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Tennis Elbow (Lateral Epicondylitis)
Tendonitis of the common extensor tendon of the forearm.
Causes
Degeneration due to ageing
Overuse of the forearm against a resistance (tennis, golf)
Faulty technique in sport i.e. tennis
The term tennis elbow is a misnomer as the condition has a higher incidence in golf, squash, rowing, manual labour and even violin playing
Signs and Symptoms
Pain at the lateral epicondyle and lateral elbow
Common during middle age at the dominant arm
Pain may radiate down to hand
Pain will be sharp on exertion, but it may be a dull and constant ache
Gripping an object or squeezing the hand may be painful
Lifting a heavy bag or working at a pc will aggravate
Tenderness, heat and slight swelling over the epicondyle if acute
Pain and weakness on wrist extension (test for tennis elbow)
Test for tennis elbow: client makes a fist with the affected arm, therapist places a thumb on the lateral epicondyle and with the other hand offers resistance to the clients fist as they bring the wrist into extension. This will cause pain if there is a tendonitis present.
Treatment
If swelling is present apply ice to the arm. Otherwise contract. Therapy treatments help to relieve the pain.
The aggravating factors should be kept to a minimum
All the forearm muscles can be treated in the supine position with the clients elbow resting on the plinth. Extensors, flexors, supinator, biceps, brachioradialis should all be treated.
Friction to the common extensor tendon (usually found by locating the most tender point) for approx 1 minute on the inital treatment working up to 5 minutes on subsequent treatments
Application of ice immediately following the friction massage can be very beneficial to ease the pain
Ice followed by heat and ice later that evening
Stretching for extensors and flexors
Next treatment 3 to 4 days. Approx 6 treatments may be required, providing the client rests from any aggravating factors. Strengthening exercises for the extensors when stretching is no longer causing any ill effects.
To stretch the flexors stretch your arm out straight, palm upwards, and grasp your hand with the other hand, gently bending your wrist towards the ground until you feel a stretch in the forearm. Hold for ten seconds and repeat three times. Do three times a day. To stretch the extensors stretch the arm out palm downwards and gently bend the wrist towards the ground until you feel a stretch. Repeat as above.
Once these stretches no longer cause any pain you can do strenghtening exercises for your extensors.
Exercises for extensors: most dumb-bell exercises, reverse wrist curl, wrist roller (palm down)
Tendonitis of the common extensor tendon of the forearm.
Causes
Degeneration due to ageing
Overuse of the forearm against a resistance (tennis, golf)
Faulty technique in sport i.e. tennis
The term tennis elbow is a misnomer as the condition has a higher incidence in golf, squash, rowing, manual labour and even violin playing
Signs and Symptoms
Pain at the lateral epicondyle and lateral elbow
Common during middle age at the dominant arm
Pain may radiate down to hand
Pain will be sharp on exertion, but it may be a dull and constant ache
Gripping an object or squeezing the hand may be painful
Lifting a heavy bag or working at a pc will aggravate
Tenderness, heat and slight swelling over the epicondyle if acute
Pain and weakness on wrist extension (test for tennis elbow)
Test for tennis elbow: client makes a fist with the affected arm, therapist places a thumb on the lateral epicondyle and with the other hand offers resistance to the clients fist as they bring the wrist into extension. This will cause pain if there is a tendonitis present.
Treatment
If swelling is present apply ice to the arm. Otherwise contract. Therapy treatments help to relieve the pain.
The aggravating factors should be kept to a minimum
All the forearm muscles can be treated in the supine position with the clients elbow resting on the plinth. Extensors, flexors, supinator, biceps, brachioradialis should all be treated.
Friction to the common extensor tendon (usually found by locating the most tender point) for approx 1 minute on the inital treatment working up to 5 minutes on subsequent treatments
Application of ice immediately following the friction massage can be very beneficial to ease the pain
Ice followed by heat and ice later that evening
Stretching for extensors and flexors
Next treatment 3 to 4 days. Approx 6 treatments may be required, providing the client rests from any aggravating factors. Strengthening exercises for the extensors when stretching is no longer causing any ill effects.
To stretch the flexors stretch your arm out straight, palm upwards, and grasp your hand with the other hand, gently bending your wrist towards the ground until you feel a stretch in the forearm. Hold for ten seconds and repeat three times. Do three times a day. To stretch the extensors stretch the arm out palm downwards and gently bend the wrist towards the ground until you feel a stretch. Repeat as above.
Once these stretches no longer cause any pain you can do strenghtening exercises for your extensors.
Exercises for extensors: most dumb-bell exercises, reverse wrist curl, wrist roller (palm down)