What is lateral epicondylitis?
Lateral epicondylitis, more commonly referred to as Tennis Elbow, is an irritation of the muscle origin of the extensor carpi radialis brevis at the elbow. If it is a chronic problem, it is considered a tendonosis. A person may have a build-up of scar tissue from small tears in the muscle. If it is a recent problem it is considered a tendonitis, in which pain is due to inflammation.
What causes it?
Current theory is that a person has poor scapular stability, which leads to the need to stabilize the hand during tasks with the wrist extensor muscles (ERCB). It often occurs when a person needs to reach out and grab something with the arm extended, and the palm pronated. This can occur while raking, reaching into the washer or dryer, playing ball, water skiing, or any combination of the above. It is a common workplace or office injury. A person can get it by doing aggressive work, or by having a poor work station/desk set up. Basically, anyone can get it, not just tennis players.
What can be done about it?
There are a variety of treatment options, both from a physician standpoint and from a therapeutic standpoint. Medically: a course of an anti-inflammatory medication, a cortisone injection, or surgery. An anti-inflammatory medication or cortisone may not be effective if the person has a tendonosis. (Tennis elbow is generally considered a tendonosis if it has lasted over 6 months.) Surgery is effective for people with debilitating pain, but has a long recovery (usually is required to take 10+ weeks off from physical work), and if changes aren’t made to the cause, it can re-occur.
Therapeutically:
Soft tissue mobilization (STM): To get the blood flowing to aid healing, to relieve any trigger points, and to lengthen the muscle fibers. Modalities: Depending on the stage the person is in, ultrasound or iontophoresis with an anti-inflammatory may be beneficial to decrease the irritation in the extensor musculature. Modalities are usually followed by exercise or STM.
Exercises: Both scapular stabilizer strengthening to prevent the problem from re-occurring, as well as wrist and hand stretching to decrease any tightness in the muscles. We also teach correct lifting mechanics to prevent re-occurrence.
Home Exercises: Tennis elbow can last a while. It is not realistic to expect a few visits to a therapist to correct the entire problem. Patients are expected to perform and complete a series of home exercises to correct their specific problem. Home exercises may include actual exercises, self STM, Kinesiotaping, and/or correct strap use.
Now what?
At Helping Hands Rehab, we are here to help. We evaluate and treat each patient as individuals. We offer certified hand therapy, which means we specialize in any injury from fingertip to shoulder. We are experts in the treatment of tennis elbow. Our philosophy in patient care is hands on. We specialize in one on one, attentive treatment. We won’t have your patient do a series of exercises and then desert them while they perform them in treatment. We stay with your patient, correcting form, and emphasizing important aspects of their care. Helping Hands Rehab takes most insurances and an order for occupational therapy is required. If you wish an in-service on tennis elbow or any other UE issue, please call us to schedule.