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Dr Jean-Marc Parisaux is a doctor of sports medicine and traumatology with expertise in manual medicine, osteopathy and rehabilitation. He is a specialist at the prestigious Monaco-based sports medicine center, IM2S, which helps world-class athletes and ordinary folk with their goals towards attaining optimal physical performance. Send your health and fitness questions to: askthedoc @ monacoreuve.com


Tennis elbow spoiling fun

Dear Dr Parisaux,

What do you suggest as a way to deal with tennis elbow? And please don’t say that I should give up the sport, because it’s my favourite pastime.

- Blanche

Dear Blanche,

What you refer to as “tennis elbow” is actually tendinitis, an overuse of the tendons which connect your muscles to your bones. Unfortunately, this painful condition can last as long as two years. Unhappily, you will have to stop sports activities or situations ­responsible for causing the ­tendinitis, for at least one or two months. I suggest two main courses of treatment: shock wave therapy, and rehabilitation. Shock wave therapy increases vascularisation, that is, the ­development of blood vessels in the tissue, and thereby helps in the ­healing process. Rehabilitation will ­allow good collagen fibre formation.

It can be useful sometimes to do infiltration (injection of a local cortisone) to decrease the pain in order to begin the rehabilitation. However, infiltration alone is often insufficient as a treatment as the pain is usually back two months later. Mesotherapy, acupuncture, osteopathy, good hydration, ice, a brace…any of these can also be useful. Be sure to talk with your doctor about the reasons for your tendinitis; but the harsh reality is that you will have to be off your favourite pastime for a while if you want to have any chance of treating your tennis elbow.



Swimming with a bad back

Dear Dr Parisaux,

Helping a friend move really did my back in. I’m used to being active, so this is really a pain (pun intended). What do you recommend? I heard swimming would help me build back muscle strength, and that the ­backstroke, ­especially would be a good idea. What do you say?

- Sam

Dear Sam,

Swimming is highly recommended for improving muscle strength. However, doing the backstroke when you have pain in the lumbar spine is not always the best idea. This is because of the ­rotation of the trunk, and so the spine, on each movement. If you experience no pain, then go right ahead and enjoy the backstroke. However, you would be better off using a board, a mask, a snorkel, and fins. ­Swimming with these aides will keep your spine perfectly straight and will help you strengthen your back muscles...you just have to adjust to the idea of showing up at the beach or pool decked out like this!



Riviera heat too much for older beach bums?

Dear Dr Parisaux,

An elderly relative will be with us on the Riviera for the summer. She’s in her late seventies, is fairly active, and likes to be outdoors, but is more accustomed to milder British weather. With the near heat waves we’ve had in France these past few years, should we be ­worried about her?

-
Molly
 

Dear Molly,

First of all, good ­hydration is essential, so ­advise your elderly relative to drink water several times a day. Secondly, it’s wise to avoid going outdoors between noon and four pm, the hottest period of the day. It would be preferable for her to venture out early in the morning or late in the ­afternoon. She would be best advised to stay in a room with good air conditioning during the hottest part of the day and at night. If you follow these guidelines, she should have a comfortable and healthy visit.



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