Sunday, 10 February 2013

Tennis Elbow overview.

Lateral epidcondylitis

Commonly known, Tennis elbow or lateral epicondylitis is the most common injury of the elbow but is often resistant to treatment and prone To repetitive overload.
It occurs as a result of strain of the wrist extensor muscles at their common point of origin, the lateral epicondyle of the humerus. It is most commonly associated with movements that require gripping actions such as holding racket handles or repetitive movements at work.
The relative poor blood supply of the tendon makes it susceptible to micro trauma through repeated loaded wrist extensions or gripping actions.
Tennis elbow usually occurs in adults. Each year, in the UK, approximately five in 1,000 adults are affected by tennis elbow. The condition occurs mostly in those who are between 30 and 50 years of age.

In the early stages of complaint, the cardinal signs of inflammation are usually present. They are: Swelling, heat, redness and pain.
If the symptoms develops, the degenerative features of tendinosis are thought to become of greatest significance.
In the chronic stages of tendinosis there is a parallel with similar
complaints as in the rotator cuff and the Achilles tendon.
When taking subjective history, it is usual for the patient to complain of a gradual increasing pain on the lateral aspect of the elbow and forearm. The symptoms are provoked by repeated gripping actions together with rotation of the arm.
Muscle weakness is normal, lifting the kettle may cause Sharpe pain radiating down the forearm.
A full range of movement is typical at the elbow. A resisted wrist extension with the arm in the lengthen position will normally reproduce the symptoms.
Palpation of the site of complaint will locate trauma.
The Sports Therapists first job is to identify the cause of complaint, this  is paramount. Modifications to the thickness of a tennis racket etc may be necessary.
The application of a brace to alter stress away from the chronic site would also be of advantage. These lightweight braces are generally inexpensive and can relieve pain considerably. Made from Plushback elastic, the stretchable material allows uninhibited mobility, while maintaining targeted compression. These specialist braces can alleviate conditions of supinator muscle strain and lateral and medial epicondylitis, tendonitis, sprains and strains.
Need to buy a Tennis Elbow Support?  Made in 3mm Stomatex.
Same as Tennis elbow sleeve with a strap for added compression for Tennis elbow
Anti-inflammatory drugs either from your G.P or over the counter alternatives are effective when coupled with bracing. Paracetamol may help with pain, always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Home care icing of the region is also widely used to reduce the signs of inflammation.
The Sports Therapist can apply massage to the extensor chain of the forearm, this will relieve tonicity. Cross fibre frictions to the tendon is unpleasant but can soften scar tissue.
Electro therapy and acupuncture are also widely used in the clinical environment with good effect.
Corticosteroid injection
This is the most common and effective treatment particularly in the early stages of management where inflammation is a key factor. Generally most of our local G.P`s will administer this form of treatment if the symptoms are diagnosed relatively early.
Once the degenerative process becomes predominant corticosteroid injection may not be as effective.
Early management is key to the treatment being successful
Chronic tennis elbow results in degenerative changes which significantly reduce the success rate of treatment. Early consultation with your Sports Therapist can provide treatment and home care management plus advice on bracing or referral.

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