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Old 11-12-2007, 07:19 AM
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ricki ricki is offline
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Default Kiter's Elbow

Quote:
Originally Posted by Neill

Let me start off by saying that this post is a GUIDE ONLY - the problem outlined below is not a definitive diagnosis for all elbow pain, it is merely an outline of the most common kiter's arm problem:

KITER'S ELBOW

I am a Sports Physiotherapist based in QLD, Australia, and have recently suffered from a bit of kiter's elbow whilst I was conveniently on a tropical island holiday with my kite. The biggest thing that struck me about it was how much it can ruin your day, and how intense the pain can be. I have summarised below a few points about this condition, and how it can be treated, in an effort to help anyone else out there who suffers from it.

Kiter's elbow - what is it?

"Kiter's elbow" is a term used by kiters to describe tendonitis of the common extensor origin in the forearm. Essentially, it is clinically indestinguishable from "Lateral Epicondylalgia", which is commonly known as "Tennis Elbow".

There is some variation in the clinical presentation among patients, but the main feature is a pathological change in the structure of the tendinous attachment of the wrist extensor muscles - principally the Extensor Carpi Radialis Brevis, but often extending in to the surrounding musculature - the Extensor Digitorum and the Extensor Carpi Radialis Longus.

Look at the Extensor Musculature here: http://en.wikipedia.org/wiki/Extenso..._brevis_muscle

Read about "Tennis Elbow" here: http://en.wikipedia.org/wiki/Tennis_elbow


What are the symptoms?

The main symptom is, of course, pain over the lateral aspect of the elbow, but often the patient complains of a dull ache throughout the whole elbow, which cannot be localised well. The pain is aggravated by repetitive gripping or lifting motions, and often extension of the wrist. It may come on slowly over the course of a kiting session, or can be initiated as soon as you do your first run.

The pain is accompanied by a marked loss of grip strength, which is due to neural inhibition of the musculature (your brain tells you to stop gripping things, because it's making the problem worse!). Often the patient will complain that they drop cups of coffee or cannot lift their suitcase.

What causes it?

The cause is only partially understood, but like any tendonitis, it is thought to arise from repeated microtrauma to the muscle/tendon complex which starts a degenerative cascade. The muscle becomes painful, and it then gets weaker because of the pain and disuse. Grip loads which were previously fine begin to irritate the muscle even further, and so on the cycle goes.

There is evidence of morphological change in the structure of the muscle, as well as degeneration of the collagen structure at the attachment site.

In real terms, what this means for us is that we have been gripping the bar too hard, almost always because of heavy bar pressure in the kite. I have also found that wearing gloves when you kite can aggravate the condition, because you will subconsciously grip the bar harder to get the "feel" of the surface feedback to your brain. At the moment, I can kite just fine without gloves, but throw on a pair of Ronstan sailing gloves and the pain kicks in straight away.

Obviously, a stronger forearm will be able to handle higher grip loads without concern, so a bigger and stronger kiter will be able to handle a kite with heavier bar pressure without a worry. If, like me, you are a skinny bloke with rake-thin arms however, you are at a much greater risk of developing the problem!

What can you do about it?

Prevention: Prevention is the best form of cure. Strengthening your extensor musculature by doing regular exercise is a great idea. If you go to the gym regularly, you're probably already doing a whole bunch of exercises which are beefing up your grip strength. Anything involving a barbell or dumbbells and requiring a solid grip is helping. If you're really worried, you can do specific extensor grip strength exercises, which I have shown below.

Cure: This is a notoriously difficult thing to treat. Often you will get it fully better, only to have the problem recur 6 months later. I have outlined the main treatment techniques that I use below, in order of importance:

1) Modify the aggravating factor(s) so that they are no longer in play. For us, this means getting a kite with lighter bar pressure! Often this is all you will need to do in order to get rid of the problem once and for all, but if that is not enough, you need to seek treatment from a Physiotherapist or your local equivalent. I can personally recommend a GK Sonic for anyone with Kiter's Elbow, but most bow kites with a direct rear line attachment and 1:1 bar are usually pretty light on the bar.

2) Disable the active trigger points in the involved muscles. I use dry needling (acupuncture needles) to break up the tender local trigger points in the extensor tendons quite frequently. This appears to be the best method of providing instant relief, apart from perhaps the lateral glide manual techniques, which cannot be done effectively at home. YOU NEED TO HAVE THIS DONE BY A PROFESSIONAL! Don't go sticking needles into your arm at home, you'll only make it worse. Here's a pic of my arm with a needle stuck in it. Yes it hurts, but feels much better afterwards.



Deep tissue massage and accupressure are also helpful, which basically means that you push on the sore muscles as hard as you can bear for about 30 seconds at a time.

3) Manual therapy and electrotherapy are useful in the clinical setting, your Physiotherapist will know more about these. There are a few mobilisation techniques which are brilliant for this problem, and combined with some heavy Ultrasound and Interferential therapy, can be very successful.

4) Therapeutic exercise is the long-term fix for this problem. Essentially you need to strengthen the extensors up so that they handle the loads of kiting without causing a problem. I usually tell my patients to do 4-5 sets of 10 of each of these exercises per day, on the provision that they are not painful, and do not aggravate the pain at all. If anything hurts, it is to be avoided!

a) Wrist extensions. Begin with a 1-3kg weight, with your palm facing towards the floor. Extend the wrist (lift the weight up using your wrist) and SLOWLY drop it down again. The key is to do the eccentric part of the exercise slowly, as that is where the most muscle strength is gained.





b) Radial Deviation exercises. Use the same weight, just turn your wrist 90 degrees so that your thumb is facing towards the ceiling.





The best thing you can do is to seek treatment as soon as you notice any pain. If the condition goes chronic (>3 months duration) it is MUCH harder to treat. In the extreme cases, you can have a corticosteroid injection (which almost never helps, and can often make it worse) or a surgical release of the tendons. I would recommend neither of these things. Go see your local Physio or equivalent and beat it before it becomes a serious problem!

Feel free to ask me specific questions in this thread, I'll do my best to answer. Mods might want to make this a sticky too?
From: http://www.kiteforum.com/phpbb/viewtopic.php?t=2343516
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Last edited by ricki; 11-12-2007 at 08:05 AM.
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Old 11-12-2007, 08:10 AM
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Nice article, particularly on the conditioning exercises! Thanks for putting it together. Some more info appears below:

Some other things that can help in addition to warming up and down for sessions include trimming kites for lower bar pressure. This often means trimming on the pigtails in the middle area or closer to the end of the pigtails. If this leaves you without enough power, rig a larger kite or sit this one out. Using the proper sized bar for a given kite can also help. IF your kite has a good stopper system consider using this to ease the load when well offshore in steady wind when not setting up for jumps or tricks. Using kites with known lower bar pressures and smaller kites can help as well.

One thing that I have found helps with irritation like this are ice massages (although not nearly as well as avoidance in the first place!). Freeze a styrofoam cup of water, peel a 1/2 inch or so off the bottom exposing a lump of ice. Press this lightly into the irritated area with circular motions. You can also buy plastic cups for this purpose:


http://www.chirocity.com/index.asp?P...OD&ProdID=1272



More kiteboarding ideas on dealing with kiters elbow appear at:

http://www.kiteforum.com/phpbb/viewtopic.php?t=2315961

http://www.kiteforum.com/phpbb/viewtopic.php?t=2315982
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Old 11-12-2007, 03:07 PM
CrazyJay CrazyJay is offline
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I have had this problem since I started kiting 8 years ago. I tried everything including accupuncture, meds, and exercises.
The only thing that worked for me were the tennis elbow braces. You can get them at Wlagreens or Walmart for about $5 each. They are basically just 2 inch wide straps with velcro.
I used them every time I kited or was working. After a couple months my elbows were back to 100%. It takes the pressure off of the elbow joint and causes your forearm to build up mass and strength.
Now if I ever feel the pain beginning I immediately start wearing them again and they never get to the point of intense pain.
Jay
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Old 11-12-2007, 05:05 PM
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Very interesting write-up. I have the same elbow pains, but I attributed it to years of weightlifting. I didn't know it was a fairly common condition among kiters. I'll have to keep those elbow braces in mind Jay. Good info gents!...
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Old 11-12-2007, 11:23 PM
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Default Tennis elbow its all in the fork

Kiteheads as a kiter with an extensive background in windsurfing, which at the Olympic level is all about (holding on to the boom and pumping your ass off combined with top level aerobic fitness and pain management) i.e. managing your aerobic threshold by pumping just to the point that you do not lose your grip; I discovered that the training, physio therapy, massage, working out, chiropractic, yoga sessions (2 hours every morning) and on the water training all helped but the fastest way to reduce inflamation in the body is to control the fork!

You are what you eat. If you eat alkaline dominant food and stay away from food that leaves an acid residue, you get an instant drop in inflammation in the body which is noticeable pretty soon after eating.

We can all relate to what if feels like to get severely dehydrated ( your body starts to feel like it is on fire- which is it becoming severely acidic at a cellular level) or to eat something that makes you get acid indigestion but we do this more or less every time we choose what to eat for a meal.

OK so the question is what are alkaline foods. Well sorry to say but the only real alkaline foods are green leafy vegetables. Any kind of spouts are extremely alkaline, Lettuce, kale, chard, bok choy, parcley, dandelion, cilantro, etc. or anything having a green leaf. Fruits are kind of neutral and grains are acidic.

http://www.essense-of-life.com/info/foodchart.htm

this is the first thing that came up when i googled alkaline food.

www.sunfood.com sells a powerful superfood powder called "Natures First Food" that can be mixed into your morning orange juice. Its made with whole Leaf barley grass, whole leaf wheat grass, nettle leaf, horsetail, alfalfa leaf juice, dandelion leaf juice, kamut grass juice, barley grass juice, oat grass juice, broccoli juice, kale juice, spinach juice, parsley juice, burdock root, nopal cactus, ginger, amla berry.

* Algaes: spirulina*, broken-cell-wall chlorella**.

* Wildcrafted aquatic vegetables: Icelandic kelp, Nova Scotia dulse. (seaweeds)

And all the ingredients are organic. SO if you loaded yourself up with something like this every day besides trying to eat less processed and cooked foods you would see a pretty fast reduction in the inflamation in oyur elbows or any joint capsule for that matter. I can feel a difference from any meal I eat (I am 100% vegetarian, eat exclusively organic produce when I can, some dairy products preferably not pasturized, and 90% raw foodist) I gravitated to this type of lifestyle as I was doing a lot of research on diet, longevity, maximum performance and recovery in sports and this is where I ended up. My changes in my diet allowed me to compete at an olympic level well into my late 30's.

Also a great product that is coming from the tampa area is www.livingfuel.com

I have all of the athletes that I coach on it and they all love it! It is the worlds strongest antioxidant superfood product you can eat. Antioxidants also help reduce free radical damage which is a major way to kkep the body more alkaline.

Living Fuel mixed with some fruit and blended up makes the perfect sports drink to take before, durrig and after kiting.

Now most americans eat what is called the standard American Diet (SAD) which is loaded with too much polluted and sick animal products and genetically modified grains in the form of corn, wheat, soy and canola oil. And we wonder why everyone is sick, fat and not out kiteboarding with us.

Just do a google on raw food, alkaline foods, eating to heal, eating to heal cancer,etc. and you will see that the trend is just what i found and wrote about up above.

A 12 year old does not have kiters elbow (well some are getting it now) as his body is still quite alkaline. As we age we become more polluted, i.e. acidic. (old age is brought on by dehydration and getting loaded up with pesticides, parasites, homogenized (cooked till dead) dairy from cows fed genetically engineered (read frankenstein foods) trans fats, sodas, alcohol, chemicals, colorants, artificial flavors, preservatives which are all toxic and acidic to any living being.

And the majority of this food is grown with artificial fertilizers and the soil is so weak in nutrients that the plants have no immune system and pesticides have to be sprayed all over the crops just to get it to grow.

SO if we cleanup our diet the body will heal faster, recover faster, heal deeper and the inflammation will reduce to a manageble level and at that point all of the modalities mentioned above will have more of a positive impact.

And drink "spring water" like volvic, figi water, evian and (not tap water ever) as spring water is wetter and more alkaline as well.

Warm winds and a discerning fork to you all.
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Old 11-13-2007, 07:18 AM
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ummmm yeah... I'm still going with stone crab claws (lot's of lemon), a bit of grilled swordfish, a few 911 hot wings from hooters (naked), and some beers to wash it all down. Might even take a hit of the greens, but only if my mouth isn't burning too much.


I'm am the anti-weight to Gebi's positive life force! Long live the Dark Sith, Neil H. "I am your father".

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Old 11-13-2007, 07:22 AM
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drinking bicarbonate water drastically reduces colon cancer in mice that are treated with carcinogens compared to those that are just given regular or acidic water


I don't think I'm going on a bicarb diet tho'
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Old 11-13-2007, 08:12 AM
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Thanks for the input Gebi. I wasn't aware of the dietary tie in to this. I don't have kiters elbow, these days fortunately though at times in the past. Seems my wrists have decided to act up over the last couple of weeks with all this wind.

You can't argue with results. Gebi, like Kent was on the Olympic Windsurfing Team for sometime. Gebi still travels all over the world coaching Olympic competitors.



Gebi and Kent, despite his avowed beer and spicey Hooter diet (that would hurt if one got caught in your eye!?), came in first to Bimini in the race from Ft. Lauderdale in 2005.
http://fksa.org/showthread.php?t=542
http://fksa.org/showthread.php?t=878

Gebi also saved some floundered boaters off Ft. Pierce Inlet a while back, more at: http://fksa.org/showthread.php?t=1448

So, whatever Gebi uses to improve performance on the water, quite a lot I imagine, it seems to work very well.
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Last edited by ricki; 11-13-2007 at 09:54 AM.
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Old 11-13-2007, 09:46 PM
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Kent, at least the lemon will add to the alkalinity..... as will all the water you get up yer arse from kiting too overpowered.

Gebs
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Old 11-14-2007, 08:01 AM
Skyway Scott
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I think Gebi has the diet advice spot on.
I first start reading about the subject of acidity in the diet when advised to do so from a Dr. friend.
Whenever I change my diet and make attempts at making it more alkaline, I can notice obvious changes in my system. Within a few weeks I usually lose weight (a recognized effect of eating properly) and my muscles feel much better, leading to increased energy and better endurance.
I am 40 now, so the effects are more noticeable. When you are young, your body deals with anything and everything better, making improvements in health less noticeable, imo. The masking effect of youth is gone now though, so the effects are more obvious to me.

Thing is, being a sponsored Wendy's rider, it's hard to follow the diet. :???:
I am going to tell Dave (Thomas) to shove it today and go back to eating better. Thanks for posting the article(s).
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