In a message dated 3/12/2003 7:10:32 PM Eastern Standard Time, [EMAIL PROTECTED] 
writes:

> Fly Tyer's Elbow...

Oh no, the Listmeister strickened with the dreaded lateral epicondylitis...! :-)  
Let's see if I can help you out here.  This is one of the more common problems it 
seems, for just about everybody BUT tennis players.  Unlike what has been mentioned 
earlier, it has absolutely nothing to do with any muscle whatsoever, and is not a form 
of tendonitis, which is obvious from the name of the problem.  What it is, is an 
inflammation of the origin of the brachioradialis muscle from the lateral epicondyle 
of the humerus, the arm bone at the elbow.  Hold your affected arm/elbow at about 90 
degrees with your thumb straight up, place the fingers of your opposite hand behind 
the thumb and run them straight back to the elbow and find the sore spot.  This will 
be the lateral epicondyle where the problem is.  Take an ice cube, hold it in a 
washclothe and massage that area right on the skin with the ice, until the ice cube 
melts. This will numb things right the hell up for ya!  Anti-inflammatory medications 
for a about a week will also help, your choice of any of the ibuprofen preparations, 
or Aleve, which is an excellent one.(contact me off list for proper doses of these 
medications)  Also, if you're going to wear anything, it should be a "tennis elbow 
brace," which you should be able to get at the local pharmacy.  Place this around the 
largest part of your forearm, about one or two finger widths down from the elbow, and 
wear it fairly tight, but not so tight that your hand and fingers turn cold, blue, or 
you lose feeling in them.  This tricks that muscle, the brachioradialis into thinking 
that it takes its' origin from right there where you placed the brace, and not from 
where it actually does(the lateral epicondyle of the humerus), and thus, the 
affected/inflammed area gets to REST.
TRy this for about a week and we'll see how you do.  This is what I do for all of my 
patients with lateral epicondylitis, before getting aggressive and sending them to a 
Physical Therapist.  If you don't respond to conservative management, this would be 
the next step, and trust me, they've got all kinds of little tricks to get you feeling 
better with it.  One thing they would stress to you is that the activity that 
aggravated it in the first place needs to be eliminated or at least modified. I used 
to take care of some commercial tiers when I lived in St. Anthony, Idaho.  They had 
what we called "fly tiers' neck..."  Changes at your tying desk will help, like the 
level of your vise, the level at which you sit for tying, how close you are to the 
vise, dictating what angle your elbow is at for tying; all sorts of little things that 
don't seem like much, but that probably screwed up your elbow... :-(  Keep in touch!

Take it easy!

Tom Tully, PA-C
[EMAIL PROTECTED]
Idaho Falls, Idaho

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