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New Treatment for Tennis Elbow

Physical therapists at the Nicholas Institute of Sports Medicine and Athletic Trauma in New York City report that eccentric exercises offer a simple and effective cure for tennis elbow (July 2009 annual meeting of the American Orthopedic Society for Sports Medicine). The researchers prescribed standard physical therapy for tennis elbow to 10 patients, and physical therapy plus special eccentric exercises to 11 others. In less than two months the eccentric group reported an 81 percent improvement in pain and a 72 percent improvement in strength, while the control group had not improved.

(Eccentric contractions occur during a biceps curl when you lower the weight and your biceps lengthens. Concentric contractions occur when you raise the weight and your biceps muscle shortens.)

You don't have to play tennis to develop tennis elbow. It can be due to any movement that puts excessive force on the wrist muscles. Tennis elbow refers to elbow pain as the result of an injury to the elbow tendons that bend and straighten the wrist. Hold your hand down with your thumb on the outside (lateral to your hand) and your elbow straight. Pain on the lateral (outside) part of your elbow is called backhand tennis elbow. Pain on the medial (inside) part is called forehand tennis elbow.

The exercise is done with an inexpensive piece of equipment called the Thera-Band Flexbar, available at Hold the bar upright with your hand of the affected side. With your hand of the healthy side, grasp the bar near the top and twist it in front of the body. Then use the sore elbow-side hand to slowly untwist the bar by flexing the wrist.


Video of the exercise


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Dear Dr. Mirkin: Should a child have his appendix taken out?

You may have had your appendix removed because doctors believed that it was a useless vestigial organ. Now researchers have found that it serves as a storage tank for healthful germs that live in your intestines. These good bacteria help to break down food so you can absorb its nutrients. They also prime your immune system to recognize harmful germs and prevent them from invading your body, prevent your immune system from attacking your own body to cause auto-immune disease, and produce immune factors that may prevent colon cancer (Microbiology, February 9, 2009).

When you have diarrhea, bad bacteria can remove the good bacteria in the intestines and colon. A study from Duke University shows that the bad bacteria cannot dislodge the good bacteria from the appendix because its inner lining is covered with a thicker and far more potent biofilm (a layer of bacteria, mucous and immune system cells) than is found in the intestines (Journal of Evolutionary Biology, August 2009). No matter how severe the diarrhea or how extensively the bad bacteria drive out the good bacteria from the intestines, the good bacteria persist in the appendix and eventually re-colonize the rest of the intestines. More on good bacteria


Dear Dr. Mirkin: What can older competitive runners do to keep from running slower in races as they age?

Train more intensely, but hard exercise can kill a person with blocked arteries, so check with your doctor first. According to a study published in the American Journal of Physiology, running in later life improves running capacity and speed, survival, and body fat content, but it does not prevent loss of muscle size, ability to use oxygen, or mitochondrial enzyme activities in muscles that convert food to energy during exercise (AJP-Regulatory, Integrative and Comparative Physiology, July 2009).

You become weaker with aging because you lose nerve fibers which take muscle fibers away. Muscles are made of millions of muscle fibers. Every muscle fiber is innervated by a single nerve. With aging, you lose nerves. With the loss of each nerve, you also lose the corresponding muscle fiber. Usually you can recover from workouts almost as well as when you were younger. You lose endurance far more slowly than you lose strength.

Therefore training for older athletes should aimed at retaining strength, and the best way for runners to do this is to run very fast. First do background training by running at least 30 minutes every day for many months. Then you may be ready to start training. On Tuesday, Thursday and Saturday, try to run faster. On the other four days, run very slowly. If you are excessively sore, take the day off. On your fast days, you can run timed interval bursts, followed by jogging until you recover your breath; fast continuous 2 to 10 mile runs, or a series of short controlled fast runs depending on how you feel, each followed by slow jogging until you recover your breath, and then go into your next fast run.


Recipe of the Week:

Spicy Crab Salad

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE


June 22nd, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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