also known as lateral epicondylitis defined as inflammation of tendon of extensor compartment of forearm specifically extensor carpi radiallis brevis (ECRB)
EPIDEMIOLOGY AND CAUSES
often results from overuse injury with sporting activities like ratchet sports tennis, squash and other sports like cricket, baseball etc most popular example among sports athletes is Sachin Tendulkar suffered from this disease in general survey annual incidence is 1-3% of the U.S. population. Men and women are equally affected. Typically, lateral epicondylitis affects individuals greater than age 40 years.
CLINICAL FEATURES AND PATHOPHYSIOLOGY
Pain in the lateral compartment of forearm along with tenderness at a point distal to origin of ECRB pain may radiate to posterior aspect of forearm and aggravates with activities like repetitive extension long standing pain may result in weakness of extensor muscles and a characteristic” coffee cup sign” i.e holding coffee cup may trigger pain is observed
Overuse action of extensor muscles may lead to micro tears of the extensor tendon leading to degenerative changes.
PHYSICAL EXAMINATION AND DIAGNOSIS
Following physical examination tests are performed to evaluate tennis elbow
COZEN TEST
MILL’S TEST
Other test includes
MAUDSLEY TEST
CHAIR TEST
WRINGING TEST
Other diagnostic tools such as ultrasound may reveal micro tears of the tendon and extent of tendon damage X-ray reveal calcification and MRI is used to rule out arthritis
DIFFERENTIAL DIAGNOSIS
Cervical Radiculopathy
Posterior Introsseous syndrome
Radial tunnel syndrome
Fibromyalgia
Elbow Osteoarthritis
MEASURES
Patient Rated Tennis Elbow Evaluation
Visual analogue Scale
QUICKDash(Disability of Arm Shoulder Hand)
PHYSIOTHERAPY MANAGEMENT
Medical management includes Corticosteroid injection at the extensor origin and NSAIDS which helps to relieve pain Physiotherapy management includes pain relief modalities like ultrasound, TENS etc Cyriax Method, IASTM (INSTRUMENT ASSISTED SOFT TISSUE MANIPULATION), Myofascial release of extensor carpi radiallis brevis, Strengthening exercises, Mulligan mobilisation with movement, Stretching techniques
Use of Kinesiotaping, braces, straps provides support and helps in rehabilitation phase
For further information visit
https://www.physio-pedia.com/Lateral_Epicondylitis