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Physical therapy for tennis elbow.

Tennis elbow is an overuse syndrome of the extensors in the wrist, that is, the symptoms usually develop and worsen gradually. Often, these symptoms occur with many unilateral activities (repetitive movements). Frequent lifting of children or shopping bags can also cause these complaints to develop. Usually these complaints arise in people between the ages of 40-50 in the dominant arm. That is, if you are right-handed the complaints are likely to occur on the right. Work that involves a lot of the same movements with the forearm is a risk factor for developing tennis elbow.

Trochantor major syndrome
Types of Tennis Elbow

There are different types of epicondalgia lateralis:

  • Irritation of the tendon of the affected muscle
  • Irritation of the attachment to the bone, in 90% of all cases this involves
  • Irritation of the periosteum to which the tendon attaches


How is tennis elbow diagnosed

Tennis elbow is often confirmed by pain on tightening, stretching and palpation of the affected muscle(s). You may be able to see some fluid or damage on an ultrasound image but in most cases, additional examination is not necessary for a muscle injury. This is because the initiated policy will not differ. Often we see that the symptoms have been present for some time and have slowly gotten worse over time.

    Anterior cruciate ligament

    Stretch and palpation of the muscle group
    With the elbow in an extended position, the forearm is rotated and the wrist with the fingers fully flexed. If there is recognizable pain, the test is positive. Palpation of the extensors may also give a recognizable pain.

    Cozen's test
    In Cozen's test, the patient is asked to place the arm on the table in an extended position. Then, with a clenched fist, the patient is asked to apply force to dorsiflexion/extension and radial deviation. The occurrence of recognizable pain in the attachment region (lateral epicondyle) of the extensors makes the test positive.

    Maudsley's test
    In the Maudley's test, we see a similar performance to the Cozen's test. The starting position is the same except for the position of the hand. This is because in the Maudsley's test, the fingers remain extended and the therapist asks you to move them up against resistance. This involves the 2nd and 3rd fingers. This is because the attachment points of the extensor carpi radialis longus and extensor carpi radialis brevis are located here. Recognizable pain around the lateral epicondyle makes the test positive.

    Physical therapy for tennis elbow

    The treatment will consist of different parts; stretching the muscles, a possible friction massage on the painful tendons and exercises for the affected muscles. In the beginning, the treatments will focus on stretching and the exercises will not be so heavy as we progress through the course, the exercises will become heavier. Eccentric training is the way to reduce the symptoms. However, this will have to be built up slowly under supervision. Exercises for home use will help to reduce the complaints.

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