Tennis Elbow Overview

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Questions and Answers

What type of exercises are encouraged in the physiotherapy management of lateral epicondylalgia?

Isometric, eccentric, or concentric exercises of wrist flexor muscles (correct)

Static stretching exercises for the wrist and elbow

Aerobic exercises for overall fitness

Plyometric exercises targeting the wrist extensor muscles

Which type of exercise should be strictly avoided until specific conditions are met in lateral epicondylalgia management?

Concentric exercises

Isometric exercises

Plyometric exercises (correct)

Eccentric exercises

Which medication is NOT recommended as part of the common conservative management for lateral epicondylalgia?

Pregabalin

Topical creams

NSAIDs

Prolotherapy (correct)

When is surgical intervention recommended in lateral epicondylalgia?

In rare patients with severe degenerative changes in common extensor origin Signup and view all the answers

At what stage of rehabilitation should plyometric exercises be avoided in lateral epicondylalgia management?

Until provocation testing and resisted loading test are asymptomatic Signup and view all the answers

What is a common clinical feature of tennis elbow?

Pain at the lateral humeral epicondyle Signup and view all the answers

Which muscle shows altered cortical excitability characteristics in individuals with tennis elbow?

ECRB muscle Signup and view all the answers

What is a key element of conservative management for tennis elbow?

Minimizing tendon load during exercise Signup and view all the answers

What tool is used to understand the level of pain-related disability in individuals with tennis elbow?

Patient-Rated Tennis Elbow Evaluation (PRTEE) Signup and view all the answers

What criteria are used to identify individuals with tennis elbow who have a good prognosis?

Pain duration of < 3 months Signup and view all the answers

Which physical therapy intervention is considered as an adjunct therapy to facilitate inflammation response in tennis elbow?

Laser therapy Signup and view all the answers

What does the evidence-informed clinical pathway for physiotherapy management of tennis elbow aim to do?

Minimize strain on the healing tendon Signup and view all the answers

Which type of individuals with tennis elbow are at risk of poor prognosis?

>3 months pain duration, concomitant neck and arm pain Signup and view all the answers

What do the orange arrows represent in the evidence-informed clinical pathway for physiotherapy management of tennis elbow?

"Poor prognosis" Signup and view all the answers

What does conservative management for tennis elbow primarily aim to optimize?

Tendon load and healing tendon strain Signup and view all the answers

What is another common name for tennis elbow?

Lateral epicondylalgia Signup and view all the answers

Which muscle is mostly attributed to the tissue pathology in tennis elbow?

Extensor carpi radialis brevis Signup and view all the answers

What type of function alteration is commonly seen in the pathophysiology of tennis elbow?

Altered sensory (pain) system function Signup and view all the answers

What imaging modality is a common tool to identify tendon structural changes associated with tennis elbow?

Grey-scale ultrasound imaging Signup and view all the answers

Which joint is mainly affected in tennis elbow?

Elbow joint Signup and view all the answers

What type of activities are commonly associated with the development of tennis elbow?

Repetitive hand grip and/or manual handling activities Signup and view all the answers

Study Notes

Tennis Elbow

Also known as Lateral epicondylalgia or Lateral elbow tendinopathy
A chronic pain condition affecting the lateral epicondyle region of the elbow joint
Commonly seen in people performing repetitive hand grip and manual handling activities with a relatively flexed wrist position

Anatomy and Pathology

Primary disorder of the common extensor tendon of the lateral elbow
Occurs due to overuse and/or age-related tendon degeneration (tendinopathy)
Tissue pathology mostly attributed to the tendinous portion of the extensor carpi radialis brevis (ECRB) muscle

Diagnostic and Clinical Features

Grey-scale ultrasound imaging is a common and feasible clinical tool to identify tendon structural changes
Clinical features include localized pain at the lateral humeral epicondyle of the elbow, often aggravated by palpation, resisted wrist extension, and resisted middle or index finger extension
Presence of elbow pain reduces muscle strength during wrist extension and gripping tasks, altering gripping behavior and leading to upper extremity activity limitation

Conservative Management

Multimodal physical therapy intervention, pain medication, and injection therapies
Key element is to optimize tendon load and minimize strain on the healing tendon during exercise and loading management interventions
Use of physical modalities (e.g., TENS, LASER, Ultrasound, heat therapy) as an adjunct therapy to facilitate inflammation response and enhance therapeutic exercise intervention
Evidence-informed criterion to identify individuals with a good prognosis: pain duration < 3 months, no concomitant neck or other arm pain, PRTEE < 54/100

Clinical Pathway

Different clinical pathways for patients with good prognosis, poor prognosis, and those that fall within the prognostic continuum
Initial clinical pathway includes education, advice, exercise therapy, and Mobilisation-with-Movement manual therapy techniques
Additional treatment options for patients at risk of poor prognosis include shock wave therapy, ultrasound, and injection therapies

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Description

Learn about tennis elbow, a chronic pain condition affecting the lateral epicondyle region of the elbow joint. Understand its causes and common symptoms. Explore its impact on individuals performing specific activities.