Tennis Elbow aka Lateral Epicondylitis

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

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MILL’S  TEST

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Other test includes

MAUDSLEY TEST

CHAIR TEST

WRINGING TEST

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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

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