缩一样吗？
是的。肌肉萎缩和肌肉消耗是两个不同的术语，用来描述肌肉质量的减少和肌肉纤维的缩短。 肌肉萎缩是一个缓慢的过程，可因长期患病、营养不良或神经系统疾病而发生。

肌肉萎缩可以逆转吗？
在大多数情况下，肌肉萎缩是可以通过适当的营养和锻炼来逆转的。与神经系统疾病（如中风）有关的肌肉萎缩则需要物理治疗来重建肌肉。

肌肉萎缩可以逆转吗？


逆转肌肉萎缩需要多长时间？
逆转肌肉萎缩可能需要一段时间。肌肉萎缩是一个缓慢的过程，恢复失去的肌肉可能需要同样长的时间，甚至更长。需要多长时间取决于肌肉萎缩的程度和你之前的身体状况。


至少需要两周的物理治疗，你才能开始感觉到肌肉的变化。要完全恢复肌肉的大小和力量，可能需要几个月的物理治疗。