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Elbow Tendinopathy: A Closer Look at Golfer's Elbow and Tennis Elbow
Hey All!

Is it really August? Or is someone Ju-lying to me?

We have some fun reading material for you all today. So, to keep it REALLY simple:

Sit back, relax, savor a very chilled beverage, and enjoy the show.

Happy August!
Tuesday Training Tips
Elbow Tendinopathy: A Closer Look at Golfer's Elbow and Tennis Elbow
Written by: Mike Campanella of PEX Health & Fitness, as well as Justin Cormier and Brendan Gates of Champion Physical Therapy & Performance.

Have you ever felt a sudden twinge in your elbow after a game of golf or tennis? Do you feel like your elbow hurts with just simple tasks, like grabbing your coffee or water bottle? Does your grip feel weak? You're not alone! These are common complaints from patients who struggle with medial and lateral elbow tendinopathy, also known as “golfer’s elbow” or “tennis elbow”, respectively. (And NO, you don’t need to play tennis or golf to have these problems.) 
What is Elbow Tendinopathy?

In simple terms, tendinopathy is when there is damage to a tendon in your body. Tendons connect your muscles to your bones and ultimately help us move. (Not the same as a ligament! Ligaments connect bones to bones.) Tendinopathy can occur in many ways, from one specific injury or from overuse after repetitive movements. When these tendons are overworked or strained, it can cause acute and long-lasting pain in the inflamed areas.

The Tale of Two Elbows: Golfer's Elbow and Tennis Elbow

To differentiate the two common types, a golfer's elbow is pain on the INNER side of the elbow, while tennis elbow affects the OUTER side of your elbow. Despite their names, these conditions aren't confined to just sports enthusiasts! They can occur due to any repetitive motion that strains the elbow joint, such as; prolonged computer use, repetitive lifting, repetitive gripping/manual labor or even playing a musical instrument. They can also be the result of compensatory movements due to range of motion deficits at the shoulder or wrist. 
A Multi-Modal Approach to Treatment

When it comes to treating elbow tendonitis, a one-size-fits-all approach won’t do the trick. There are many reasons why someone may develop this problem and having a thorough evaluation done to find the root cause is key. With that being said, everyone should be treated differently and there are a lot of interventions that can be used to assist someone's recovery.

Soft Tissue Work and Massage

Soft tissue work (massage) can be a starting point for alleviating pain. By working on the muscles and tendons around the elbow, massage can promote blood flow and decrease muscle tension, which will reduce some discomfort and promote healing.

Dry Needling

Dry needling, which involves inserting a thin needle into the painful area to trigger a twitch response and stimulate an inflammatory response, has been shown to assist in healing. Sounds nerdy, but this can be very effective! In a nutshell, the inflammatory response, caused by the needle itself, can reduce muscle tension, alleviate pain, and expedite the healing process by promoting blood flow.
Resistance Exercises

In addition to these therapies, introducing local strength work to your whole arm and wrist should be a priority! Tendons crave resistance and resistance training can actually help with the healing of the tendon itself (through a process called "tissue remodeling"). In a nutshell, resistance training causes micro-tears in the muscle fibers, triggering a healing response. This involves the removal of damaged tissue and the synthesis of new proteins to repair and reinforce the area. Depending on what led to their pain, each person should have a personalized program to incorporate resistance training to remodel the inflamed tissue and increase strength in the supporting musculature.  

Blood Flow Restriction Training

Blood Flow Restriction (BFR) training is a novel approach gaining traction in rehabilitation. It involves reducing the blood flow to a muscle group while performing high volume, low-intensity exercise. This unique combination triggers a hormonal response that promotes muscle growth and enhances recovery, without placing undue strain on the affected tendons. Imagine getting the same gains as lifting heavy weights but with way less weight?! This is very helpful in a tendinopathy situation as patients typically can’t lift heavy weights due to pain.
Wrapping It Up

Elbow tendinopathy, be it golfer's elbow or tennis elbow, can be a real pain in the butt (or elbow, ha ha ha). It typically lasts a long time for people and many just wait for it to go away. But, you don’t need to! You can help expedite that process with a comprehensive and personalized approach to treatment. Just as you wouldn't build a house with only one tool, the best outcomes are seen with many tools (soft tissue work, dry needling, resistance exercises, isometric training, and blood flow restriction training) employed in a comprehensive combination.

It's essential to remember that while these modalities can significantly help, they should be undertaken under the guidance of a trained healthcare professional. This ensures your safety and helps you achieve optimal recovery. It's time to say goodbye to elbow pain and reclaim the activities you love.

Seeking Referrals!
Do you have any friends living in the Medfield area that are interested in joining the PEX community? The summer isn't over yet!

Katie Woodilla, owner of Bomber Fitness is offering a super crazy deal for new PEX clients. If you are a PEX client and refer someone new through Bomber Fitness, BOTH of you will receive a FREE private one-on-one session at our Medfield location!

Grab anyone you know and have them come in for the full fitness experience.

New referrals must complete their session before clients can redeem their free session.

Time slots are LIMITED. Grab this deal while it's hot!

Call (and leave a message!): 508-656-0220
Posture Control
Posture and Mobility
By: Jennifer Hart

Locusts? Frogs falling from the sky? No, the plague taking the world by storm today is the disease of…TERRIBLE POSTURE!

It’s not difficult to name the one deficiency that affects 99% of the clients I work with. Poor, weak, sad-looking, just all sorts of bad posture. I see it in all ages, genders, and fitness levels (and the mirror, sadly). For most it is not a congenital issue, although that does occur from time to time. For MOST, it is a side-effect of our daily lives spent driving, at a desk, browsing on our phone…ya know, solving the world’s problems and such. 
And it can sneak up on us, since it doesn’t happen overnight. I was recently discussing this with a fellow-trainer, and she shared with me a story of a client who was a long-time previous dancer who was lamenting the decline in her posture once she began a desk job. Some professionals - such as surgeons - are particularly prone to it, but even some hobbies can lead to a more hunched-over back back…puzzle posture anyone? 

The clinical term for this phenomenon is postural kyphosis. Kyphosis describes the effect that poor posture has on the upper back, or more specifically, your thoracic spine. Our spine has a natural curve to it, however a chronically slouched posture can actually change that natural curve and cause a whole slew of domino-effect problems in your neck, head, and limbs. 

The good thing is that this is reversible for most clients. I have seen several sources say it is reversible by fixing your posture…ummm, no kidding. But what does that entail other than the old tried and true “Shoulders down and back?” If it was really that easy, I doubt anyone would choose to resemble the lovely gentlemen on the right side of the above picture. 

So in reality, to get long-lasting results, it is a two step process. Just two! We can handle two steps right? The first is to increase mobility through our upper back and trunk with the use of more passive movement. Once you have unlocked the muscles and joints, you can teach your body new postural habits through targeted muscle training.

In this post I will focus on the mobility aspect of posture recovery. There are many, many, MANY mobility exercises out there aimed to improve posture, so I will choose my top three that I pretty much want to see every client do. OK maybe four…like I said, there are so many!!!
Yes, I just aged myself drastically by using the world’s first meme...

1) T-spine Extension with Foam Roller
All you need is a foam roller. The idea is to increase mobility in the thoracic spine by moving it into extension. Since we spend so much time with our t-spine in flexion, we need to reverse train the spinal joints. Added bonus, this move tends to feel amazing.

2) Kneeling T-spine Extension with Dowel
This can actually be done without a dowel, however I like the physical cue aspect of holding the dowel. The key is to start with a posterior pelvic tilt, which puts the lumbar spine in flexion. This is helpful in targeting the t-spine with the extension, rather than absorbing that extension in the lumbar spine. This move is also effective in stretching tight lats and triceps, and again, just feels damn good.

3) Seated Thoracic Rotation for Rib Mobility
This one is always the most eye-opening to clients, as they see how quickly you can improve mobility with the right exercise. Rib mobility is a very underrated element in posture correction, but through unlocking your ribs, you create room in your ribcage for proper breathing (something else I will write on in a later post). This in turn releases tension in your upper back/traps/neck.

4) Windowpane Squat
Kind of toeing the line on being included in my next post regarding more active muscle activation, but the use of the wall makes it more of a passive type of stretch for the upper back. However, you will definitely feel your abdominals firing to stay balanced. I love this one as it works on t-spine extension while the body is moving, which translates a little better to real-life. It is also easy to progress by simply moving closer to the wall as you gain more flexibility in your upper back.
The truth is, anyone can do these at almost any time, since they don’t require a ton of equipment. But if you need some help building these habits, and want an expert eye on you to coach you through the moves, shoot me a message through the link below.
Champion Joins PEX Medfield
Welcome to Medfield, Champion PT! With our new private office spaces upstairs, we now are accepting new clients to seek out the one and only, Justin Cormier. You may have seen his face around our Needham location for the last few months, but he will be setting up shop with our Medfield team starting in August. What does he do?

Physical Therapy
Body Work
Strength Training
So much more!

Remember, you don't need to be recovering from an injury or surgery to benefit from Justin's expertise. And you don't need to have all the answers either! Justin is an expert when it comes to preventative training, soft tissue health and maintenance, strength training, and, yes, also in post-injury or surgery care. He's got you covered, both inside and outside the gym, ensuring a safe journey to optimal health.

Reach out today to schedule an appointment!

Will Barbie Or Oppenheimer Come Out On Top This Summer?

Oppenheimer For The WIN 41.7%

How Many Sharks Have Been Spotted In New England This Summer?
Shark Week Every Week
Sharks Come Up This Far?
Too Many To Count
PEX Client Ambassador Program–Want to make $100 cash?

Anytime a CURRENT PEX Health and Fitness client recruits a NEW client to PEX, the recruiting client is eligible to receive an ambassador’s fee of $100 after the new client's completion of 5 sessions!

Ask your PEX trainer for details! 💰
This is a real thing -- we know there are clients out there who have generated new referrals and have not cashed in on this offer! (eh hem, Laurie Gold, eh hem).
We're Accepting Applications!

PEX is accepting applications! Know of any fitness professionals in the area looking to advance their career in the fitness industry? Send them our way! They can fill out this form to schedule an interview.

In Conclusion
Ahhhh the dog days of summer...tis the finale of the season.

August is like a long Sunday evening before the start of the school.

Get outside while you can, have fun in the sun, and keep on crushing it out there.
To send cash and diamonds
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