Despite the title tennis elbow, tennis is a direct cause in only 5% of people with lateral epicondylitis. Physiotherapy has been shown to be effective in the short and longterm management of tennis elbow. The injury associated with tennis elbow more often than not occurs at the lateral epicondyle. These muscles originate on the lateral epicondylar region of the distal humerus. Tennis elbow advice and exercises churchill hospital. Cost effectiveness of brace, physiotherapy, or both for. The patient responded well to the intervention, with subjective improve. Acute tenderness over the lateral epicondyle, pain on resisted wrist and or middle finger extension and painful grip strength testing, along with stiffness of the superior radioulnar joint and problems with supinator muscle. Tennis elbow, or lateral epicondylalgia as it has more recently been named, often involves more than localised pathology around the elbow.
Lateral epicondylitis, also known as tennis elbow, is the most common overuse syndrome in the elbow. Restoration of normal muscle length, strength and movement patterns. We explored the different causes and effects of tennis elbow in the assessment course including central. Rehabilitation protocols southeast georgia health system. The name tennis elbow is used for patients with pain from the common extensor origin, implying a relationship with repetitive mechanical load while using a forceful grip, like in playing tennis.
Tennis elbo w is considered an o verload injur y, typically after minor and often unrecognised tr auma of the extensor muscles of the forearm. Your elbow hurts, youve been told you have tennis elbow, and yet you havent played tennis in years. We dont know exactly why some people develop a painful tennis elbow, and others dont however it may relate to general strength and conditioning as well as the how the patients nervous system regulates pain and sensitivity. Tennis elbow is a common overuse injury typically causing pain at the outer aspect of the elbow. These protocols are listed by diagnosis, so clinicians who are providing patient care may reference the applicable protocol to help rehabilitate their patients condition. Handshake stretch holding the weight or can with your thumb pointing up. Research has shown that physiotherapy treatment which combines specific exercises with other treatments such as manual therapy, taping or bracing can result in faster and longerlasting improvement from tennis elbow pain. The following stretch and exercise are recommended for patients who have been diagnosed with tennis elbow.
Physiotherapy management of tennis elbow we see many variations on a theme when assessing patients with tennis elbow. Appendix a lateral epicondyle tendinopathy details of. Its typically an overuse injury triggered by repetitive activity. May 03, 2016 tennis elbow is caused by inflammation of the muscles of the forearm that attach to the elbow. Oct 21, 2014 physiotherapy treatment for tennis elbow tennis elbow is an injury to the muscles that are involved in the extension of the wrist and fingers. A number of simple treatments can help alleviate the pain of tennis elbow.
Turn your forearm so the thumb side of hand is pointing down towards the floor. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow. The early goal of a therapeutic exercise program is to promote muscle endurance and improve resistance to. Ellenbecker, tad pieczynski, and david carfagno o b jectives after completing this chapter, the therapist should be able to do the following. Several concepts have been put forward concerning its aetiology ranging from intrinsic causes such as bursitis, periostitis, etc, to cervical dysfunction thurston, 1998.
What is already known on this topic tennis elbow is a chronic condition that can be challenging to treat. However, it can often last for several weeks or months, because tendons heal slowly. Tennis elbow is a selflimiting condition, which means it will eventually get better without treatment. For the benefit of achieving long term goals and to meet individuals needs, rehabilitation should be a multimodal perspective. Restoration of the normal joint range of motion and function. Sep 12, 2012 lateral epicondylalgia tennis elbow is a condition that i, and am sure many other physiotherapists out there, treat very commonly. Chartered society of physiotherapy members are aacpaccredited acupuncturepracticing physiotherapists i. Journal of physiotherapy 61 2015 174181 key words tennis elbow physiotherapy lateral elbow physical therapy bisset lm, vicenzino b 2015 physiotherapy management of lateral epicondylalgia.
You need physiotherapy, but first you want to have a good understanding of the problem to make sure you are on the right track. Physiotherapy and tennis elbowlateral epicondylitis. P rocedures used in bisset l, beller e, jull g, et al. Treatment goals include pain relief and prevention of symptom recurrence.
Dtfm is applied with the thumb at the common extensor tendon just anterior to the epicondyle. Even though the above two terms are not the appropriate to describe this condition, these two will be. An effective program for using powerball in the direct treatment of lateral epicondylitis tennis elbow. Rehabilitation of the elbow scottsdale sports medicine. Tennis elbow te or lateral epicondylitis le is one of the most frequent lesions of the arm. A physiotherapy treatment approach is to firstly advise of the dos and donts. The vast majorityup to 95%of tennis elbow cases can be successfully treated without surgery. Figures 1 and 2 and the accompanying descriptions are the components of this treatment approach. Other treatment techniques offered as physiotherapy for tennis elbow have not been compared to placebobased treatments and therefore cannot be rated for effectiveness. Keep your arm still by resting it on the table and only move your wrist. Even though the above two terms are not the appropriate to describe this condition, these two will be used in this.
Consequently, the treatment approaches for lateral epicondylalgia vary. This is a painful condition typically aggravated by tension in the wrist and finger extensor muscles located in the forearm posterior. Elbow pronated, the examiner fully flexes the wrist while moving the elbow from flexion to extension. Effectiveness of a specific physiotherapy regimen on patients. Hand works occupational therapy lateral epicondylitis. Tennis elbow this leaflet provides general information about tennis elbow and simple exercises that may help. Acupuncture for the treatment of pain is a common treatment offered by chartered physiotherapists. Up to four in ten people may experience it at some point in their life. Interestingly, despite the frequency with which healthcare is sought for this condition. Your therapist may advise you on how you position your arm when using it for prolonged activities at work or may give you some gentle exercises to do. May 10, 2006 tennis elbow, or lateral epicondylitis, is characterised by pain on the lateral side of the elbow, which is aggravated by resisted dorsal flexion of the wrist. Place your sore arm in front of your body with your elbow straight do not bend your elbow. Tennis elbow is usually easily diagnosed by a physical examination. Tennis elbow lateral epicondylitis treatment, cause, symptoms.
The main factors in the pathogenesis of tennis elbow are overuse, inflammation and degeneration. Discuss the functional anatomy and biomechanics associated with normal function of the elbow. Tennis elbow can occur at any age, although it most commonly occurs in people aged between 35 and 55. Wrist rotations hold the weight or can in your hand. Ive even watched my mom another competitive tennis player get cortisone shots and surgery on her elbow. Evidencebased answer topical or oral nonsteroidal antiinflammatory medications nsaids, corticosteroid injection, and acupuncture are more helpful than placebo in treating lateral epicondylitis, or tennis elbow strength of recommendation sor. Tennis elbow is one of the most common lesions affecting the arm. Therapeutic exercise program for epicondylitis tennis. Corticosteroid injections do show large painrelieving.
Tennis elbow and the role of physiotherapy mount merrion. There are a number of nonsurgical treatment options available, ranging from rest and watchful waiting to prescription medications to physical therapy, among other modalities. Physiotherapy treatment for tennis elbow mississauga physio. Patients elbow is supported in a 90 degrees flexion, fully supinated position. The majority of people who develop tennis elbow are not actually tennis players.
Wrist flex keeping your arm straight in front with your palm facing down, gently bend your wrist down. Despite a wealth of research, there is no true consensus on the most efficacious management of tennis elbow especially for effective longterm outcomes. This case study documents the use of acupuncture in addition to typical physiotherapy modalities in the management of a 41yearold manual worker with lateral epicondylalgia tennis elbow. The results of limited trials for techniques such as hydrotherapy and electrotherapy do not provide evidence to support physiotherapy for tennis elbow as an effective treatment. The management approach of tennis elbow te, also known as lateral epicondyle tendinopathy, is adapted from the general principals of tendinopathy rehabilitation. In a lot of cases, the insertion of the extensor carpi radialis brevis is involved. Use the opposite hand to press the stretching hand back towards your body and hold for 1530 seconds. Tennis elbow is caused by inflammation of the muscles of the forearm that attach to the elbow. In some cases, tennis elbow can persist for more than a year. Physiotherapy for tennis elbow lateral epicondylitis. It is a tendinopathy injury involving the extensor muscles of the forearm. Mills tennis elbow test originally described as a manipulation maneuver, but can be used as a clinical test.
Research tennis elbow, or lateral epicondylalgia, is a. The protocols listed below were developed by southeast georgia health system physicians and therapists and are intended for use by clinicians and patients alike. Jun 08, 2011 what is the best treatment for tennis elbow. You may be given a splint to wear at night, or be advised to wrap a towel around your elbow, to prevent you from bending your elbow and compressing the nerve.