UKC

I found this journal on tennis elbow and was wondering what the UKC communitee thought about it. The research seems well done and unbiased, but the ASMT website looks a bit dodgy.

https://peerj.com/articles/967.pdf

Let me know what you think

Alex

In reply to climb the peak:

Interesting. Never heard of Astym before. A few thoughts:

1) what makes Asytm any different from using an Armaid or similar device, or even various types of massage?
2) Their eccentric program doesn't seem very good. Not high enough intensity, or frequency. Unless I missed something they were doing 2 or 3 sets of 15 reps 2 times a week. When I had cripplingly (is that even a proper word?) bad tennis elbow I was doing double their weekly total, nearly every day, and intense enough to elicit pain response. Plenty of anecdotal data that says eccentric exercise is more effective when causing at least some pain. Dave Macleod talks a fair bit about this in his book, and there's the funny story of the guy trying to snap (!) his Achilles tendon so he can have hospital treatment, and instead ends up fixing it himself.
3) Interesting that people who didn't respond to EE responded well to Astym. More power to them if it works!
4) If Astym has been around since the end of the 90's how come nobody has heard of them? Once the word gets out that a treatment has even some potential usually all of the long-term sufferers jump on the bandwagon in the hope of resolving their problems. I know I bought an Armaid as soon as I heard about it and it has done wonders for my TE alongside EE.

In reply to jsmcfarland:

1) Yes, that's what I was thinking
2) Good point, I've read the book too and will be starting a high intensity eccentric exercise program soon.

I just can't help thinking it's a bit of a gimmick, but I would love to be proven wrong, although Astym isn't yet available in the UK

In reply to climb the peak:

Interesting, I would have liked to see placebo controlled study as well to gauge its benefits over doing nothing and getting on with your life and avoid aggravating it.

I bought an expensive very medical-technical Sports Medicine book (recommended in the bibliography of Dave MacLeod's excellent Make or Break book). Indeed that technical-medical Sports Medicine book said that golfer's elbow and tennis elbow was normally expected to recover within a few months pretty much no matter what treatment was used. No recommendation of eccentric exercise over normal "concentric" exercise.

otherwise ...
* Most climbers with elbow problems do _not_ have "tennis elbow".

* My memory is that in another place in Dave MacLeod's book, he says that there is no substantial clinical evidence supporting _eccentric_ contraction exercise for golfer's elbow. Apparently he recommends eccentric because it worked well for himself.

* As normal "concentric" contraction exercises are normally performed, the each complete motion cycle _includes_ an eccentric contraction. So even it it's true that eccentric is somehow better for healing golfer's elbow, you are getting it anyway "for free" just by doing normal exercise.

I think what's really great about the discussion of elbow problems in Dave MacLeod's book, Make or Break, is that he starts with more careful _diagnosis_, which if done carefully could save half the time and effort spent on golfer's elbow rehab exercises.

Ken

In reply to kenr:

I am in agreement, the Astym protocol includes a strengthening and stretching program the difference being the intervention with a plastic spatula and some moisturiser.

Perhaps it would be better again if just the use of the Astym compared to rest, also rather than using subject perception (ahem* like beauty products X out y people felt their hair was shinier..), I would want quantified analysis from medical imaging, grip test etc.

Also more interestingly is that on the FDA website for registering the clinical trial, most of the Astym sites/sponsors have withdrawn their support.

I smell quackery (and not just the none sense on page 4)

In reply to climb the peak:

The two treatment groups in the study did not receive equivalent interventions. One group were sent away to do exercises at home for four weeks. The other had a convincing ASTYM massage with prolonged contact with an (attractive?) therapist twice a week for four weeks. That's a huge dose of placebo. Of course this group reported less pain at the end.

That study is junk science.

The ASTYM looks like a (probably quite expensive) pointy piece of plastic. The vendors are understandably a little coy about showing any pictures of their invention and prefer to hide it behind sciency jargon. They might as well massage your arm with a knife and fork for all the difference it would make.

I think a sceptical approach is warranted.

In reply to climb the peak:

Yes,

A lot of other factors that I hadn't taken into account and are easy to miss!