Tennis elbow refers to painful elbow syndrome encompassing lateral, medial and posterior elbow symptoms.
Amongst all the most commonly encountered is LATERAL TENNIS ELBOW, approximately 75% cases. It is a lesion affecting the tendinous origin of common wrist extensors from lateral epicondyle.
The main causes for this condition include – epicondylitis i.e., tears and inflammation in common extensor origin, inflammation of adventitious bursa, calcified depositions within common extensor tendon, painful annular ligament, pain of any neurological origin, may occur owing to occupation like in
tennis players; tightening screw; using a wrench; wringing washed clothes; vigorous hand shake.
More than 1/3rd tennis players all over the world are affected and majorly age group of more than 35 years of age are affected.
Household activities are also one of the major contributing factors for Indian household women suffering from tennis elbow.
The symptoms for tennis elbow – initially in acute phase, pain occurs only during activity; later on in chronic stage, pain persists during both activity and at rest, localised tenderness, pain on stretching extensor tendons
At first clinical test are performed such as observing over local tenderness and performing cozen test in which – painful resisted extension of wrist with elbow in full extension elicits pain at lateral elbow.
Later on, investigations like – MRI can be useful.
Initially CONSERVATIVE treatment like rest, oral painkillers, injection of local anaesthetic and steroids in some cases.
Physiotherapy measures in acute phase – rest, an above elbow POP splint, heat modalities like US TENS, cold packs on tender area, electrical stimulation, massaging, active exercises, progressive resisted exercises, manipulation in some cases.
In post-acute case – Avoid repeated wrist extension and supination movements, strengthening exercises, passive and resisted exercises are advised. Local infiltration of hydrocortisone is effective in certain resistant cases.
In severe cases where pain persists longer than 6 weeks, SURGICAL APPROACH used where percutaneous release of epicondylar muscles, excision of proximal annular ligament or arthroscopic release of common extensor muscle origin.
GOLFER’S ELBOW
GOLFER’S ELBOW, also known as medial tennis elbow is a tendinopathy of insertion of flexors of fingers of hand and pronators.
It is usually similar to lateral epicondylitis but occurs on the medial side of elbow.
The main causes for this condition include – epicondylitis i.e., tears and inflammation in common flexor origin, inflammation of adventitious bursa, calcified depositions within common flexor tendon, painful annular ligament, pain of any neurological origin, may occur owing to occupation like in
tennis players; tightening screw; using a wrench; wringing washed clothes; vigorous hand shake.
Golf players all over the world are more prone to golfers’ elbow and majorly age group of more than 35 years of age are affected.
The symptoms for medial tennis elbow – initially in acute phase, pain occurs only during activity; later on in chronic stage, pain persists during both activity and at rest, localised tenderness, pain on stretching flexor tendons
investigations like – MRI can be useful.
Initially CONSERVATIVE treatment like rest, oral painkillers, injection of local anaesthetic and steroids in some cases.
Physiotherapy measures in acute phase – rest, an above elbow POP splint, heat modalities like US TENS, cold packs on tender area, electrical stimulation, massaging, active exercises, progressive resisted exercises, manipulation in some cases.
In post-acute case – Avoid repeated wrist flexion and pronation movements, strengthening exercises, passive and resisted exercises are advised. Local infiltration of hydrocortisone is effective in certain resistant cases.
In severe cases where pain persists longer than 6 weeks, SURGICAL APPROACH used where percutaneous release of epitrochlear muscles, or arthroscopic release of common flexor muscle origin.
