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eReport 2006-08

Photo of Romano Sulit

Romano Sulit,  BSc(Hons), MScPT
Physiotherapist

Most everyday actions and sport activities require us to use our wrists and hands. Certain activities such as turning doorknobs, lifting groceries or playing sports such as tennis require adequate arm strength and proper technique.

Occasionally, the outer part of the elbow becomes painful and tender, usually as a result of a specific strain, overuse, or a direct bang. Sometimes no specific cause is found. This edition of eReport discusses the concept of Tennis elbow or Lateral Epicondylitis - factors that contribute to this pain and the rehabilitation for this condition.

How Do I Know If I Have Tennis Elbow?

  1. Recurring pain on the outside of the upper forearm just below the bend of the elbow; occasionally, pain radiates down the arm toward the wrist.
  2. Pain caused by lifting or bending the arm or grasping even light objects such as a coffee cup.
  3. Difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments).
  4. Pain that typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several years.

How Does Lateral Epicondylitis Occur?

Although called tennis elbow, lateral epicondylitis is much more commonly seen in people who are over-using their arm doing something else.

The most common cause is over-use of the muscles which are attached to the bone at this part of the elbow. These are the muscles which pull the hand backwards (the wrist extensors). All the extensor muscles of the hand attach to the elbow at the outer part (the lateral epicondyle). If they are strained or over used they become inflamed, which means they are swollen, painful and tender to touch.

Sometimes the inflammation is caused by a direct injury or bang. Sometimes, especially when the cause is direct injury or strain, the muscles are actually partially torn.

Sometimes the problem is partly or completely due to a neck problem, which is causing pain in the elbow via the nerves from the neck.

What Can I Expect from Rehabilitation?

Lateral epicondylitis, is a common and often lingering pathologic condition. It is critical, therefore, that you progress your rehabilitation only when you experience minimal or no pain.

As a general guideline, the more chronic or longer you have experienced the condition, the longer the recovery time is to be expected.

What Kind of Rehabilitation is Appropriate for Epicondylitis?

Phase 1 Decrease inflammation and pain, promote tissue healing, and retard muscle atrophy.
 
  • Education, RICE principle, Manual therapy and modalities

  • Phase 2 Improve flexibility, increase strength and endurance, increase functional activities and return to function.
     
  • Stretching and Strengthening of forearm musculature

  • Phase 3 Improve muscular strength and endurance, maintain and improve flexibility, and gradually return to prior level of sport or high level activity.
     
  • Progressive return to functional activities (sport, work, daily activities)




  • Your therapist can also provide information on bracing, taping and equipment modification.

     

     

     

     

    Romano Sulit, BSc(Hons), MScPT
    Physiotherapist

    Printed: August 2006
    Copyright ©2006 SEMI

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    Thank you for providing an integrated approach to health and fitness. I was referred to SEMI for physiotherapy for the debilitating pain of sciatica. As treatment progressed, I also added exercise, massage, osteopathy treatments and counseling with the dietician for weight loss, all available at SEMI. It was wonderful the way the services offered all worked together to compliment and support each other to promote recovery and renewed health. Today I am pain free and healthier and fitter than ever !

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