How Effective Is Physiotherapy for Tennis Elbow?

In tennis elbow (external epicondylitis of the humerus), the tendon inflamed and pained at the starting point of the forearm extensor of the lateral elbow joint. The pain is caused by chronic lacerations caused by repeated exertion of the forearm extensor muscles. The patient may feel pain in the affected area when holding or lifting the object hard. Tennis elbow is a classic example of overwork syndrome. Tennis and badminton players are more common, and housewives, bricklayers, carpenters and other people who repeatedly do elbow exercises for a long time are also susceptible to this disease.

Basic Information

nickname

Humeral epicondylitis

English name

tennis elbow

Visiting department

orthopedics

Multiple groups

Tennis, badminton players, housewives, bricklayers, carpenters, etc.

Common causes

Excessive arm movements, such as caused by playing tennis or painting

Common symptoms

Sore elbow joints, sore movements, hands cannot be held firmly

Causes of Tennis Elbow

The forearm extensor tendons contract and strain when grasping something (such as a tennis racket). Excessive use of these muscles can cause the tendon of these muscles to degenerate, degenerate and tear, commonly known as tennis elbow.

1. Tennis elbow causes include

The technique is not correct when hitting the tennis ball, the tennis racket is not the right size or the racket line tension is not suitable, the golf grip or swing technique is incorrect. Some activities of the arm are too much, such as tennis, badminton, and baseball; other tasks such as painting, rowing, using a hammer or screwdriver, etc.

2. Risk factors for the onset of tennis elbow

Play tennis or golf; engage in work that requires repeated wrist extensions with fists; imbalanced muscle strength; decreased flexibility; and increased age.

Clinical manifestations of tennis elbow

Most of the symptoms of this disease are slow. In the early stage of the symptoms of tennis elbow, the patient only felt soreness on the outside of the elbow joint. The patient consciously felt pain in the movement above and outside the elbow joint. Sometimes the pain can be radiated upward or downward. Hand can not hold the object hard, holding the spade, carrying the pot, twisting towels, sweater etc. can make the pain worse. Generally, there are localized tenderness points on the outer epicondyle of the humerus, and sometimes the tenderness can be dissipated downwards, and there is even mild tenderness and movement pain on the extensor tendon. There is no local swelling, and elbow extension is not affected, but pain can occur when the forearm rotates. In severe cases, pain can be caused by finger extension, wrist extension, or chopstick movement. A small number of patients experience increased pain on a rainy day.

Tennis Elbow Check

On examination, the origin of the radial wrist short extensor, that is, the upper elbow tenderness, was found. Joint mobility is normal and local swelling is uncommon. When the patient's forearm is rotated internally, and the wrist joint is repetitively injured from palm flexion to dorsiflexion, pain outside the elbow joint will occur.

X-rays are generally not necessary. If necessary, you can use the X-rays to know whether the bones of the elbow joint are normal and whether there is calcium deposits at the proximal end of the extensor tendon.

Tennis Elbow Diagnosis

The diagnosis of tennis elbow is mainly based on clinical manifestations and physical examination. The main manifestations are pain and tenderness on the outside of the elbow joint. The pain can be radiated to the hand along the forearm, the forearm muscles are tense, the elbow joint cannot be fully straightened, and the elbow or wrist joint is stiff or affected by movement. limit. Pain worsens when doing the following activities: shaking hands, revolving door handles, picking things down with palms, tennis backhand, golf swing, pressing the outside of the elbow joint.

Tennis Elbow Treatment

According to the specific circumstances of the patient, a personalized treatment plan is formulated. The purpose of treatment is to reduce or eliminate symptoms and avoid recurrence.

Non-surgical treatment

(1) Rest Avoid activities that cause pain. Do not exercise until the pain is gone, especially forbidden to play tennis.

(2) Ice pack Apply ice pack to the outside of the elbow for 1 week, 4 times a day, 15-20 minutes. Do not touch the skin with ice when wrapped in a towel to avoid frostbite.

(3) Medication Aspirin or non-steroidal anti-inflammatory painkillers (such as ibuprofen, etc.).

(4) Protective gear Use of pressure resistant protective gear on the forearm can limit the strength of the forearm muscles.

(5) Hyperthermia Hyperthermia is applied before traction and exercise preparation activities.

(6) Stretching therapy When the acute pain disappears, gently stretch the elbows and wrists as instructed by the doctor. Do not cause pain. Keep stretching for 10 seconds and repeat 6 times.

(7) Strength training Carry out the training to strengthen the muscles of the wrist extensors as directed by your doctor.

(8) Gradually resume exercise According to the doctor's recommendation, start the arm movement required for exercise (work activity).

(9) Local closure with cortisone Injecting cortisone drugs in specific parts of the elbow joint can reduce inflammation and relieve pain.

(10) Extracorporeal shock wave treatment can improve local blood flow, reduce inflammation, and has a better effect on tendinopathy.

2. Surgical treatment

If it is late or intractable tennis elbow, after six months to one year of formal conservative treatment, the symptoms are still serious and life and work can be affected by surgery. Surgical methods include minimally invasive arthroscopy and open surgery with minimal trauma to remove unhealthy tissues, improve or rebuild local blood circulation, and heal tendons and bones.

Tennis elbow prevention

1. Correct the movement of straight arm hitting, so that the main arm and forearm maintain a fixed and elastic angle no matter when swinging forward or swinging forward.

2. Protect your wrists and elbows with strong braces and elbows. Limit wrist and elbow flipping and straightening.

3. Wrap an elastic bandage around the abdomen of the forearm muscles when playing, which can reduce the occurrence of pain, but the tightness needs to be moderate.

4. Once diagnosed as a tennis elbow, it is best to stop the exercise and continue the exercise after you have fully recovered and corrected the wrong movements.