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