Lateral Epicondylitis
- Description / Cause
- AKA tennis elbow
- Pain over the lateral epicondyle
- Caused by repetitive microtrauma from overuse
- Extensor carpi radialis brevis most commonly involved tendon
- Prevalence / Risk factors
- Significantly more common than medial epicondylitis
- 1%-2% of the general public
- High association with tennis players
- One handed backhand stroke
- 40%-50% of tennis players will suffer from this conditions
- Any sport/occupation that requires repetitive wrist extensions
- 35-54 years old are most commonly affects
- Affects both genders equally
- Independent risk factors
- Repetitive task demanding occupations
- Smoking
- Obesity
- Diabetes
- Signs / Symptoms
- 4 stages of Lateral epicondylitis
- 1) early inflammatory reactions
- 2) angiobibroblastic degeration
- 3) structural failure leading to
- 4) fibrosis or calcifications
- Pain and weakness gripping
- Tenderness to palpation over lateral epicondyle
- Swelling and ecchymosis is not typically present
- Hx of repetitive wrist extensions
- Objective / Special Test
- Imaging – MRI (more useful to rule out other conditions)
- Elbow Varus test
- Polk’s Test
- Cozen’s Test
- Mill’s Test
- Treatment / Interventions
- Non-operative management can have a successful result in 90% of patients
- Conservative care
- NSAID
- Physiotherapy
- Stretching wrist extensors
- Strengthening wrist extensors
- Eccentric muscle training
- Corticosteroid injections
- Shockwave therapy
- Benign neglect
- Bracing
- RICE
- Platelet rich plasma therapy
- Change in body mechanics (tennis – 2 handed back swing)
- Surgical Interventions
- Arthroscopic means
References
1. Calfee RP, Patel A, DaSilva MF, Akelman E. Management of lateral epicondylitis: current concepts. J Am Acad Orthop Surg. 2008;16(1):19-29.
2. Taylor S., Hannafin J. Evaluation and Management of Elbow Tendinopathy. Sports Health: A Multidisciplinary Approach September/October 2012 vol. 4 no. 5 384-39.
2. Taylor S., Hannafin J. Evaluation and Management of Elbow Tendinopathy. Sports Health: A Multidisciplinary Approach September/October 2012 vol. 4 no. 5 384-39.
Acknowledgements:
David Funk, Student Physical Therapist at A.T. Still University
Ethan Hunke, Student Physical Therapist at A.T. Still University
Morgan Johnson, Student Physical Therapist at A.T. Still University
Ed Nheiu, Student Physical Therapist at A.T. Still University
Lindsay Walczak, Student Physical Therapist at A.T. Still University
Last edited: July 13, 2015
David Funk, Student Physical Therapist at A.T. Still University
Ethan Hunke, Student Physical Therapist at A.T. Still University
Morgan Johnson, Student Physical Therapist at A.T. Still University
Ed Nheiu, Student Physical Therapist at A.T. Still University
Lindsay Walczak, Student Physical Therapist at A.T. Still University
Last edited: July 13, 2015