Tennis elbow and golfer’s elbow are the typical names given to elbow pain; tennis being pain on the outside of the elbow and golf being pain on the inside of the elbow.  The more technical term is lateral epicondylitis which simply indicates tendonitis in a specific location.  Putting a name to elbow pain doesn’t really help you get rid of it, but understanding why it happens and where it comes from will.
Tendons are the tough bit of tissue that attaches muscle to bones, and tendonitis literally means inflammation of the tendon.  This term can be misleading when it comes to elbow pain because many people have pain that persists for months in the complete absence of swelling and inflammation.  That is because elbow pain is not just an overuse injury.  It happens when the muscles being used are in an irritable state due to a nerve irritation stemming from your neck and shoulder.  Nerves are the electrical wiring of muscles and when they are irritated, it doesn’t take much to overuse the muscles and tendons that they innervate, resulting in inflammation and pain.  If you rest the joint, the body will heal the inflammation, but the nerve irritation may persist and thus the inflammation and pain will return as soon as you attempt to use your arm again.

Muscles are comprised of a whole bunch of stringy tissue that can stretch and contract.  The muscle should have a certain amount of resting tone in it, i.e. at rest it is slightly contracted, not flaccid or extremely tense; this is dictated by the input of the nerve.  If the nerve is irritated as it extends from the spine, or anywhere in the periphery it will result in an altered signal getting to the muscle.  Read More

IMS stands for intramuscular stimulation and is an anatomy specific form of acupuncture performed by specially trained physiotherapists and some doctors.  It has its roots in traditional Chinese acupuncture, but is fundamentally different in many ways.  IMS uses Western medicine’s understanding of the neurophysiology of pain and Dr Chan Gunn’s assessment techniques of identifying underlying nerve irritations to treat chronic pain issues.  The technique does use acupuncture needles, but not in the way someone practicing traditional acupuncture would.  Traditional acupuncture focuses on pre-mapped out points in the body that relate to different organs and meridians of energy running through the body.  Fine acupuncture needles are then inserted into a number of these points and the person rests with them in for 10-20 minutes.  It can be very useful for the right condition, but it is not as specific or as purposeful as IMS.

To understand why IMS is performed the way it is you should have a basic understanding of how your body experiences pain.  If you haven’t already, please read the article titled Why Things Hurt: Explain Pain.

When a physiotherapist performs IMS he will first assess your basic posture and movement patterns to look for some common signs of underlying nerve irritation.  The most common one is to palpate for tender bands or knots in particular muscle groups.  He will look for restriction of movement in major joints such as your hips and shoulders and note the appearance of the skin and muscle tissue on either side of your spine.  When there is an underlying nerve irritation in an area, the skin can start to look like the rind of an orange peel, feel thickened and respond differently to light touch.  A person may develop goose bumps easily and/or have areas of coolness or hair loss.  The therapist will take all these things into account when determining where to treat you. Read More