Lateral Epicondylitis(Tennis Elbow)

Danielle Wolk

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Anatomy

Humerus Ulna Radius

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Muscles that cross the elbow joint:

Biceps Brachii Brachialis Brachoradialis Triceps Brachii Pronator Teres, Supinator Wrist Flexors- Pronator Teres, Flexor Carpi Radialis, Flexor Carpi Ulnaris,

Palmaris Longus

Flexor Digitorum Superficialis, Extensor Digitorum Wrist Extensors- Extensor Carpi Radialis Longus/ Brevis, Extensor Capri

Ulnaris(Jarmey 108-30)

Definition

A pathologic condition of the common extensor muscles at their origin on the lateral humeral epicondyle. Epicondylitis suggests an inflammation at one of the epicondyles of the elbow. (Dutton 419-22)

Tennis Elbow generally occurs in adults between the ages of 35-50. It affects between 1%-3% of the population.(Dutton 419-22)

Tennis elbow is typically an overuse injury. Occupations or sports that involve repetitive grasping, with the wrist in extension, place the elbow at risk because its the wrist extensors that must contract during grasping activities to stabilize the wrist.(Dutton 419-22)

Leads to tendonitis of the origin of the extensor carpi radialis brevis tendon. (Sliker)

Common Complaints

Diffuse achiness Morning stiffness Occasional night pain Dropping of objects/ weak grip strength Pain w/ palpation of lat. epicondyle Pain w/active or resisted extension Pain w/ grasping objects with the effected hand

(Dutton 419-22), (Sliker)

Cozens Test Resistive Tennis Elbow Test: The

patient sits with the examiner stabilizing the involved elbow while palpating the lateral epicondyle

With a closed fist, the patient pronates and radially deviates the forearm and extends the wrist against the examiners resistance (Sliker)

A positive result would be if there is pain along the lateral epicondyle or objective muscle weakness

Intervention Techniques

Flexibility exercises ROM exercises Stretching Active assistive and resistive exercises Pain Reduction ("Physical Therapy Management Of Lateral Epicondylitis")

Anticipated Goals

Decreased pain ROM improved Joint swelling, inflammation, or restriction

reduced

Muscle performance increased Ability to perform activities is improved ("Physical Therapy Management Of Lateral Epicondylitis")

Initial Treatment

Rest Ice Anti-inflammatories (aspirin, ibuproufen)

Treatment Intervention

Deep Friction Massage Acupuncture Bracing/ Splinting Cryotherapy Strengthening Exercises Stretches Surgery

Image obtained from: http://www.bing.com/shopping/mih-international-39me-epicondilitis-

brace-blue-size-extra/p/83D42C85828302FF5002?q=lateral+epicondylitis+brace&lpq=lateral

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Image obtained from: http://morphopedics.wikidot.com/physical-therapy-management-of-lateral-epicondylitis

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Strengthening Exercises

("Physical Therapy Management Of Lateral Epicondylitis")

Stretches

Wrist Flexion Wrist Extension

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Video

http://www.physiotherapy-treatment.com/lateral-epicondylitis.html

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ReferencesDutton, M. Orthopaedics for the physical therapist assistant. Sudbury, MA: Jones & Bartlett Publishers, 2012. 419-22. Print.

Jarmey, Chris. The concise book of muscles. 2. Chichester, England: Lotus Publishing, 2003. 108-30. Print.

"Physical Therapy Management Of Lateral Epicondylitis." Morphopedics. N.p.. Web. 6 Mar 2013. .

Sliker, Jessica. The elbow. Powerpoint, Fall 2012

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