616281181
Tennis elbow - causes
Micro-injuries can occur in various ways. They can be repeated specific movements of the forearm and wrist over a long period of time, such as twisting furniture for hours. In such a situation, the wrist extensors are subjected to prolonged contraction, with no time for regeneration. The problem is related to local overload of the structure. Tennis elbow can also arise as a result of working for hours at a computer, when the wrists are leaning against a table and the hands are slightly raised. This unfavorable position can cause inflammation. Microinjuries can also occur as a result of incorrect biomechanics of movement. Such an example would be poor squash technique. A player who underutilizes the work of the trunk, shoulder girdle and legs has a high chance of the wrist extensors compensating for the movement. This situation over time can also result in the appearance of enthesopathy.
Occupational groups most vulnerable to wrist extensor muscle strain:
- mechanics
- seamstresses
- office workers
- athletes (tennis, squash)
- musicians
Tennis elbow - symptoms
The main symptom of tennis elbow is pain that appears on the outside of the elbow joint. It can radiate to the forearm and wrist. Sometimes it intensifies when making hand movements or when trying to clench the hand. It can cause difficulty in performing activities of daily living, such as opening a door or lifting a cup. Tissue tenderness is clearly felt on palpation.
Tennis elbow - diagnosis
Pain on the side of the elbow does not necessarily mean that we are dealing with tennis elbow. The pains that mimic this ailment can have a very different source. Their origin can be in the cervical and thoracic spine or the upper thoracic opening. Pain to the elbow can also radiate from other soft structures (muscles, fascia). In order to effectively treat tennis elbow, we need to be sure where the source of the problem is. To do this, an orthopedic doctor, or physiotherapist, must conduct a history and physical examination. Based on this, the orthopedic doctor may decide to indicate an ultrasound to confirm the diagnosis and determine the extent of the damage. He may also refer to a physiotherapist for further examination. The physiotherapist, on the other hand, may decide that a consultation with an orthopedic doctor is necessary, or that a physical examination of the cervical spine, upper thoracic orifice, examination of musculo-fascial structures and evaluation of movement biomechanics is necessary.
Tennis elbow - treatment
Depending on the cause of the pain, treatment can look quite different. The first and basic principle in the treatment process is rest and regeneration of the damaged tissue. If the overload arises during physical activity or professional work, then it is certainly worth modifying these activities or introducing a break so that the damaged tissue has conditions for healing. A method that stimulates the cells of the damaged tendon to regenerate in a short period of time is injection with platelet-rich plasma containing growth factors (PRP). However, the procedure must be performed precisely by an experienced orthopedic surgeon.
During the rehabilitation process, a physiotherapist can deal with musculo-fascial structures directly related to the elbow itself, as well as areas distant from the site of pain. In his work, he usually uses musculo-fascial methods. If the pain is the result of abnormal movement biomechanics, it is important to improve movement technique, strengthen weakened muscles and make overly tense muscles in the trunk, shoulder girdle and upper limb more flexible. As you can see, the method of dealing with tennis elbow is not so obvious. The most important thing is a good diagnosis to identify the source of the problem.
Tennis elbow - exercises and rehabilitation
Presented by Natalia Reke, M.D.
Tennis elbow - return to physical activity
As a rule, the results of non-operative treatment are very good. In most patients, pain symptoms completely resolve and they can return to their previous level of physical activity. It is important to increase training time and the amount of load gradually.
Related articles:
Learn about other possible elbow injuries and contusions.
Bibliography:
- National Library of Medicine - Tennis Elbow - Benjamin K. Buchanan; Matthew Varacallo.
- Ortho Bullets - Lateral Epicondylitis (Tennis Elbow) - Richard Yoon MD, Christopher S. Ahmad MD, American Shoulder and Elbow Surgeons
- Tennis elbow - Anatomical, epidemiological and therapeutic aspects - J. A. N. Verhaar -International Orthopaedics volume 18, pages263–267 (1994)
- Elbow tendinosis/tennis elbow. - Nirschl RP- Clinics in Sports Medicine, 01 Oct 1992, 11(4):851-870
