Treatments for Tennis Elbow

You have tennis elbow and are now looking for a way to deal with the pain and heal it completely. The good news is not every elbow tendon injury or condition requires surgery. With most cases, you will notice a great improvement within 6 to 12 weeks; however it can take many months in some chronic cases - even a year or more to return to normal. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results.

It is generally understood by doctors and surgeons, that surgery will introduce more scar tissue into the elbow tissue. This added scar tissue will be problematic, requiring physical therapy and conservative treatment options post-surgery. If not dealt with properly, your elbow and tendon tissue could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.

Most doctors, physicians and orthopedic specialists will recommend conservative therapy for minor elbow injuries before considering surgery.

Some conservative treatment methods recommended include:

• Rest - This is important for initial healing to reduce pain, swelling and inflammation in the early stage of your elbow injury. Too much rest can also be harmful to elbow injuries because joint immobility can actually cause stiffening in the elbow (and even shoulder) joint. This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
• Avoid Activities that Caused Your Injury - While resting your elbow, it's important to avoid activities that may have caused your injury in the first place and this definitely includes pretty much any type of sport where your upper body is involved. Continuing on with regular activities will not only make your injury worse, but trying to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body.
• Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups.
• Use Blood Circulation Boost (Blood Circulation Boost) - You can use your own blood flow to maximize your rehabilitation, maintain healthy blood flow to your arm and elbow, decrease recovery time, and boost overall long-term healing. Promoting blood flow to your elbow joint will help to minimize the growth of scar tissue, increase flexibility and help prevent atrophy.
• Physical Therapy - Surgery is usually the last resort. This means doctors or surgeons typically won't perform a surgery until they feel that their patient has put effort into treating their injury with conservative treatment methods. This includes 4 to 6 months of physical therapy. If you haven't experienced any improvement in your condition during that time then surgery may be considered. Agressive physical therapy approaches will focus on forced or manual manipulation of your elbow joint - this means your physical therapists will be trying to move your elbow past the point of comfort as they strive to increase range of motion and prevent further atrophy. This can be painful and end up making your injury worse if not done correctly. (reference: 1)
• Stretching - Stretching your elbow and arm in physical therapy and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key to maintaining good Range of Motion (ROM) in the elbow, and stretching can be made much easier with the use of a TShellz Wrap before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.

For acute (new or recent) elbow injuries that have the ability to heal on their own - your doctor may even suggest use of a removable sling. This can be helpful to prepare you for physical therapy sessions and mobility exercises.

However, prolonged use of a sling or long-term rest (restricted movement) without proper exercise or stretching can make your elbow condition worse (and also affect shoulder mobility). If your arm remains completely immobilized and at constant rest, the edges of your soft tissue tear will begin to fill in with scar tissue as part of the healing process. You may also have on-going symptoms of pain, swelling, inflammation, and even poor blood flow circulation.

Other Conservative Treatment Methods can be Risky

In some cases, physicians may recommend drugs or medications like NSAIDs (non-steroidal anti-inflammatory drugs) to manage pain and inflammation. Alternative medications like cortisone injections will help only with symptoms and not dealing with the actual tissue damage. It is designed to reduce inflammation, by slowing down the blood flow to the area that is trying to heal your injury. Yes, you may have pain relief, but at the high cost of re-injury or your tendon injury is healing at all!

"Medical evidence shows that cortisone shots can damage the surrounding tissue, fray the tendon and ligament tissue, and even trigger a rupture. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin (depigmentation) can be permanent." (reference: American Academy of Orthopaedic Surgeons)

 

What About Surgery?

It is true that 5% of all people suffering from Tennis Elbow may need to undergo surgery. The other 90 to 95% of all people will recover from their Tennis Elbow symptoms within 12 months of consistently using conservative treatments. (source: WebMD)

Before surgery is even considered, your physician will advise many months commitment to a conservative therapy program at least 6 consecutive months. Why so long? Your doctor will encourage you to stick to your at home treatments, your body has the ability to heal all on its own. In most cases time is needed for the tissue to form and be healthy enough to cope with our busy lifestyles. Surgery is only the last resort for the elbow! This is because the elbow joint is very flexible and the skin is thin. This flexibility stretches the tissue and lack of blood flow makes damage to the tissue very hard to heal.

Cold Therapy Treatments, Blood Circulation Boost, and Physical therapy will prepare your elbow for surgery. Strengthening your arm before surgery will give you the best chance for a successful recovery. Surgery is not the end of the journey with your elbow recovery, but another new chapter that has it's own challenges. You may not return your arm to the complete function and range of motion you had before. After surgery, you will undergo another 6-12 months of conservative therapy to help heal your arm.

Learn more about Post-Surgery Rehabilition and Recovery for your Tennis Elbow Surgery

Tennis Elbow Supports and Exercises

Your doctor may encourage you to use a tennis elbow cuff or brace. The brace or cuff gently adds compression to the muscles in the forearm to support the tendons in the elbow. Most physicians caution you in not wearing the elbow brace too frequently, as elbow tissue is then not allowed the time to heal. In some cases, prolonged use of a brace may cause increased secondary conditons such as pinched nerves and interruption to the blood flow to the joint.

Restoring Your Elbow's Flexibility and Strength

Physical Therapy is a very helpful way to decrease pain in the soft tissue, restore strength to atrophied muscles and improve elbow, forearm and wrist strength and mobility. Your physical therapist will start you on a program will be tailored for your tennis elbow injury.

Once your pain starts to reduce, a physical therapist will also set up an individualized arm and shoulder strengthening and stretching exercise program for you to perform at home or in the gym.

This will be based on your needs and abilities, and will help you return to performing your normal routines.

A trained physical therapist will help to ensure your rehabilitation process is effective. For best, long term results use the T•Shellz Wrap^® before undergoing physical therapy to gain residual elongation and extensibility of collagen tissue. (reference: Chapter 9 of "Therapeutic Heat and Cold", 4th edition [amazon.com link] Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

As you start to return to your activities, it is good to gauge how well you are using your arm in these activities to determine if you can decrease stress on the injured tissue. This may involve changing your technique for sports, for example using a two-handed backhand instead of a one-handed backhand in tennis, or using a properly weighted racquet (which will take stress off your forearm muscles).

You may also need to change equipment you use at your job or at home to help you perform tasks more effectively and safely. You may opt to start taking a taxi temporarily. More frequent short breaks (and even stretches) at work are usually very helpful, as this allows your body a chance to relax and take some strain off your stressed soft tissue.

It is important to speak with a medical professional or occupational therapist to get more information about proper equipment, procedures and tools necessary for the specific activity you participate in or the office/work setting you work in during your normal daily life.

Lifelong Health

The best way to manage the health of your body is to understand the tools for a healthy lifestyle. Using proven conservative treatments, alternative therapies, protection, and self-management (diet, rest, exercise), you can proactively manage your own recovery. Your lifelong health depends on your commitment to living a healthy and safe lifestyle.

You may have to modify some of your activities or movements during your recovery to ensure the long term health of your elbow. Even if you are already feeling less pain and greater mobility, you need to continue with your treatment plan. Until your elbow is healed, you are still at risk for further damage. Keep in mind, the longer you wait to treat your Tennis Elbow injury, the greater the potential for re-injury or for permanent damage to occur.

Most often, Tennis Elbow injuries are developed after ignoring your body's warning signs. Masking pain and immobility or continuing strenuous repetitive movements cause micro tears to form in your tendons. If your body is not given a chance to heal, scar tissue will form. This weak, inflexible tissue will cause chronic Tennis Elbow symptoms that include constant pain and functional restriction.

Most cases of Tennis Elbow are completely treatable by conservative therapies. If you want to continue to enjoy your activities, sports, or have a physically demanding job, committing yourself to a conservative treatment routine, as soon as possible, will increase your chances of a full recovery.

Non-surgical Tennis Elbow Treatments

Your initial treatment should involve decreasing any swelling, relieving any pain and stress on the elbow, correcting any bio-mechanical dysfunction, and then restoring strength and mobility to your injured elbow. It's also very important to follow any instructions you receive from your physician.

Allowing your elbow to rest is recommended following injury, however, some careful arm movement is required to prevent the joint from freezing and losing range of motion. See your doctor or physical therapist for stretches that will not cause further injury to your elbow. Avoid activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible.

The trick to healing your injury and getting your elbow back in the best possible condition you can is getting it to heal with minimal scar tissue - something our Elbow T•Shellz Wraps^® are great at! Even with optimum healing, there is always less elasticity in previously injured tendons, muscles and ligaments. However, if you heal your tissue properly and treat scar tissue build up, your chance of re-injury or chronic elbow conditions later on is much lower than average.

There are healing tools that can help treat your elbow or forearm tendon, bursa, or other soft tissue and speed up the healing process so you can get back to a life without pain and risk of further injury. Blood Circulation Boost (via the T•Shellz Wrap^®) will help minimize scar tissue by accelerating the healing rate of soft tissue. The T•Shellz Wrap^® will promote blood flow to heal your tendons and muscles faster and more completely than any other conservative home treatments available.

Although steroid injections may provide temporary relief from the pain of tennis elbow, tendinitis, bursitis, and other injuries they should generally be avoided as they weaken the tendon and may lead to a rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.

Conservative Treatment Step 1: Reduce The Initial Inflammation

Inflammation is the body's natural response to an immediate soft tissue (muscle, tendon, ligament, bursa) injury and is a normal part of the healing process - helping to reduce tissue infection in the early stages of injury. Swelling, pain, heat sensation, redness, and loss of function are the main symptoms experienced.

The combination of rest, topical pain relief cream and minor amounts of cold therapy is the gold standard in medicine for minimizing tissue damage and reducing inflammation after injury or activity. It serves as a critical bridge into the next phase of the healing process.

Conservative Treatment Step 2: Enhance Blood Flow to the Injured Soft Tissue

Tendons,ligaments, cartilage, and some muscle fibres are dense tissues. As a result, they naturally receive limited blood flow and this is precisely why injuries to these tissues take so long to heal. The challenge is, how do you effectively increase blood flow to these tissues?

It is through the blood that the body carries nutrients, oxygen, and antibodies that injured tissue needs to repair and rebuild. Research shows that electromagnetic energy is a very effective treatment for stimulating blood flow to dense tissues such as tendons, ligaments, muscles, and even vascular portions of cartilage. This dramatically improves the healing process.

Electromagnetic energy is an energy waveform that is absorbed by dense tissue (muscles, tendons, ligaments) and not absorbed much by less dense tissue (fat cells, skin). Absorption of this energy translates to thermal heat, and the body increases blood flow to the area as a response to this heat. This increased blood flow speeds up the healing process, clearing the area of toxins and excess fluid build up, thereby reducing inflammation. More details on this are found further down the page.

Electromagnetic Energy is recognized in scientific circles as a legitimate treatment for many forms of muscle and soft tissue injuries.

Conservative Treatment Step 3: Recognize That Healing is a Process

With dedication, the right tools, and the right information - you will achieve your goal of a sustainable recovery. A combination approach of cold therapy, deep heat treatments, and functional movements will make it happen much more quickly. Healing takes a comprehensive approach and will differ from person to person.

If you have questions, we welcome you to call our office toll-free at 1-866-237-9608 (Continental US), or Internationally at +1-705-532-1671.

Surgical Treatment

When Conservative Treatments Fail

About 85% of people with tennis elbow or golfer's elbow experience pain relief within 12 months of starting their preliminary treatments. A tennis elbow or golfer's elbow injury will usually heal without surgery.

However if you continue to suffer from persistent pain, weakness or recurring inflammation after trying the above conservative treatments, you may require a surgical option. Although rare overall, this is more common in tennis elbow than golfer's elbow.

The type of surgery you require will depend on the size, shape and location of your injury. This will be completed through day surgery; however it will require extensive rehabilitation utilizing the preliminary treatments noted above. Physical therapy and strengthening normally begin about 6 weeks after surgery.

Your surgeon should provide a treatment plan to help you regain normal use as soon as possible. Speak with your doctor about using the Elbow T•Shellz Wrap^® for reducing your post-surgery recovery period.

Elbow Arthroscopy

Elbow Arthroscopy involves making a small incision on the outside of your elbow and inserting a pencil-thin, fiber optic camera with a small lens and lighting system.

The surgeon will take a look inside your joint to investigate all the soft tissues and bones. These images will then be transmitted to a TV monitor, which allow the doctor to make a diagnosis and/or perform the repair under video control.

Your surgeon may repair tears or remove damaged tissue. They may have to cut the tendon at its attachment to the epicondyle bone and remove a small portion of the bone to increase blood flow to the area.

Afterwards, sutures (stitches and/or anchors that hold the tissue together after they have been severed) can be used to attach the tendon to the bone. At the end of surgery, your incisions are closed, a dressing is applied, and you are placed in a splint.

There are always some risks associated with any surgery, which include but are not limited to possible infection, allergic reaction to medications, and damage to surrounding nerves or blood vessels. However, modern techniques have significantly minimized the occurrence of these problems. Tenderness, pain, stiffness and weakness are very common after surgery, but with proper rehabilitation these should diminish.

Although surgery is often successful at repairing any damage and/or relieving pain, it does not necessarily return strength to your elbow or forearm. That is why a strong commitment to rehabilitation is essential. Healing and recovery time is generally dependent on the extent of your injury, your age, pre-injury level of function, and your commitment to rehabilitation. Know that if conservative treatments are the right option for you, then consider dealing with your therapy seriously by incorporating the use of an Elbow T•Shellz Wrap^®.

Self-Management

In order to live a healthy lifestyle, it is important to manage your weight, diet, and level of exercise. Self-management of your health will result in lifelong benefits. Information Seeking and being Proactive are key tools to understanding and maintaining your body. It is important to keep a positive attitude and to always seek the guidance of your physician if you have any questions or concerns about your health.

Weight Loss/Weight Maintenance

Being overweight or underweight, places unnecessary stress on your body. These stresses can reduce your energy levels and put you at risk of developing injuries, life altering conditions, or disease. Maintaining a healthy body weight will increase your energy, your self confidence, and your ability to complete activities. A healthy weight can be achieved through exercise and a diet rich in vitamins and minerals, antioxidants and phytochemicals, protein, fats, and complex carbohydrates. Speak to a registered nutritionist about developing a healthy eating plan catered to your individual lifestyle and favorite foods.

Exercise and Activity

Keeping a regular routine of exercise and activity will not only promote weight loss/weight maintenance, but will also make you feel good! Exercise releases chemicals in your brain called endorphins. These chemicals affect your mood and leave you feeling energized, happy, and self-confident. Exercise has been proven to help deal with the effects of depression and other mood disorders. Exercise will strengthen your body to prevent injury and allow you to accomplish all of your physical goals - whether those goals are for athletic activity or being able to lead a normal, active, healthy life.

Understanding your Tennis Elbow Injury

The best way to tackle a problem is to face it head on. To do this, you have to understand what you're up against. It is important to know how you sustained your injury and the effects it is having on your body. This will allow you to take the steps you need to treat your symptoms and prevent further injury. Sometimes this involves modifying or limiting the way you participate in activities.

Dealing With Negative Emotions and Planning for Success

It is important to keep a positive attitude, but sometimes that can be difficult. Focus on your goals and create a realistic plan on how to achieve them. Speak to your physician to fully understand your recovery process. Talk to other people who are experiencing Tennis Elbow symptoms like you. Look at all of the things you can/have accomplished and reward yourself for achieving your goals. Remind yourself that you are in control of your recovery and the commitment to your treatment will help you achieve lifelong health.

Tennis Elbow Injuries Not Only Affect the Elbow - But Can Lead to Other Conditions and Injuries.

Every time we use our injured elbow - damaged and swollen tendons and muscle tissue move; when they are inflamed, every movement hurts. With injured tissue, pain happens - sometimes a LOT of pain, so we try not to move it. So, when doing something we need to use our elbow for (getting dressed, driving, talking on the phone), we start to use the shoulder and wrist more. If we can, we use our other elbow instead even though it is inconvenient.

A couple days later (after purposefully avoiding movement of our elbow), the pain has gone down (as well as the swelling) and this is where the trouble begins! The pain disappeared with the swelling but we still aren't fully healed! Not knowing this, we start using our elbow normally again and then the injury swells up again like it did before - all because the injury wasn't fully healed in the first place. We continually re-injure our tennis elbow through our daily activities and now this injury has become chronic, continuing to worsen week after week.

Eventually, we use the other elbow more and more. This is why the elbow and opposite shoulder start to hurt - they are being overused now. Soon, aches and pain can become commonplace in the upper body - all as a result of the orignal elbow injury and the body's instinctive nature to "protect" it - all because the injury wasn't fully healed in the first place!

We continually re-injure our elbow through our daily activities and now this injury has become chronic.

Muscle imbalances result, placing tension on bone and softer tissues - leading to a misalignment within the upper body. The extra stress on the opposite side of the body will also result in weakness and fatigue of the tissues - increasing the chances they can eventually be injured or gradually degenerate. This is a textbook example of how you get an overcompensation injury. In some cases, physical therapists warn that overcompensation can be very dangerous as it will affect gait or alignment on a permanent basis.

An injury to one elbow can easily lead to straining in other areas, making an overall recovery hard to initiate. For example, a serious muscle strain in the right elbow can often lead to over-straining of the left elbow. Most commonly, the injury occurs on the dominant side, so the risk of straining the other (weaker) side increases. The longer the injury (and corresponding pain) persists, the greater the chance that you will sustain more strain from overcompensation, eventually leading to issues in those areas as well. To minimize potential secondary injuries, know that it is important to deal with your tendon/muscle injury quickly and completely.

Truly, elbow injuries can become a vicious cycle - which is why it is absolutely critical to focus on healing methods designed to rebuild and strengthen the injured tissues in a timely manner. The faster you truly heal, the less chance you have of sinking into a downward spiral of re-injury, scar tissue growth and overcompensation injuries.

Okay, So I Have an Elbow Tendinosis Injury...What Should I Do Now?

Stage 1: If the elbow injury is very recent - use a good quality cold pack and Arnica Pain Relief Cream.

Note: If you are suffering from a tendinosis injury that has been going on for awhile, then skip the cold treatment as inflammation will be minimal. Anytime you are experiencing significant pain, you may find our Arnica Infusion Pain Relief Cream to be quite helpful.

If you are experiencing pain and swelling in the very early stages of the injury (first 48 to 72 hours), the first step in a conservative treatment protocol would be to focus on reducing the discomfort by applying a quality cold pack to the injured elbow along with a high quality pain relief cream such as our Arnica Infusion Cream.

Not only will you use your cold pack for the first 48 to 72 hours after the injury, but you should also use it during other stages of the healing process. Some examples include...

• after any activity that stresses the elbow in a moderate way. It is wise to quickly apply cold therapy to not only reduce the pain, but to also minimize tissue damage that may have occurred during the prior event.
• If you have a job that requires you to place some demands on your injured elbow. If that is the case, use cold therapy immediately following work and if the opportunity allows - use it for 15 to 20 minutes during lunch or another break time.
• If you are in a post-operative situation where cold compression therapy would be utilized heavily for at least the first few weeks following the procedure. Similarly, if you are scheduled for upcoming surgery, then you will need a high quality cold therapy device to use.

Having a Cold Compress or Ice Pack available at home to use if and when the need arises is helpful. Many of you already do so.

However, too many people over-focus on cold therapy while ignoring the most critical aspect to healing - nourishing the injured tissues with a healthy supply of blood flow needed to repair and rebuild the injured tissues.

This leads to the most important recommendation...

Stage 2: Focus on Increasing Blood Flow To The Injured Tissue - As This is The ONLY Way It Will Heal For the Long-Term

Even though the concept is simple, improving blood flow to injured tissues can be difficult. When the injury is elbow related, the challenges are even greater. Traditional methods require your muscle to move to promote blood flow (exercise), but that same motion that promotes blood flow can at times lead to making your pain and condition worse.

• Have you reinjured your elbow by returning to work too quickly?
• How many times in the past have you aggravated your elbow just trying to perform basic tasks around the home?
• Is your debilitated elbow preventing you from work or activities you love to do?

Most people we deal with tell us these scenarios have happened to them many times in the past. Perhaps it has already happened to you.

Promoting blood flow within a muscle or soft tissue injury to help the body heal itself is a concept that has been utilized for centuries. This is where the focus has to be if you are seeking long-term improvement.

Oxygen and nutrients, carried within the blood, are critical for the body to heal itself. Without proper blood flow, recovering from an injury or condition will be delayed...sometimes for a very long period of time.

The real challenge is how do you promote blood flow to the elbow injury site without causing further injury? This goal is further complicated by the fact the elbow (and muscles controlling the elbow joint) are involved in the majority of the physical movements we perform each day.

When people think blood flow beyond exercise, they instantly think "heating pad". Unfortunately, many individuals make the mistake in believing that a simple heating pad or microwavable gel packs will provide the blood flow needed to heal injured tissues. Nothing could be further from the truth.

To begin with, heating pads and warmed gel packs work on conduction. The heat they generate has to be forced through multiple layers of skin and fatty tissues. With each layer of skin the heat passes through, there is a corresponding energy loss because that heat is absorbing into each layer it passes through- the skin is an excellent insulator! Your body responds to this heat by increasing the blood flow near your skins surface (not in your injured tissue) to dissipate the heat and it does so quite effectively.

By the time what little heat reaches below the skin, sub-dermal layer and fat layer into the targeted area (the dense, injured tissues), very little energy remains and this does not effectively enhance blood flow. With little blood flow reaching these injured tissues - healing just doesn't happen.

The heating pad may feel comforting when on the body, but that is because the warmth is absorbing into the skin. Moist heat has been believed to be more effective at warming internal tissues versus dry heat, because it is believed that water transfers heat more quickly than through air. Clinical studies do not support that popular belief.

When you are using a heating pad, all that you are really accomplishing is warming of the skin. The unintended consequence is that you draw blood flow AWAY from the targeted tissues (the injured ones deeper in the body) and direct the blood flow to the surface of the body.

So If A Heating Pad Is Not The Answer, What Is?

In order to effectively stimulate blood flow to the dense tissue deep within the body, an energy based on an electromagnetic principal (diathermy) is needed. In essence, this is a conversion energy vs a conductive heat (like the heating pad example above - that is conductive heat).

Electromagnetic energy waves are not conductive heat waves - they are a much longer wavelength and hence, penetrate deep into the body. They are very safe and very effective as research over decades has shown. The F.D.A recognizes this as fact.

When these energy waves are emitted,they penetrate right through your skin and fat layers until they are absorbed by tissue high in protein. This means ligaments, muscles, cartilage, tendons and bone. Once they reach the targeted areas, they are absorbed and quickly converted into thermal energy... right at the location of the injury.

This results in relaxation of the vessel walls. The vessels then gently expand, allowing for more nutrient rich blood flow along with extra oxygen and antibodies to reach the damaged tissues. Plus, the enhanced blood flow helps in flushing cell waste and fluid build-up from the injury site - further enhancing the ability of the body to heal.

As mentioned above, standard heating pads and heated gel packs accomplish the exact opposite of your goals. They direct blood flow to the skin, not to the injured muscles and soft tissues you are trying to heal.

Electromagnetic energy is a form of energy will easily penetrate through clothing, skin, and fatty tissues... directly into your injured muscles and soft tissues within the elbow. After the energy absorbs into soft tissue around the elbow (tendons,muscles,ligaments), the metabolic response then kick starts the repair and rebuilding process.

More blood now begins to flow effectively to the injured tissues deep within the body. The injured tissue needs the extra blood flow to heal as it is through the blood the body carries the oxygen, nutrients, and antibodies needed for proper and long-term healing.

While the concept of electromagnetic energy is slowly catching on in North America, the truth is, it is a technology that has been utilized in other societies for decades. Over the past 30 years, researchers in Japan and China have completed extensive studies on the use of the modality and their findings have been impressive. In addition, success has been reported in studies from countries such as Sweden and Germany.

Research is continuing and soon, much of North America will know what the Far East and Europe has known for a long time; electromagnetic energy provides a wide range of health benefits for those not only suffering from tendon injuries, but for many other ailments (plantar fasciitis, bursitis, tenosynovitis, hamstring strains, rotator cuff damage, muscle strain, etc.) as well.

Now, on to recommendation number two in the journey to heal your injured elbow...

The Elbow T•Shellz Wrap^® - Heal Your Elbow For The Long Term

The best option we came across in our research to accomplish true healing of elbow injuries is the Elbow T•Shellz Wrap^®. Use of this device results in a dramatic increase in blood flow to the injured tissues located deeper within the body - all in a non-invasive manner.

Using a T•Shellz Wrap^® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The Elbow T•Shellz Wrap^® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.

T•Shellz Wrap^® = Accelerated Healing Power for Your Elbow Injury

The Elbow T•Shellz Wrap^® is based on the scientifically validated principal of Electromagnetic energy as we discussed previously. This form of treatment is safe and effective as shown in numerous studies which can be referenced through the National Library of Medicine. Professional athletes and those in the medical field have been users of the technology for decades - it really hasn't been until recently that companies like ours introduced the treatment devices to the home user.

The healing energy from the T•Shellz Wrap^® does not absorb into the skin - it absorbs directly into the damaged muscle and soft tissue (as a result, you will not feel the same level of heat on the skin versus a heating pad). The longer wavelength provides the electromagnetic energy wrap with the capability of penetrating deep into the body (well over two and a half inches).

EM energy emitted from the T•Shellz Wrap^® is absorbed by high protein tissue (muscle, tendon, ligament, cartilage) and is converted into Kinetic energy - much of this energy being released as heat. Overall, EM energy will warm soft tissues, improve blood circulation, and boost metabolism and enzyme activity. In stimulating localized blood flow to damaged soft tissue, you provide needed oxygen, nutrients, and antibodies to regenerate new, healthy collagen. In addition, you will experience a clearing of toxins and excess fluid build up from the injury site. Over the intermediate term, this helps to reduce incidents of swelling as trapped fluids will be whisked away - reducing pressure on blood vessels.

Using the T•Shellz Wrap^® is truly a unique experience. Within moments of applying a treatment to your injured elbow, you can feel the healing sensation due to the increase in blood flow deep within the area. During a treatment, and for quite some time after you finish, the treated area will feel relaxed and less painful. It's a very soothing sensation and extremely effective.

Who Should Use the T•Shellz Wrap^®

We recommend the use of a T•Shellz Wrap^®:

• If you have injured tendons, muscle or any soft tissue in your elbow, then the T•Shellz Wrap^® will accelerate your healing.
• If you are dealing with conditions affecting your range of motion such as tendinosis, tenosynovitis, or even arthritis.
• If you have a chronic elbow condition that has lasted for years- this device will help start the rebuilding process and help strengthen the surrounding and supporting tissues. Many of our past clients had suffered for years, then were completely amazed at the results only after a few months of treatments.
• If you are still working with an injured elbow, the T•Shellz Wrap^® will help relax injured soft tissue prior to work and after a day at the job.
• If you are still trying to enjoy your favorite activities such as gardening, tennis, golf, etc - use the T•Shellz Wrap^® prior to activity to help reduce chances of re-injuring or re-aggravating those targeted tissues.
• If you are suffering from bursitis in your elbow and want to treat the major source of it (secondary damage to the muscle and tendon surrounding the bursa sac). Through overuse or degenerative changes in the elbow, the muscle and tendons surrounding the bursa sacs will tighten and constrict. When they do, they place pressure on the bursa, causing it to become irritated. Applying a soothing and deep penetrating energy to the elbow relaxes the tissues and takes the pressure off the bursa.
• If you are experiencing atrophy in your elbow and want to reduce the chance of re-injury - this is a perfect treatment to use on a regular basis.
• If you have been to physical therapy for some form of regenerative therapy and your physical therapist or physician told you to get a radiant energy wrap for your tennis elbow, then this is exactly what you need.
• If you have injured your elbow and need surgery, then this is exactly what you need after your surgery to help the surgically repaired tissues rebuild for long-term health.(once the surgery wound has healed)
• If you are experiencing atrophy in your elbow and want to reduce the chance of re-injury while stretching - this is a perfect treatment to use every time before you stretch.

T•Shellz Wraps^® contain a unique Carbon Fiber Energy Pad which is flexible and will shape to conform to your body. This Energy Pad emits a uniform wave of perfectly safe electromagnetic energy over its entire surface. This energy travels deep inside to the soft tissue in your elbow and arm, stimulating blood flow your own body needs to heal your injury. It is the electromagnetic energy that is crucial to the healing process.

Best of all...

The Elbow T•Shellz Wrap^® is an FDA Registered Medical Device and is suitable for use in therapeutic clinics and FROM HOME. It is completely safe for people and patients to use for themselves.

As mentioned earlier, the use of electromagnetic energy is becoming much more commonplace in North America for everyday people. The technology has been used for decades in the worlds of professional and amateur - a contributing factor as to why athletes seem to recover from injuries so quickly.

Have you ever wondered by an athlete can return to activity after 3 or 4 weeks following a severe elbow injury - while your average person takes much longer to return back to normal? The secret isn't really that much of a secret - it involves consistent treatments (meaning multiple times a day) using a diathermy treatment like the T•Shellz Wrap^® to stimulate blood flow to the injured tissues. Most athletes have the luxury of using in-house therapy facilities many times per day.

How many us can afford the time and money to visit a therapy clinic multiple times a day? Very few indeed. This is how you can gain the same advantage that athletes enjoy in healing their own injuries - by using a device like the Elbow T•Shellz Wrap^® two or three times a day on a consistent basis.

What Else Makes the Elbow T•Shellz Wrap^® So Special?

We believe the T•Shellz Wrap^® to be one of the most effective treatments to stimulate blood flow to dense, injured tissues such as muscles, tendons, ligaments, and other similar tissues.

We can promise that you will receive a product that is designed to be safe and does what it is supposed to do...quickly relieve pain and aid in the recovery from tendon, muscle and other soft tissue injuries.

The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v.

It has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long so you can sit or lie comfortably and watch TV, read or surf the net while you're using it.

Treatments are max 30 minutes in duration and the device can be worn over clothing. This allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.

A Recap of the Benefits of the T•Shellz Wrap^®..

• Can be used ANYWHERE on the Arm, Elbow or Upper Arm - very versatile!
• Targeted treatment of Tendinosis, Tenosynovitis, Tendon Tears, Bursitis, Impingement, Arthritis, etc
• It can be used before exercise to warm up your arm to reduce the risk of injury
• FDA Registered medical device for use in home or clinics - very high quality
• Greatly enhances healing of tendons, ligaments, and muscles
• Increases flexibility of tissues (reducing the re-injury factor)
• It soothes pain and whisks away toxins
• Carbon fiber Energy Pad is strong, lightweight, and flexible - contours very easily
• It provides an accelerated healing rate that will save time and money when associated with doctor or physical therapist visits
• it is an outstanding tool for post-surgery rehabilitation, getting you back to work faster

The most common question we receive from individuals prior to purchasing is - how many times a day should I be using my elbow wraps and when should I be using them? While treatment plans will differ for each individual and their specific injury, there are general guidelines that should be adhered to.

• Use a Cold Compress or Ice Pack when you are experiencing inflammation (usually after exertion or movement of the injury area).

The Elbow T•Shellz Wrap^® would then be used:

• Right after rising from bed in the morning (as this is when it is most stiff)
• Prior to going to bed at night (to relax the arm, allowing for better sleep)
• Before you know you will be using your injured joint (going to work, driving, typing, etc).

Stage 3 - In Between Treatments With T•Shellz Wrap^®, Apply Our New Fast Acting Pain Relief Cream Called ARNICA INFUSION

Dealing with aches and pains affecting the foot, ankle, leg, knee, hamstring, hip, back, arm, shoulder, elbow, wrist, or hand? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.

Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, backaches, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.

This is a product that many of our current MendMeShop customers asked us to develop. So we focused our time and resources over the past few years and came up, with we believe, will be one of more effective, fast acting, topical pain relief creams on the market.

You are likely familiar with some of the standard topical agents on the market as most of our customers use them. The are mass marketed and even found in most department stores now.

Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.

Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.

The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!

Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.

Arnica Infusion Ingredients

The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.

The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.

The notable ingredients in the Arnica Infusion formula include:

• Arnica - powerful anti-inflammatory, speeds recovery, enhances circulation
• Menthol - provides deep penetrating pain relief with a nice cooling sensation
• Vitamin B6 - promotes normal nerve function
• MSM - supports healthy connective tissues, anti-inflammatory
• Ilex Leaf Extract - increases circulation, skin conditioner
• Vitamin E - anti-inflammatory, enhances circulation, hydrates the skin
• Aloe - anti-inflammatory properties, soothes the skin
• Tea Tree - enhances penetration of ingredients

Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.

When Do I Apply the Arnica Infusion?

While At Work

Apply Arnica Infusion at work to help reduce acute discomfort associated with overuse of muscles and joints. No matter if you are in a physical demanding job or work within an office environment, you will be placing stress on different parts of the body and aches and pains will result.

Before Or After Work, Sports, & Activity

If you suffer from a sprained ligament, pulled muscle, strained tendon, or even bruising - apply Arnica Infusion for quick relief of the pain.

Chronic Pain Suffering

Application of Arnica Infusion can be done up to a maximum of 4 times per day on a consistent basis to help bring about relief from various pains and aches.

In-between Treatments With the T•Shellz Wraps^®

Follow up your T-Shellz and Cold treatments with an application of Arnica Infusion. Combine the pain relieving benefits of Arnica Infusion along with the healing benefits of the wraps to make your recovery go much more smoothly.

Do not apply Arnica Infusion within a 2 hour timespan before a T•Shellz Wrap^® treatment.

Whether you decide to use the Arnica Infusion in conjunction with the T-Shell and other treatments - or if you decide to use the cream as a stand-alone product - you will not be disappointed with the results. We guarantee it.

A Note On OverCompensation

Since you are reading this, you probably know that serious elbow tendinosis injuries do not just disappear. Over time, they usually wreak havoc on your shoulder & wrist due to lack of movement and over-compensation. It will also wreak havoc on your opposite elbow due to overcompensation. Recovery takes a longer time for such chronic (long term) injuries, but proper healing is essential to regain strength and get you back to the activities you enjoy.

The longer your injury endures, the greater the risk of running into serious overcompensation injuries.

To Stop Re-Injury & Reduce the Risk of a More Serious Overcompensation Injury, You Need to Heal Quickly & Completely!

Anyone in need of rapid recovery and complete healing must consider a comprehensive treatment plan that includes an effective means to minimize swelling and inflammation yet also stimulate healing and tissue elasticity. We have found no better set of tools that can be used at home than this:

Conservative treatment tools just like these have been used successfully by thousands of tendinosis injury sufferers - just like you.

We believe the use of T•Shellz Wraps^® for effective treatment of soft tissue injuries is one of the most under-utilized home treatment options available on the market today. We have thousands of customers that have tried many options out there and have been amazed at how effective and fast the TShellz Wrap treatment can heal soft tissue injuries.

With regular use of the Elbow TShellz Wrap:

• Your pain will be reduced.
• Your injury will heal at an accelerated rate with reduced potential for re-injury.
• Your elbow will have a larger range of motion and increased extensibility of collagen tissue. (Chapter 9 of "Therapeutic Heat and Cold", 4th edition. (amazon.com link - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

Click HERE to Go To Our Online Store If you have questions, call our office at 1-866-237-9608 (toll free continental US).

Doctors and Surgeons are always improving the techniques used in surgery, and results from surgery now are much more positive than they were in the past. However, all surgeries introduce scar tissue, and recovery from elbow surgery can be less than ideal and take longer than anticipated.

If you do wind up getting surgery, know that rehabilitation at-home while attending regular physical therapy or doctor appointments is vital for your overall recovery.

Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor or physical therapist is key. This is why you should seriously consider maximizing your recovery by using the T•Shellz Wrap^® at home once you are approved for physical therapy.

The more consistent you work at enhancing blood flow to surgically repaired soft tissue, the more consistent the healing process will be. Nourishing the tissues will more oxygen and nutrients (which are carried through the blood stream) will give the body a better ability to produce new, healthy collagen. In effect, you will help the body produce stronger tissues while potentially reducing the number of setbacks that can occur following surgical procedures.

Click HERE to Go To Our Online Store We take all major credit cards and Paypal.
If you have questions, call our office at 1-866-237-9608 (toll free continental US).
We are currently offering FREE SHIPPING and a 60 day trial period on all our Wraps.

The Key Point To Keep in Mind When Treating Your Elbow Injury

Make Sure That Complete Healing is Your #1 Goal

We all know that if the injury was healed, the pain would go away but what about the opposite situation? If the pain is gone, does that mean the injury is better? Unfortunately, this is not always true.

Too many people only focus on suppressing pain symptoms while providing less attention to the true healing aspects of the body. Experiencing less pain, while obviously a good short-term goal, never equates to underlying healing. Scar tissue can remain for months after one gets to a point of being relatively pain-free. However, as long the weak and brittle scar tissue remains, you are susceptible to re-injury or re-aggravation. Certain motions or movements can cause the weaker tissue to easily tear - resulting in some reversal of the recovery up until that point.

This is why we recommend for people to continue with their doctor or therapist recommended exercises and to continue with mild treatments of the T•Shellz Wrap^® for a period of time - to better ensure complete healing.

Ongoing treatments to enhance circulation will soothe, relax and promote healing of your damaged elbow muscles and tendons. Elbow T•Shellz treatments will also allow your soft tissue to extend further due to the deep warming sensation created by the enhanced circulation to the treatment area. The more extensibile your tissues are, the less likely they are to strain or sprain.

The Elbow T•Shellz Wrap^® is a highly effective therapy tool for people suffering from elbow, forearm, upper arm or general elbow injuries - such as muscle tears, tendon tears, strains, tendonitis, tendinopathy, tendinosis, impingements, elbow bursitis, and any pain associated with trigger points, scar tissue, and arthritis in the arm, elbow or forearm.

Let me tell you, we appreciate all the feedback we have received over the years. We have had many medical professionals, athletes and everyday people call and write to tell us about their positive experiences with our devices and the company in general. It never gets old hearing about the successes and it provides us with the motivation to continue doing what we do best - provide individuals with options to heal from the comfort of their own home.

Below is a small sample of some of the Customer Service comments we have received from customers...

If you're tired of being told that resting, drugs and surgery are the only answers to your elbow injury.... Be optimistic, because there are effective alternatives for you.

We will never claim our products will work for everyone. That is simply impossible to achieve. Everyone has a different capacity for healing and different circumstances behind their injuries and/or conditions.

In addition, some people may have a hard time sticking with recommended protocol in order to achieve benefits from our devices. Quite simply, our clients that have had successful outcomes have made a small effort to invest 60 minutes a day into the program. If you do the same, chances are you will be very happy with the outcome.

We have helped thousands of clients since 2006 and during this time, our refund rate has held steady at an astonishingly low 6%.

That means that for every 100 people who try our products, 94 of these individuals are happy with the results these products provide. Odds are certainly in your favor that you too will achieve a happy outcome. This fact alone speaks volumes to the effectiveness of our solutions and with a full 60 day money back guarantee on our wraps, there really is no risk in trying.

Right after you place an order, email us and we will have a plan developed immediately so you will be able to get started upon arrival of your parcel. We can't promise you miraculous results, however, we do promise to do everything we can to help you with your condition.

Everything you have read up to now has hopefully given you some hope.

However, words are meaningless unless a company stands strongly behind the products they sell. This is what sets us apart from others...we offer people a comprehensive, 60 day, full 100% money back guarantee. We take on all of the risk because we know our products work well for the overwhelming majority of people who purchase them.

We Will Support You Every Step of the Way

You are never alone when making a purchase from us. When we say we stand behind our products, we truly mean it!

If any question or concern arises, simply send us an email at any time (we check our emails constantly all throughout the day and night - even on holidays!). We will respond as soon as possible.

Click HERE to Go To Our Online Store We take all major credit cards and Paypal. If you are on your mobile phone, Click HERE to Call Our Office (toll free continental NA).

Simply call toll free 1-866-237-9608 to place an order with one of our knowledgeable Product Advisers. They have the ability to answer all your questions...ensuring you only receive the products you need.

Product Advisors are available 9:00 am to 5:00 pm Eastern Standard Time Monday to Friday.

North America Toll Free 1-866-237-9608

Outside North America +1-705-532-1671

We Stand Behind All Our Promises With An Iron-Clad Guarantee

• Guarantee #1

  Use your products diligently for up to 60 days and you will experience a significant reduction in pain. If not, I encourage you to send back the items for a no-hassle 100% refund.

• Guarantee #2

  You will not be left in the dark after purchasing any product form us. AidMyTennisElbow Advisors and Product Specialists are available 7 days a week by toll free phone or email to answer your questions or concerns.

• Guarantee #3

  Your order is guaranteed to be shipped within 24 hours on every business day.

• Guarantee #4

  All purchases receive a one year, full replacement warranty with guaranteed, prompt service.

• Guarantee #5

  You could save hundreds of dollars and possibly more, by utilizing our products, and getting back to work sooner.

• Guarantee #6

  Everything You Read on this Site is Absolutely True. Unlike us, companies not registered by the FDA can state anything they want about their products. Because we are FDA registered, you can rest assured that these products do exactly what we say they do.

Overall, we are able to be cost effective and value oriented due to two major reasons:

1. Word is spreading and as a result, our sales are increasing. With this increase, we can achieve economies of scale...meaning we receive the best component pricing because our volume is high.


2. We keep our overhead costs low by selling only on-line versus setting up costly distribution channels offline.

Think about it – you can now have the ability to treat your pain from the comfort of your own home while saving money in the process.

Best of all, you are fully protected when making a purchase from us as we offer a no-hassle 60 day, full money back guarantee.

Living with pain is never easy as it affects your entire lifestyle. Nothing is more important than making the proper decision when it comes to treating your muscle injury. Most methods only mask the problems or provide temporary relief; they do not treat the pain at its source.

AidMyTennisElbow stands out in this regard as our goal is to help you heal for the longer-term.

The bottom line is, you are welcome to try our products for a full 2 months. If you do not receive the benefits that others have experienced, simply return your purchase back to us and we will issue a prompt & full refund. There will be no hassle and no hard feelings.

Are You Now Ready to Properly Heal Your Elbow Injury? Let's Make It Happen...

The fastest option you have to get our product into your hands as soon as possible is by placing your order online - at this very moment..

Or, Call Our Office. We are open Monday to Friday to allow you place an order over the phone. Simply call toll free 1-866-237-9608 to place an order with one of our knowledgeable Product Advisors. They have the ability to answer all your questions...ensuring you only receive the products you need.

If you choose to order through our online shop, know that we keep no credit card data on file. Once the transaction is completed, the credit information disappears from our internal systems.

As you can see, ordering from us is a very easy and safe process, no matter if choosing to order on-line or over the phone.

Are you still unsure about placing an order? let me address some questions that may causing some hesitation...

What is the success rate of the Elbow T•Shellz Wraps^®? Do they really work?

The short answer is - yes, the T•Shellz Wraps^® are very effective at healing muscle and soft tissue injuries. We try and keep in touch with a large percentage of our customers, and we encourage them to do the same. In doing so, we have received a lot of feedback as we have sold Electromagnetic Devices since 2008.

We can say that the return rate on our products is only around 5% any given month. That is exceptional by anyone's standards. Therefore, we can safely indicate that the overwhelming majority of people who purchase from us do achieve benefits with our products.

What is the difference between the T•Shellz Wrap^® and a standard heating pad?

The differences between the T•Shellz Wrap^® and heating pads, moist gel packs, etc - is a night and day comparison. There is nothing that compares to the healing capacity of the T•Shellz technology.

To begin with, heating pads and the like work on conduction. The heat has to be forced through multiple layers of skin and fatty tissues. With each layer of skin the heat passes through, there is a corresponding energy loss because that heat is absorbing into each layer it passes through. By the time the heat reaches the targeted area, very little energy is remaining and this does not effectively enhance blood flow. Without the enhanced blood flow effect to the injured tissues - healing just won't happen.

The heating pad may feel good when on the body, but that is because you are merely heating the skin. Moist heat has been believed to be more effective at warming internal tissues versus dry heat, because it is believed that water transfers heat more quickly than through air. Clinical studies do not support the popular belief.

In comparison... The T•Shellz Wrap^® is based on the scientifically validated principle of Electromagnetic energy. This form of treatment is safe and effective as shown in numerous studies which can be referenced through the National Library of Medicine.

The energy from the T•Shellz Wrap^® ultimately will gently warm deep tissue, improve blood circulation, and boost metabolism and enzyme activity. This is why it works so well - because the body responds very well to this form energy. In stimulating blood flow to the damaged tissue, you provide the tissue with the oxygen, nutrients, and antibodies it needs to regenerate new, healthy collagen. In addition, you will experience a clearing of toxins and excess fluid build up from the injury site. Over the intermediate term, this helps to reduce incidents of swelling as trapped fluids will be whisked away - reducing pressure on vessels.

How much time do I need to dedicate for treatments? Are the products easy to use?

The T•Shellz Wraps^® are very easy devices to use. After one or two uses, you will engage in the treatments with ease. Very detailed instructions are included and you are always welcome to contact us by phone or email if the need for help arises.

In regards to the T•Shellz Wrap^®, it is ideal to use the device two or three times a day on average. Each treatment session is a maximum of 20 minutes in duration and the device will turn off automatically at that time. Typically, people use the T•Shellz Wrap^® before bed, upon awakening (or not long after) and one other time during the day when the opportunity presents itself. For people in an office setting, many will use the device at work (as it can be worn over clothing). For others, they will use the device an our or two after work.

A Cold Compress or Ice Pack is primarily used following activity that stresses the injured tissues (following work, after a sports activity, or just suffering a general re-injury). This is done to reduce inflammation and to minimize tissue damage. Treatments are 15 to 20 minutes in duration.

How long has MendMeShop been in business

We established our firm in December of 2005. Our track record in this field continues to grow and we plan on being around for many decades to come.

What is your return policy? Is it the standard 30 days?

We go above and beyond what other companies offer - we offer a full 60 day money back guarantee with no restocking fees.

AidMyTennisElbow advisors do not work on commission, so be assured you will only receive fair and objective information.

Product Advisors are available 9:00 am to 5:00 pm Eastern Standard Time Monday to Friday.

I want to learn more about T•Shellz Wrap^® Blood Circulation Boost

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I want to learn more about Elbow Post-Surgery Recovery

During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!