Lateral Epicondylitis
is dominant or non-dominant arm usually involved?
dominant
according to studies, which kind of training is good?
eccentric training
is bilaterally symmetry always present?
no - unilaterally dominant athletes may be unequal in size due to adaptive changes
what is lateral epicondylitis a lesion of?
origin of tendons of muscles that extend the wrist
in PT, what is our focus (rather than strict mobilization)
relative rest
what is critical with lateral epicondylitis?
rest interval between exercise bouts
were corticosteroids helpful?
showed improvement of s/s at early follow up (3 days to 6 weeks) - at 1 year no better
Nirschl technique
surgery for removal of angiofibroblastic degeneration of ECRB
lateral epicondylitis is also known as?
tennis elbow
Extracorporeal shock wave therapy (ESWT) is used to treat what?
variety of tendonopathies
when are symptoms worse with lateral epicondylitis?
when elbow is in full extension
what kind of splint is used commonly
wrist splint
could you have pain to resistance of radial deviation?
yes
is the nirschl technique a vascular enhancement?
yes
should you also exam UE and trunk with your physical exam?
yes
__% of patients will have improvement at 1 year after diagnosis
80%
risk factors for elbow
- age > 11 - height > 150 cm - pitching - days of training - grip strength - shoulder ER ROM <130 - Increased ER and IR strength
stress testing to which muscle will indicate lateral elbow symptoms
- extensor carpi radialis brevis - finger extensors
where are other areas of tenderness with lateral epicondylitis?
- extensor carpi radialis longus - extensor carpi radialis brevis - extensor carpi ulnaris
what population does lateral epicondylitis usually effect?
- men and women - age 40-50
angiofibroblastic tendinosis
- numerous blood vessels - large amount of unorganized fibrotic tissue - chronic low grade re-injury - absence of inflammatory cells - NOT acute - repair process has been turned off
goals of conservative treatment for lateral epicondylitis
- reduce pain - increase ROM - increase muscular strength and endurance - ensure RTC and ST stabilization strength
what is lateral epicondylitis usually a result of?
- repetitive forceful arm movements - sports or occupational activities
what motion will have discomfort?
- resisted wrist extension - passive wrist flexion
eccentric training program
- rubber bar - 30 second rest between sets - isokinetic wrist extensor eccentric
where is maximal tenderness with lateral epicondylitis?
5mm anterior and distal to lateral epicondyle
where is the incision from the nirschl technique?
an inch proximal and just anterior to the lateral epicondyle to the level of the radial head