Lateral Epicondylitis, also known as “Tennis Elbow”. It is the most common overuse syndrome in the elbow.
Causes:
Repetitive arm movements can cause your forearm muscles to get fatigued. A single tendon attaches this muscle to the bony bump on the outside of your elbow (lateral epicondyle). As your muscle gets tired, the tendon takes more of the load. This overloading can cause inflammation and pain, known as tendinitis. Over time, this overloading can cause a degenerative condition known as tendinosis. Together tendinitis and tendinosis can then lead to tendon tearing.
Sometimes, a sudden arm or elbow injury causes tennis elbow.
Other causes:
gardening
sporting activities that involve high amounts of throwing
swimming
manual work that involves repetitive turning or lifting of the wrist, such as plumbing, typing, or bricklaying.
Symptoms :
The most common symptom of tennis elbow is recurring pain on the outside of the upper forearm, just below the bend of the elbow. Pain may also be felt further down the arm, towards the wrist.
A weak grip
Increased pain when shaking hands or squeezing an object
pain when lifting something
Special test
Cozen’s test is also known as the resisted wrist extension test. The elbow is stabilised in 90° flexion. The therapist palpates the lateral epicondyle and the other hand of the therapist positions the patient’s hand into radial deviation and forearm pronation. Then the patient is asked to resist wrist extension. The test is positive if the patient experiences a sharp, sudden, severe pain over the lateral epicondyle. High sensitivity has been found with positive findings
Chair test: The patient grasps the back of the chair while standing behind it and attempts to lift the chair by using a three finger pinch (thumb, index long fingers) and the elbow fully extended. The test is positive when pain occurs at the lateral epicondyle.
Mill’s Test: The patient is seated with the upper extremity relaxed at the side and the elbow extended. The examiner passively stretches the wrist in flexion and pronation. Pain at the lateral epicondyle or proximal musculotendinous junction of the wrist extensors is a positive sign for LET.
Maudsley’s test: The examiner resists extension of the third digit of the hand, while palpating the lateral epicondyle. A positive test is indicated by pain over the lateral epicondyle.
Physiotherapy management
Ice Massage
Ultrasound Therapy
Transcutaneous Electrical Nerve Stimulation (TENS)
Laser Therapy
Shockwave Therapy
Exercise Therapy-
1.Strengthening and Stretching- Stretching exercises = repeat 10 times (15-25 seconds)
- Isotonic exercises = repeat 15 times (3 series)
- Stretching exercises = repeat 10 times (15-25 seconds)
- Icing massage the tender area with ice or crushed ice for 10-15 minutes
Manual therapy-
Mulligan – Mobilisation with movement
Extracorporeal Shockwave therapy (ESWT)
Cyriax Physiotherapy Techniques
Deep Transverse Frictions
Kinesio-Taping
