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Non responsive tennis elbow


#1

Hi all

I have a client who is not responding too well to treatment for tennis elbow, it hurts especially badly when they try to pick an object up from above shoulder height, the pain radiates from LI11 down to sj5, they are finding it increasingly difficult to do every day things like as I say pick up eg jars of honey from a cupboard above the work surface, beat a cookie mix etc. Client is a massage therapist but they have stopped for a few months to try and get it right, it flared up when they got work in a spa and were doing 6-10 hour long deep tissues massages a day, they have been doing massage for about 20 years so are not a novice.

I have done ashi points, distalpoints, classical combinations , clearing excess points etc, I am not familiar with Tungs Points but would be open to trying them at this point, any other asdvice would be greratly appreciated.

Many thanks

Kastym


#2

Hello Kastym,

When you say "not responding too well" - what does this mean exactly? How many treatments and with what frequency have you done? What is the response - none at all?, worse?, 70% better but comes back after x # of days?

Also when you say "have done ashi points, distalpoints, classical combinations , clearing excess points etc" - describe in exact detail including the points used, why, and the duration along with other techniques, cupping, etc. that you have done - say in the last 4 or 5 treatments.

Also, include your -tcm- diagnosis along with supporting signs and symptoms (tongue, pulse, etc.)

Then I can offer some help.


#3

Hi Chad

Thanks for the reply, my client has been getting twice weekly treatments for 4 weeks. She is a fit 43 years old active woman, doing swimming, running and pole dancing, she is a massage therapist of 20 years experience, she has recently stopped pole dancing because of the pain. The pain started about 10 years ago,(it has not been ongoing) she thinks from carrying numerous buckets of water to give to horses, 30-40 buckets of water twice daily, I told her then to buy a long hose pipe which she subsequently did.

I have seen her on and off over the years and am treating this case mainly as a channel problem, there is an ongoing lung xu and liver stagnation, tongue body colour is good with very slight purple to orange sides, shallow toothmarks, thin white coating, small crack in the right lung position that comes and goes, pulse at the moment is slightly floating in the liver, heart and small intestine positions, (she has a head cold at the moment) and small and hard in the kidney position. she is prone to her lung qi dropping characterised by a very weak breathless voice, this often co incides with a drop in blood sugar, she gets breathless on slight exertion, like climbing the stairs and her skin gets a bit clammy/sweaty. She does not like acupuncture and can start to hyperventilate if daqi is even slightly strong. I use a 1-5 pain scale with 1 being no pain, hers is generally at a 3, managable but irritating, she has been using NSAIDS and Kerol 50mg with no relief, she has not had any cortizone injections, the pain is only there when she goes to pick something up or when she exrtends her arm. Heat helps very short term, as in a few hours. The acupuncture has helped alleviate the pain for a few days each time but never completely and it always comes back to a 3.

The principal of treatment for this instance has been to clear and invigorate the channels and move stagnation and cold.

Distal points have been hegu LI 4, yangxi LI5 and Pianli LI6, 3 consecutive points boost the effectivness of themselves, also they are all for elbow problems and pianli is the lu point which would help her lung qi xu. Zusanli St36 and yanglingquan GB34 yangming and shaoyang points, also yanglingquan is emperical point for sinews.

sj10 tianjing relaxes the sinews and regulates zhong qi and helps liver qi stagnation (tongue and prior treatments) chize Lu5 is needled deep as an ashi point, also combined with kongzui Lu6 and an ashi point midpoint of the two, Quchi Li11relieves bi syndrom, local. Shousanli Li10, invigorates the channel, moves stagnation, bi. I have alternated these two points on each treatment, quchi left arm, shousanli right arm, next treatment quchi right arm and shousanli left arm. Quyangwei with moxa. Obviously I needle the distal points 1st with fairly vigorous stimulation fi possible, then I needle the local, ashi and conductor points,they will be left in for 40 minutes. I don;t use all of these point on every treatment, they would be the more common ones, her records are kept in the clinic, I am at home at the moment.

I hope this helps you help me

Many thanks


#4

Massage & Qi working

I’m a big fan of Acupuncture but more-so of acupressure needling somehow just seem so impersonal and clinical to me! A drastic short cut, a supplementing of the real needs for attention and change. Epically considering that your client is a time tested friend. I think that sometimes this mind & body simply needs a little (TLC) touch is a part of my practice that I never want to do without, In Qigong ther is a (Mudra) hand-posyure called (“Ironing with the hands“) Thumbs & index fingers over lap and palms are pressed forward (flat) Use palm friction 1st. Scan closely to client’s skin’s surface be persistent’ stay close & stay busy moving just enough to called movement w/ accessional pause. The Idea is to create/build, transfer, reflect, deflect discharge recharge and in as many ways as you know how to give attention to the person’s problem area. Great masters say “if we can effect it we can correct it” meaning with persistence and the application of (abundant Qi) all conditions will be made better.” A reflexologest told me (of late,) that fear is a cause for this type and area of painful stiffness ? Who new, any way I would sugest that you learn some reiki fundamentals such as the prelude chants or exercises and then combine them with Hand posturing/Mudras only to improve and enhance your laying on of Hands skills. Trust in the power of a (caring worm gentle touch) enhance it with energy building and energy deflection skills and 40 min of that type of quality presence and attention will work wonders! One might suggest hot & cold aqua therapies when they have a challenging task ahead or Moxibustion with the fattest cigar you can find, or incur rage them to work a little more often on themselves “ say’ with a squeeze ball in the affected hand and a pulsing/squeezing grip with the other at the area. The point is that it is most likely an energy blockage since apathy is not an issue within their lifestyle. Good luck (Reiki enhanced with Mudras) enhanced with lots of (persistent’ worm caring kindness and contact! Good luck.. You two! Shaktimanah


#5

Hi Shaktimanah

Sorry for the late reply, thank you for the info, I had already asked if she would consider reiki, not an area I am familiar with or really interested in myself so I said I could refer to her a collegue of mine who may be able to help. She has attended a few sessions with them. So far her condition has just got worse with the pain travelling down sanjiao to her fingers but also her shoulder has become very stiff. This is alleviated with cupping more so than with massage or acupuncture and she has been using a TENS machine 3X daily.

Many thanks

Kastym


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