Wednesday, February 27, 2008

Medial epicondylitis or Snow-shoveler's elbow

I'm told that I hold a snow shovel wrong. Who's to say really what's right or wrong when it comes to wielding a snow shovel? My spouse claims the proper way is to grip the snow shovel with the left hand by grabbing it fingers down. That, unfortunately, requires that you have a brachioradialis muscle on the top of your forearm with which you can both grip and lift pounds and pounds of snow. I was not issued one of those muscles.

So what's a spaghetti-armed doctor to do? Exactly what my mush-armed patient did--grab the shovel handle in an underhanded sort of way, which brings the trusty biceps into play along with the pronator teres, flexor carpi radialis, and palmaris longus muscles on the palmar side of your forearm. After moving mountains of snow, these overused muscles which attach on the inner aspect of the elbow, start screaming with pain. This is known as medial epicondylitis, golfer's elbow, or, for all of us who weathered this difficult winter season, Snow-shoveler's elbow.

Those scoopers who favor the overhand shovel technique, however, would overuse the brachioradialis muscle causing pain at its tendinous insertion on the outer aspect of the elbow. This is known as tennis elbow, or Snow shoveler's elbow.

I assured my patient today that the orange crocuses were in bloom in my garden, and the end of the snow surely cannot be far behind. Tendinitis starts to heal when the patient stops bothering the tendon. While extraordinary repetitive motion creates tendinitis, ordinary daily activities like lifting kids, books, grocery bags, and suitcases can perpetuate the problem.


JeanMac said...

I had to get mine injected this winter - pain was gone in 48 hours.I am sure my shoveling technique is bad,bad - I just get out there and want it to be over!

Mauigirl said...

I got a pain in that exact muscle the day after I shoveled out my aunt's walkway on her vacant house so the real estate people would be able to get in. At first I couldn't figure out why it hurt and then I remembered the shoveling!

Ruth said...

Forearm braces can help redistribute forces that would irritate the insertion of this group of muscles. But it is best to avoid the repetitive strain. I push snow with a big scoop, but our banks are so high now there is no place to dump it.

Anonymous said...

Unfortunately, I don't have anyone to help me shovel - the two men I live with are both disabled/handicap so it is left to me. I have just started noticing my elbow hurting these last two times it snowed. When the snow is extremely heavy, it hurts.
Since I do the cooking and cleaning - there is not much relief in site but I just keep thinking, spring will be here and I will get a very long reprieve to build up those muscles for the end of the year.

CA B said...

I did my elbow in moving a pile of dirt. The pain goes across the whole inside of my elbow. It seems to be taking a very long time to heal. But I guess having horses and doing some type of shovelling every day isn't helping. I just try to modify my moves by keeping my elbows close to my body.