Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Golfer’s elbow can also be referred to as Medial Epicondylitis. It’s a kind of tendonitis. It provides rise to ache and irritation within the tendons across the elbow and forearm. The causes embody repetitive actions like bending, greedy or twisting. These actions could additional result in minor tears within the tendons which result in ache within the elbow and different signs. It’s generally seen to have an effect on the golfers and therefore referred to as as Golfer’s Elbow. But it surely needn’t have an effect on the golfers as a rule. It may possibly happen in anybody. People who find themselves concerned in actions involving repetitive motions and use of wrist, forearm and elbows, as in enjoying tennis, carrying heavy objects, hammering or intensive typing on computer systems could turn into victims of this situation. If this situation will not be handled, it will possibly result in continual ache together with restricted vary of actions, weakening of grip and would impression every day actions and in addition total high quality of life.
Associated Studying – ‘Golfer’s Elbow – causes, signs, prevention, therapy, Ayurveda Understanding’
Golfer’s Elbow – Ayurveda Understanding
No situation precisely resembling Golfer’s Elbow has been defined in Ayurveda. However on this article we are going to attempt to perceive and decode this illness from an Ayurveda perspective.
Kurpara Sandhi and Kurpara Marma
Kurpara Marma – The very best single out there reference associated to elbow joint is the outline of ‘Kurpara Marma’ by Acharya Sushruta in Sushruta Samhita Sharira Sthana.
Kurpara Sandhi – elbow joint is one among the many Sandhi Marmas i.e. important spots situated in joints. There are two Kurpara Marmas, one in every elbow joint. Together with the joint, the marma entails all of the vital constructions in its neighborhood i.e. bones, ligaments, tendons, muscle tissue and blood vessels.
Kurpara Marma is a Vaikalyakara Marma i.e. belongs to the group of these Marmas which when injured would trigger deformity or crippling within the affected limb or a part of the physique. Harm to this marma is alleged to trigger kunthataa i.e. useful deformity of the elbow joints. Elbow joint and the actions happening therein contribute in direction of many actions that we do in a day utilizing our higher limb.
Golfer’s Elbow could also be one of many outcomes of damage, overuse or harm to the kurpara sandhi vis-à-vis elbow joint.
Vata aggravation and Dhatu destruction hyperlink
Repetitive actions’ resulting in small tears within the tendons is the primary and most vital occasion within the pathogenesis of this illness. Irregular Vata aggravation resulting from repetitive actions results in dhatu kshaya – depletion and destruction of tissues and constructions together with tendons which ends up in tears in them. When these occasions happen within the elbow joints it will possibly result in signs resembling these of Golfer’s Elbow. Occasions defined in trendy drugs and Ayurveda nearly seem comparable.
The occasions of this pathogenesis result in continual ache, lowered vary of movement, weakened grip and different signs. These signs are induced as a result of aggravated vata.
Situations which can lead to signs resembling Golfer’s Elbow
Golfer’s Elbow is a situation which presents with ache and irritation within the tendons across the elbow joint. The signs of Golfer’s Elbow are present in a number of of the under talked about situations. Subsequently, certainly one of these situations may be thought of as nearer correlation –
– Kurpara Sandhigata Vata
– Kurpara Snayugata Vata / Kandaragata Vata
– Vataja / Pittaja Kurpara Sandhigata Shotha
– Kurpara Sandhistha Amavata
– Kurpara Sandhistha Vatarakta
– Kurpara Sandhigata Vata
From the angle of causes
Extreme use of forearm, actions demanding fixed and vigorous gripping and frequent flexing of wrist are the primary causes of Golfer’s Elbow, every of which or all of them collectively could cause vata aggravation. Repetitive actions resulting in tears in tendons will trigger vata aggravation, as mentioned earlier.
From danger elements perspective
Extreme indulgence in athletic actions like golf, squash, tennis, weightlifting, baseball, rowing and so forth will trigger aggravation of vata on the elbow joints. Equally the occupations involving repetitive and extreme wrist actions or use of forearm and elbow – like in butchers, laborers, plumbers, laptop customers, cooks and painters can even predispose for vata aggravation within the higher limb, primarily elbows, resulting in golfer’s elbow.
From the angle of signs
The signs of Golfer’s Elbow are additionally resulting from Vata aggravation. If Vata is predominantly aggravated within the elbows, ache can be predominant. Irritation and inflammatory indicators can be predominant within the elbow when pitta is related to vata. Vatarakta or Amavata occurring on the elbow joint also can trigger inflammatory signs involving the tendons therein. Extreme swelling could depict involvement of ama if the situation is with ache or kapha whether it is related to much less ache and extra of heaviness and stiffness.
Ache with wrist flexion, which frequently radiates from elbow to little finger, ache throughout handshakes, weak hand grip, are all resulting from vata aggravation within the elbows.
Problem in shifting the elbows and stiff elbow could also be resulting from vata, ama, samavata, amavata or kapha. Tingling sensation and weak point of wrist joint is unquestionably resulting from vata aggravation in elbows.
Therapy Rules
Nidana Parivarjana
One ought to consciously keep away from all of the causative elements which have been talked about as causal for Golfer’s Elbow. From Ayurveda perspective, all vata aggravating elements needs to be averted.
If different doshas are discovered to trigger or are related to vata, the causative elements of the identical too shall be averted.
If signs resembling Golfer’s Illness are brought on by another illness, therapy ideas particular for that illness shall be applied.
Therapy for Vata
Contemplating that a lot of the signs are brought on by aggravation of vata across the elbow joints, all therapy ideas meant for combating Vata shall be applied, together with medicines, therapies, way of life modulation and recurring adjustments and weight loss program schedules.
Related doshas together with pitta or kapha, rakta or ama shall be handled by administering applicable therapies.
Exterior Therapies
Abhyanga – natural oil therapeutic massage to fight ache, swelling, irritation and motion restriction / stiffness.
Murivenna is good when there’s damage. Ksheerabala Taila is sweet when there’s irritation or degeneration within the backdrop of signs. Mahanarayana Taila would fight vata and associated ache whereas Mahamasha and Balashwagandha Taila are useful for strengthening the muscle tissue, tendons, joints and mushy tissues. Pinda Taila needs to be utilized in case Vatarakta is inflicting the signs and Kottamchukkadi Taila within the presence of ama.
Dhara and Pichu – The identical oils can be utilized for dhara – showering the joint with oil and pichu – pad soaked in oil saved in place over the affected joint and bandaged.
Swedana – Sudation adopted by therapeutic massage is good to fight vata and associated signs. Sud
ation with out utility of oil or making use of minimal oil (like Kottamchukkadi Taila) is good for amavata. Ruksha Sweda i.e. dry sudation is sweet in these circumstances, instance – valuka sweda (sand bolus sudation). Swedana shall be averted or minimal in Vatarakta or inflammatory signs involving pitta together with vata. Dry sudation is sweet for edema resulting from involvement of kapha together with vata.
Nadi Sweda – tubular sudation or Upanaha Sweda – poultice sudation are good for symptomatic reduction. Decoctions like Dashamula Kashaya shall be used for Nadi Sweda.
Upanaha, Lepa and Churna Pinda Sweda – Medicated Powders like Dashanga Lepa Churna, Kottamchukkadi Churna, Grhadhumadi Churna, Ellumnishadi Churna and so forth shall be used as and when required for upanaha, lepa – utility as paste and churna pinda sweda – powder bolus fomentation / sudation.
Patra Pinda Sweda – leaf bolus fomentation / sudation needs to be finished with vata mitigating leaves (or leaves chosen as per dosha aggravation) and Shashtika Shali Pinda Sweda – for strengthening the muscle tissue and mushy tissues across the joint.
Paste of Cheriya Marmani Gulika or Karutta Gulika blended or unmixed with oil needs to be utilized on the affected half.
Inside Therapies
Virechana needs to be administered to fight ache and irritation. If the signs are extreme, cussed or continual, Vasti needs to be deliberate. Raktamokshana could also be wanted if Vatarakta is causal.
Helpful formulations
– Mahayogaraja Guggulu
– Kaishora Guggulu
– Simhanada Guggulu
– Maharasnadi Kashayam
– Mustadi Marma Kashayam
– Guggulutiktakam Kashayam / Ghrtam
