To use this website, you must agree to Palomar Health’s Terms of Use.
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By using this website, you agree to Palomar Health's Terms of Use:

Last Updated October 17, 2023

By using this website, you agree to the following Terms of Use. If you do not agree to all of these terms, please do not use this website. Palomar Health reserves the right to change, modify, add, or delete portions of these Terms of Use at any time, including to the arbitration and class waiver provisions identified below. Your continued use of this website following any changes to the Terms of Use will mean that you accept those changes. Please refer to the date listed above to determine when the last changes were made. Please read carefully below regarding your rights with respect to disputes, which includes an agreement to resolve disputes by arbitration on an individual basis.

Use of Personal Information/Privacy:

This website is owned and operated by Palomar Health, a public health district in California. By using this website, you agree that Palomar Health may monitor your use of this website and may use the results of such monitoring without limitation.

During your visit to our website, we may request information from you, such as your name, email address, physical address, telephone number and other personal information. Further, we will collect any other personal information you share with us.

Personally identifiable information may be collected from visitors to our website and provided in an aggregate form to other parties within the Palomar Health family, or external to it, for marketing, advertising or other similar uses. Third parties may monitor your use of this website.

We provide several ways to e-mail us with questions you may have as you navigate our website. Please note that any information sent through an e-mail message is unsecured and can be seen on computers which transfer data from your computer to Palomar Health. We recommend that you do not email sensitive personal health information, or any other confidential information, to Palomar Health or anyone else. Should you choose to provide information in this manner, you do so at your own risk.

For further information regarding Palomar Health’s Privacy Policy, which is incorporated into these Terms of Use by reference, please review: https://www.palomarhealth.org/privacy-information/

Cookies:

Please be aware that your browser must be enabled to accept cookies for you to use certain areas of our website. A cookie is a piece of data that a web server stores on your hard drive so that it can be retrieved later. Other than as discussed above, we do not use this information for any other purpose. All of the information Palomar obtains from you is stored in our database and may be retrieved by people who are gathering that information. A cookie containing your unique ID is all that is stored on your computer.

Copyright:

  1. Ownership: In general, information presented on this web site, unless otherwise indicated, is considered in the public domain. It may be distributed or copied as permitted by law. However, Palomar Health does make use of copyrighted data (e.g., photographs or other materials) which may require additional permissions prior to your use. Palomar Health shall have the unlimited right to use for any purpose, free of any charge, all information submitted via this site, except those submissions made under separate legal contract. Palomar Health shall be free to use, for any purpose, any ideas, concepts, or techniques contained in information provided through this site.
  2. Permission May Be Required From Other Parties: This website may include copyrighted materials owned by third-party contributors who have granted Palomar Health permission to post those materials on this website. The fact that Palomar Health has permission to post the materials does not give you the right to use those materials. To use any copyrighted material that is not owned or created by Palomar Health, you must seek permission directly from the owning or holding sources.

Trademarks:

“PalomarHealth.org,” “Palomar Health,” and all logos related to Palomar Health’s services are either trademarks or registered trademarks of Palomar Health or Palomar Health’s licensors. You may not copy or otherwise use them without Palomar Health’s prior written consent. In addition, all page headers, custom graphics, button icons, and scripts are similarly protected and you may not copy, imitate, modify or use them without our prior written consent. You may use HTML logos provided by Palomar Health for the purpose of directing web traffic to Palomar Health. You may not alter, modify or change these HTML logos in any way, use them in a manner that misrepresents Palomar Health or its services or use them in a manner that implies Palomar Health’s sponsorship or endorsement, unless so authorized in writing by Palomar Health.

You must be over 13 to use this Website:

This website is intended for use by people age 13 or older. If you are younger than 13, you should seek permission from your parent or guardian to use this website and any information submitted on your behalf to this website must be by a parent or guardian.

Content of this Website Is for Informational Purposes Only – No Medical Diagnosis or Advice is Given:

The content and materials provided in this website are for informational and educational purposes only and are not intended to supplement or comprise a medical diagnosis or other professional opinion, or to be used in lieu of a consultation with a physician or competent health care professional for medical diagnosis and/or treatment.

PALOMAR HEALTH DOES NOT GUARANTEE THE ACCURACY, TIMELINESS OR COMPLETENESS OF SUCH INFORMATION AND CONTENT AND MAKES NO WARRANTY, EXPRESS OR IMPLIED, REGARDING THE USE OF SUCH INFORMATION AND CONTENT. PALOMAR HEALTH ASSUMES NO LIABILITY OR RESPONSIBILITY WHATSOEVER OF ANY KIND FOR THE INFORMATION OR CONTENT CONTAINED IN THE WEBSITE, OR FOR ANY DIAGNOSIS OR TREATMENT MADE IN RELIANCE THEREON.

PALOMAR HEALTH DOES NOT GUARANTEE THE CONFIDENTIALITY OR RELIABILITY OF ANY COMMUNICATIONS MADE THROUGH THIS WEBSITE. THE INTERNET SHOULD NOT BE USED TO TRANSMIT ANY SENSITIVE OR CONFIDENTIAL INFORMATION TO PALOMAR HEALTH, AS OTHERS MAY INTERCEPT THE INFORMATION. ADDITIONALLY, INFORMATION TRANSMITTED TO PALOMAR HEALTH VIA ELECTRONIC MEANS TO THIS WEBSITE MAY NOT BE RECEIVED AT ALL, MAY NOT BE RECEIVED OR REVIEWED IN A TIMELY MANNER, OR MAY BE RECEIVED BY THE WRONG PARTY.

Linked Sites:

The Palomar Health Website contains links to external websites which may be useful to you and which may provide services. These links are provided as an information service only. It is the responsibility of the user to evaluate the content and usefulness of information obtained from other websites. Linking to another website takes you away from the Palomar Health Website and subjects you to the privacy policy of the new website. Palomar is not responsible for the content of any external website. Palomar Health will not be liable in any way for any external website, including, without limitation, for any loss or damage of any kind incurred as a result of your use of the such sites. You agree that you must evaluate, and bear all risks associated with the use of any external website, including, without limitation, any reliance on the accuracy, completeness or usefulness of the material contained therein.

Third Party Advertising:

Third parties may offer goods and services to you through marketing that is made available at or through this website. Unless otherwise expressly stated, Palomar Health makes no endorsement regarding such parties, nor does Palomar Health make any representation, recommendation or warranty with respect to these third parties’ goods, services or advertising. You agree to hold Palomar Health harmless in connection with the selection of third party advertisers, as well as their acts and omissions.

Disclaimer of Warranties:

All materials on this website are provided “as is” and Palomar Health expressly disclaims any and all warranties of the material provided herein, expressly stated or by implication, including any: (i) implied warranties of design, merchantability, or fitness for a particular purpose or title, (ii) warranties arising from a course of dealing, usage or trade practice, and (iii) warranties of non-infringement.

No oral or written information or advice given by Palomar Health in connection with this website will create any warranty.

Palomar Health does not warrant or promise that the functions contained in any of the services or products provided on this website will meet your requirements, or that the operation of any such services or products will be uninterrupted or error-free, or that defects in any such services or products will be corrected, or that this site or the server that makes it available are free of viruses or other harmful components. Furthermore, Palomar Health does not warrant or make any representations regarding the use or the results of the use of any such services or products in terms of its correctness, accuracy, timeliness, reliability or otherwise.

(State Limitations)

Some states do not allow the exclusion of implied warranties, so some of the above exclusions may not apply to you. You should check your local laws for any restrictions or limitations regarding implied warranties.

(User Information, Data, and Content)

PALOMAR HEALTH ASSUMES NO LIABILITY OR RESPONSIBILITY FOR THE INFORMATION, DATA OR CONTENTS GENERATED BY YOU IN CONNECTION WITH THIS WEBSITE OR SERVICES. PALOMAR HEALTH EXERCISES NO AUTHORITY OVER SUCH INFORMATION, DATA AND CONTENTS, DOES NOT REVIEW OR MONITOR SUCH INFORMATION, DATA AND CONTENTS, AND WILL NOT BE LIABLE OR RESPONSIBLE FOR DETERMINING THE ACCURACY, TIMELINESS, COMPLETENESS, APPLICATION OR CORRECT USE THEREOF.

Limitations on Damages

BY USING THIS WEBSITE YOU AGREE THAT PALOMAR HEALTH SHALL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR PUNITIVE DAMAGES THAT RESULT FROM THE USE OF, OR THE INABILITY TO USE, THIS WEBSITE.

Arbitration

  1. Affects your and our rights and will impact how claims between you and us are resolved;
  2. Includes a Prohibition of Class and Representative Actions and Non-Individualized Relief pursuant to which you agree to waive your right to participate in a class action lawsuit against us;
  3. Requires you to follow the Opt-Out Procedure to opt-out of these arbitration provisions by mailing us a written notice that must be postmarked no later than 30 days after the date you accept these Terms of Use for the first time.

If a dispute arises between you and Palomar Health, our goal is to learn about and address your concerns. If we are unable to do so to your satisfaction, we aim to provide you with a neutral and cost-effective means of resolving the dispute quickly. Disputes between you and Palomar Health should be reported to Palomar Health according to the provisions of the Government Claims Act, California Government Code section 810, et seq. All notices under the Government Claims Act, section 910 et seq. should be directed to:

Attn: Government Claims Act
Secretary of the Board of Directors of Palomar Health
2125 Citracado Pkwy, Suite 300
Escondido, CA 92029

In the event that resolution under the presentation requirements of the Government Claims Act is not successful in resolving your claim, you agree to abide by the following:

  1. Arbitration Agreement: To the maximum extent permitted by law, you and Palomar Health each agree that any and all disputes or claims that have arisen or may arise between you and Palomar Health, including without limitation federal and state statutory claims, common law claims, and those based in contract, tort, fraud, misrepresentation or any other legal theory, will be resolved exclusively through final and binding arbitration. This agreement to arbitrate is intended to be broadly interpreted. The Federal Arbitration Act governs the interpretation and enforcement of this agreement to arbitrate.
  2. Arbitration Venue: Following the procedures set forth in the Government Claims Act, either you or Palomar Health may initiate arbitration. You and Palomar Health each agree to use JAMS (https://www.jamsadr.com/) and to submit any demand for arbitration through JAMS’ process. You and Palomar Health agree to the jurisdiction of the JAMS arbitrator over any dispute between you and Palomar Health, unless you and Palomar Health agree otherwise in writing. If JAMS is not available to administer the dispute, you and Palomar Health agree to use an arbitrator from the American Arbitration Association (https://www.adr.org/).
  3. No Class Actions: To the maximum extent permitted by law, you and Palomar Health agree that each of us may bring claims against the other only on an individual basis and not as a plaintiff or class member in any purported class or representative action or proceeding. Unless both you and Palomar Health agree otherwise, the arbitrator(s) may not consolidate or join more than one person’s or party’s claims and may not otherwise preside over any form of a consolidated, representative or class proceeding. Also, the arbitrator(s) may award relief (including monetary, injunctive and declaratory relief) only in favor of the individual party seeking relief and only to the extent necessary to provide relief necessitated by that party’s individual claim(s) and in keeping with the damages limitations in the Limitations on Damages section above.
  4. Arbitration Procedures: Arbitration is more informal than a lawsuit in court. Arbitration uses a neutral arbitrator or arbitrators instead of a judge or jury, and court review of an arbitration award is very limited. However, the arbitrator can award the same damages and relief on an individual basis that a court can award to an individual. All issues are for the arbitrator to decide, except that a court of competent jurisdiction may decide issues relating to arbitrability, the scope or enforceability of this agreement to arbitrate, or issues that these Terms of Use indicate that a court can resolve.

Any arbitration will be administered by JAMS, a well-respected arbitration and mediation service. For all claims in which the value of the relief sought is $10,000 or less, JAMS’ Streamlined Arbitration Rules and Procedures, as modified by these Terms of Use, will apply without exception unless otherwise agreed to in writing by both you and Palomar Health. For all other claims, JAMS’ Comprehensive Rules, as modified by these Terms of Use, apply. All of JAMS’ rules are available on their website at https://www.jamsadr.com/adr-rules-procedures/.

The arbitrator must decide the substance of all claims in accordance with applicable law, including recognized principles of equity, and will honor all claims of privilege recognized by law. No court or arbitrator is bound by rulings in prior arbitrations involving different users of Palomar Health’s website, except that a court or arbitrator will be bound by rulings in prior arbitrations involving the same Palomar Health website user, to the extent required by applicable law. The award of the arbitrator shall be final and binding, and judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof.

  1. Arbitration Costs: Payment of all JAMS or arbitrator fees will be governed by JAMS’ rules, unless otherwise stated in these Terms of Use. If you are able to demonstrate that the costs of accessing arbitration will be prohibitive as compared to the costs of accessing a court for purposes of pursuing litigation on an individual basis, Palomar Health will pay as much of the JAMS or arbitrator fees as the arbitrator deems necessary to prevent the cost of accessing the arbitration from being prohibitive. Any request for payment of fees by Palomar Health must be submitted by mail to JAMS along with your Demand for Arbitration. In the event the arbitrator determines that either the substance of your or Palomar Health’s claim or the relief sought was frivolous or brought for an improper purpose, then you or Palomar Health may seek to recover from you or Palomar Health any fees paid, including attorneys’ fees, to the extent permitted by JAMS’ rules and applicable law.
  2. Severability: You and Palomar Health agree that all of the terms in these Terms of Use are severable. You and Palomar Health agree that, if a court decides that any part of these Terms of Use is invalid or unenforceable, the other parts of these Terms of Use still apply. You further agree that, if any disputes are determined by a court not to be subject to arbitration, then those disputes must be severed from any other disputes and may be litigated in court, with the remaining claims heard in arbitration.
  3. Choice of Law: You agree that, except to the extent inconsistent with or preempted by federal law and except as otherwise stated in these Terms of Use, the laws of the State of California, without regard to principles of conflict of laws, will govern these Terms of Use and any claim or dispute that has arisen or may arise between you and Palomar Health.

Opt-Out Procedure: You can choose to reject the arbitration provisions of these Terms of Use by mailing us a written opt-out notice. The opt-out notice must be postmarked no later than 30 days after the date you accept these Terms of Use for the first time. You must mail the opt-out notice to:

Attn: Opt-Out Notice
Secretary of the Board of Directors of Palomar Health
2125 Citracado Pkwy, Suite 300
Escondido, CA 92029

Your opt-out notice must contain the following information: Your name, your address, and the first date after August 11, 2023, on which you first accessed Palomar Health’s website. PLEASE NOTE: You must sign the opt-out notice for it to be effective. This procedure is the only way you can opt out of the arbitration provisions of these Terms of Use. Please note that even if you opt out of the arbitration provisions of these Terms of Use, all other parts of the Terms of Use continue to apply.



    Tennis Elbow

    women elbow pain

    Tennis Elbow

    by

    Tennis elbow is a common term used to describe lateral epicondylitis, which is inflammation of the tendons near the outside of your elbow that pull your hand up (wrist extension). “Overuse can lead to micro-tears in the tendons, as they originate at the elbow, and also scar tissue, which leads to pain and limited flexibility at the wrist. You may have difficulty with gripping, lifting the coffee pot, keyboarding, and with straightening your elbow after prolonged static positions, like sleeping, or even while at rest. Any repetitive wrist extension, whether it’s clipping your rose bushes, painting, and yes, even too much tennis, can increase the risk of elbow pain.

    Painful resisted wrist extension is a positive test for lateral epicondylitis. There is usually localized tenderness when palpating over the bony top of your elbow and into the forearm.

    How to help yourself:

    • Reduce repeated strains
      • This could mean changing your work techniques by using tools with a larger grip or using gloves.
      • You should check your work station – height of computer, and your seat, your keyboard position, and bring the mouse closer to you. The use of a head set is encouraged for phone use.
      • If you are a tennis player, attempt a double-handed backhand. Play less!
      • Check your posture regularly to avoid the forward head posture and take frequent breaks to stretch both your neck and forearm muscles.

    • Stretching
      • Attempt to stretch the forearm muscles as shown above 3 x day, 3 x each side holding for 30 seconds.

    • Anti -inflammatory techniques
      • The use of ice 2-3 x a day over the elbow for 10-15 mins will help increase circulation and assist with healing.
      • The use of short-term non-steroidal anti-inflammatories, like Ibuprofen, may help.
    • Cross friction Massage
      • With the affected palm facing up, and using your opposite thumb, perform a deep, sweeping massage across approximately 1 inch of underlying soft tissue on the area shown (see photo).
      • Perform for 1- 2 minutes daily. Make sure not to bruise the skin, but rather move your thumb and the skin of forearm in conjunction across the tendon structures.

    • Eccentric exercise
      • Eccentric strengthening has been proven to be a great adjunct in reducing tendinitis symptoms.
      • Use a small weight or can of food for this. Using the unaffected hand, assist extending your wrist upwards, then remove the unaffected hand, and slowly control lowering the weight downwards with the affected hand. Repeat 2-3 sets of 10, followed by stretching and icing.

    • Braces and taping
      • Kinesio-taping and wearing a brace can help for short- term pain relief.
      • Please consider stopping in at your doctor’s office and asking for a referral to physical therapy for a check-up and advice on how to relieve your lateral epicondylitis. Your physical therapist can help identify your overuse postures and address ways to decrease your symptoms.

    For further assistance a Physical Therapist or Occupational Therapist can provide further assistance to guide you through your rehabilitation needs.

    Debbie Kayton, P.T.

    Debbie Kayton received her Bachelor of Science (Physiotherapy) at the University of Cape Town, South Africa in 1987. She has been working in the United States since 1991 in a variety of different in-patient and out-patient settings. She loves to play tennis!

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