All posts in Elbow & Wrist

Repetitive Strain Injuries


As your workload at the office increases, so do repetitive actions, such as typing, using your computer mouse and talking on the phone. These routine tasks seem simple, but they can add a level of physical stress to the emotional and mental stress of getting the job done. In fact, repetitive strain injuries have skyrocketed in the last 20 years due to the increasing reliance on workplace technology.

Try these tips to reduce the strain:

Computer Monitor

Position your computer screen directly in front of you. Allow the muscles in your eyes to relax by following the 20/20/20 rule: Take a 20-second break every 20 minutes and focus on an object that is at least 20 feet away from you.


Use your hand to support the telephone against your ear and alternate sides regularly. Do not cradle the phone between your ear and your shoulder. Consider using a headset or speaker.


Sit upright and all the way to the back. Place a support cushion or roll against the arch of your low back for lumbar spine support. Here are some tips to help you adjust your chair:

  • Stand in front of the chair and adjust the height so that the highest point of the seat is just below your knee.
  • Sit on the chair and make sure that your knees are bent at approximately a 90-degree angle when your feet are flat on the floor.
  • Adjust the backrest forwards and backwards as well as up and down until it fits the hollow in your lower back.
  • Sit upright with your arms hanging by your sides. Bend your elbows at about a right angle and adjust the armrest height until they barely touch the undersides of the elbows. Remove the armrest from the chair if the right level cannot be achieved.

Lastly, don’t forget to take a quick stretch break or change position every 30 to 45 minutes. Your back, neck and shoulders will thank you for it!

Provided by Dr. Luciano Di Loreto, HBSc., D.C. & Associates



Preventing Tennis Elbow, Shoulder Tendinitis and Shin Splint


Playing sports, sitting at a desk all day, or even running outside are all simple actions performed in our day-to-day lives. But, did you know that most of these actions require repetitive movement that can often cause muscle strain. The motions of everyday activities can sometimes contribute to common injuries, such as tennis elbow, shoulder tendonitis and shin splints.

Here are three types of preventative exercises you can do at home to help alleviate and prevent those everyday injuries from slowing you down:

  1. Tennis Elbow, a common overuse injury that happens in the summer months due to increased sports activity with racquet sports, cycling, or golf.
    Preventative exercise: Eccentric strengthening. Use weights to strengthen the area and muscles used in your favourite activities.
  2. Shoulder Tendonitis, a common injury often due to faulty shoulder mechanics that can be a result of sitting disease.
    Preventative exercise: Chest stretches. Chest stretches helps get the shoulders back into the right position. Shoulder blade exercises are also a great way to help mobilize the muscles around your shoulder blades and strengthen the muscles of the mid-back.
  3. Shin Splints, a common injury as people increase their mileage outdoors. It is caused by running on concrete or other hard surfaces for longer periods of time.
    Preventative exercise: Leg stretches. Use a foam roller to warm up your calf muscles and lower leg muscles prior to running.

Being mobile and staying active is a great way to keep fit and healthy. Remembering these simple preventative exercises will help you stay on an injury-free path.

Provided by Dr. Luciano Di Loreto, HBSc., D.C. & Associates



Back of my elbow pain…Is this Olecranon Bursitis?

Back of my elbow pain…Is this Olecranon Bursitis?

What is Olecranon Bursitis?

A 35 year old carpenter came to our clinic complaining that the back of his elbow was swollen and very tender/painful after banging it on a kitchen cabinet during installation. After conducting a health history and detailed physical examination, we determined that this was a case of olecranon bursitis.

What causes Olecranon Bursitis?

A fall, hit, bang or blow to the back of the elbow, repeated weight bearing, improper exercise technique or dragging of the elbow to the ground may cause swelling, inflammation, pain and pooling of edema in the elbow bursa thus causing olecranon bursiitis.

Think of it this way…subdivision and cities often have areas where water collects and distributes during flooding, heavy rainfall or snow melt.  When heavy rain covers our streets it collects in a city catch basin.  The bursa is the elbow’s catch basin for when inflammation, edema or swelling occurs.  It, the bursa, fills up and allows our body to slowly take it away through the lymphatic system and out of our bodies through urine/excretion (similar to a sewage system which ends up distributing the water into larger areas of water outside of the city/subdivision).  

What are Signs and Symptoms of Olecranon Bursitis?

Olecranon bursitis is the size of a goose egg.  The olecranon is the surface of bone at the end of the ulna bone (elbow). It is very difficult to miss since it looks abnormal and may present with redness and feel tender to the touch. It must be differentiated from gout and/or kidney failure which present similarly in the elbow and other joints. Infection is another condition to rule out – however, it typically occurs near an open wound.

How do I treat olecranon bursitis?

At our clinic we treat olecranon bursitis with support tape, along with ice therapy, ultrasound therapy, laser therapy and advice about what activities to avoid. If the bursa is infected, we refer out for aspiration or antibiotic therapy. Our chiropractic and physiotherapy team, reviews the area and assesses the range of motion of the elbow before determining which treatment could be most effective.

Dr. Luciano Di Loreto, HBSc., D.C. & Associates




Chiropractic & You!

Chiropractic & You!

Chiropractic health care

The word “chiropractic” comes from ancient Greek and means “done by hand.”

Adjustment of the joints of the body has been used in the healing arts for many centuries and is at the heart of modern chiropractic care.

Chiropractors are specialists in manual adjustment of the vertebrae of the spine and other joints of the body. Adjustment helps relieve pain and restore normal functioning to the joints and supporting muscles and ligaments – so you can enjoy your everyday activities again as quickly as possible.

Your chiropractor will recommend a course of treatment specific to you that may also include mobilization of the joints, ultrasound, muscle release techniques, muscle stimulation and therapeutic exercises.  Chiropractors are also trained to provide nutritional counselling, and recommend rehabilitation and injury prevention strategies.

Back health is important

The body’s information highway – your nervous system – is protected by the spine. The nervous system travels out between the vertebrae or joints of the spine to carry messages from the brain to every corner of your body. Stress and strain on the vertebrae can put pressure on the nerves in the affected area. That is why a problem with your spine can have far-reaching effects causing symptoms such as arm or leg pain.

When to consider chiropractic care

If aching joints and muscle pain are affecting your ability to get through the day and keeping you away from your favourite activities, consider chiropractic care.  Work, accidents, sports injuries, household chores, even the stress of daily living can cause painful joint and back problems. Even if you do not have painful symptoms, chiropractic care can help you maintain healthy spine and joint function.

Here are some of the most common reasons why more than 4 million Canadians visit a chiropractor each year:

  • Back pain
  • Neck pain
  • Headache
  • Whiplash
  • Strains and sprains from daily activities
  • Repetitive strain injuries
  • Work and sports-related injuries
  • Arthritis
  • Restricted movement in the back, shoulders, neck or limbs

Benefits of chiropractic care

Chiropractic treatment is skilled, hands-on health care that relieves pain and helps your body be its best. Here are some of the ways it can help you.

  • Improved movement in your neck, shoulders, back and torso
  • Better posture
  • Relief from headaches, neck and back pain
  • Prevention of work-related muscle and joint injuries
  • Enhanced athletic performance
  • Improved flexibility
  • Relief of pregnancy-related back ache
  • Correction of gait and foot problems



Tennis Elbow vs. Golfers Elbow

Tennis Elbow vs. Golfers Elbow

Tennis elbow and golfer’s elbow are both forms of tendinitis, which is inflammation of the tendons. Despite their names, these conditions can occur in individuals who don’t play tennis or golf.

Tennis Elbow (Lateral Epicondylitis):

Location of Pain: Pain occurs on the outer part of the elbow.

Affected Tendon: The condition involves the extensor tendons on the lateral (outer) side of the elbow, specifically the common extensor tendon.

Common Causes: Repetitive gripping, wrist extension, and excessive use of the forearm muscles, often associated with activities like playing tennis, hence the name.

Golfer’s Elbow (Medial Epicondylitis):

Location of Pain: Pain occurs on the inner part of the elbow.

Affected Tendon: Golfer’s elbow involves the flexor tendons on the medial (inner) side of the elbow, specifically the common flexor tendon.

Common Causes: Repetitive gripping, wrist flexion, and excessive use of the forearm muscles. Despite its name, it can be caused by various activities and is not limited to golf.

Key Differences:

Location of Pain: The primary difference is the location of pain. Tennis elbow causes pain on the outer side of the elbow, while golfer’s elbow causes pain on the inner side.

Affected Tendons: The tendons affected are different. Tennis elbow involves the extensor tendons, while golfer’s elbow involves the flexor tendons.

Activities: Tennis elbow is often associated with activities that involve repetitive use of the wrist and forearm, such as gripping a tennis racket. Golfer’s elbow, despite its name, can be caused by a variety of activities involving gripping and wrist flexion, not limited to golf.

Treatment: Treatment for both conditions may include rest, ice, anti-inflammatory medications, physical therapy, and in some cases, braces or splints. Severe cases may require more advanced interventions like corticosteroid injections or, in rare cases, surgery.

It’s essential to note that these terms are somewhat misnomers, as the conditions can affect anyone, not just tennis players or golfers. The key is understanding the specific tendons involved and addressing the underlying repetitive strain or overuse causing the inflammation.

How can we help? 

Physical therapy plays a crucial role in the management and rehabilitation of both tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis). The primary goals of physical therapy are to reduce pain, promote healing, and strengthen the affected muscles and tendons. Here are some common physical therapy options for tennis and golfer’s elbow:

Rest and Activity Modification:

Physical therapists may advise rest from the activities that aggravate the condition. Modification of techniques or equipment in sports or daily activities may also be recommended to reduce strain on the affected tendons.

Ice and Heat Therapy:

Cold packs (ice) can help reduce inflammation and numb the area, especially after activities. Heat may be used to improve blood circulation and promote healing during the later stages of rehabilitation.

Stretching Exercises:

Gentle stretching exercises for the forearm muscles can help improve flexibility and reduce muscle tension. Stretching should be done gradually and without causing pain.

Strengthening Exercises:

Eccentric exercises (lengthening of the muscle while it contracts) are often prescribed to strengthen the affected tendons. Resistance exercises with bands or weights may be included to improve overall forearm strength.

Shockwave, Ultrasound and Electrical Stimulation:

Modalities such as shockwave, ultrasound or electrical stimulation may be used to promote healing and reduce pain. These techniques can increase blood flow to the affected area and stimulate the healing process.

Manual Therapy:

Manual therapy techniques, including massage and manipulation, may be employed by physical therapists to improve tissue mobility, reduce muscle tension, and alleviate pain.

Bracing and Taping:

Orthotic devices or braces may be recommended to provide support and alleviate stress on the affected tendons. Taping techniques can also be used to offload the injured tissues.

Functional Training:

Functional exercises that mimic specific activities or sports movements are incorporated to ensure a smooth transition back to regular activities. This helps the individual regain strength and coordination in a more task-specific manner.

Education and Ergonomics:

Education on proper body mechanics, ergonomics, and techniques to prevent re-injury is an essential component of physical therapy. This may involve guidance on proper equipment use, workplace setup, and body mechanics during daily activities.

Home Exercise Program:

Physical therapists often design a customized home exercise program for individuals to continue their rehabilitation independently. Consistency in performing these exercises is crucial for long-term success.

It’s important for individuals to work closely with their physical therapist to tailor the treatment plan to their specific needs and to gradually progress through the rehabilitation process. Additionally, following the therapist’s recommendations for activity modification and lifestyle adjustments can contribute significantly to a successful recovery from tennis or golfer’s elbow.