A physical therapy and rehabilitation blog covering common athletic injuries. This is an offshoot of my work blog where I cover surgical and non-surgical rehabilitation. This is in no way intended as a blog or journal of the super intricate and technical aspects of therapy and rehab. For that there already is a wealth of information. It is my hope that this can be used to in some way simplify and make readable the truly necessary info that patients are looking for. Feel free to give feedback and or requests of topics. Good luck!
www.rehab101.wordpress.com
www.rehab101.wordpress.com
Lateral Epicondylitis / Tennis Elbow
Posted 04-22-2011 at 11:36 AM by big10fan
Tendonitis (literally tendon inflammation - itis) is an inflammatory reaction of a tendon due to repetitive trauma (overuse). Tendonitis is often confused with tendinosis, which is also a damaging of the tendon, but without the inflammation. There is significant disagreement in parts of the medical community on whether what is commonly thought of as tendonitis is actually tendonosis. This post will focus on the traditional definition, but with reservations that there is still much research to be done.
Tendonitis, like sprains and strains, can really be anywhere, wrists, elbows, shoulders, knees, etc, but for now we'll focus on maybe the most common/recognized to the average person, lateral epicondylitis. You have two epicondyles on your humerus (upper arm bone), one on the inside (medial), and one on the outside (lateral). Lateral epicondylitis is the inflammation a tendon or tendons that attach to that lateral epicondyle. It is an injury very common to racket players, but I have seen just about every walk of life come down with this, from hairdressers to weightlifters.
It is traditionally thought, and still taught, that tendonitis most frequently occurs when there is a significant change in activity level or when a normally non-painful, non-irritating motion is done so frequently that it causes irritation. An example of this is when a golfer or tennis player takes all winter off and then abruptly starts playing their sport with no warm up period. Many factory workers may encounter this when they start a new job, or switch lines, now using muscles they aren't used to using, and doing that several hundred times a day.
Rehab for tendonitis consists of protecting the injured area through rest and activity modification. Ice, especially ice massage, is a great way to reduce pain and inflammation. NSAIDs like Ibuprofen and Aleve help to reduce inflammation and to help reduce pain as well. Physical therapy will focus on gentle, non-irritating stretches to relieve tension on the affected tendon. As the symptoms lessen, gentle strengthening and gripping exercises will as focus on being primarily pain-free. Bracing can be helpful, but the research is inconsistent on just how helpful it is. Cross friction massage, while painful, helps to break up scar tissue that forms from the chronic inflammation. Therapists will work to strengthen up surrounding muscles and correct poor form with their swing if applicable. It can be a long road, but you can do it!
A consult with an orthopedic doctor may be necessary if conservative measures have failed. In this case, a cortisone injection may be helpful or some prescription level anti-inflammatory meds. Surgery is very rare and controversial, and I have only seen one case, though with a good result.
A site about the different types of tendonitis and treatment - http://www.itendonitis.com/
Another article about lateral epicondylitis - http://www.stockton.edu/ospreys/ATCommonLatEpi.htm
Tendonitis, like sprains and strains, can really be anywhere, wrists, elbows, shoulders, knees, etc, but for now we'll focus on maybe the most common/recognized to the average person, lateral epicondylitis. You have two epicondyles on your humerus (upper arm bone), one on the inside (medial), and one on the outside (lateral). Lateral epicondylitis is the inflammation a tendon or tendons that attach to that lateral epicondyle. It is an injury very common to racket players, but I have seen just about every walk of life come down with this, from hairdressers to weightlifters.
It is traditionally thought, and still taught, that tendonitis most frequently occurs when there is a significant change in activity level or when a normally non-painful, non-irritating motion is done so frequently that it causes irritation. An example of this is when a golfer or tennis player takes all winter off and then abruptly starts playing their sport with no warm up period. Many factory workers may encounter this when they start a new job, or switch lines, now using muscles they aren't used to using, and doing that several hundred times a day.
Rehab for tendonitis consists of protecting the injured area through rest and activity modification. Ice, especially ice massage, is a great way to reduce pain and inflammation. NSAIDs like Ibuprofen and Aleve help to reduce inflammation and to help reduce pain as well. Physical therapy will focus on gentle, non-irritating stretches to relieve tension on the affected tendon. As the symptoms lessen, gentle strengthening and gripping exercises will as focus on being primarily pain-free. Bracing can be helpful, but the research is inconsistent on just how helpful it is. Cross friction massage, while painful, helps to break up scar tissue that forms from the chronic inflammation. Therapists will work to strengthen up surrounding muscles and correct poor form with their swing if applicable. It can be a long road, but you can do it!
A consult with an orthopedic doctor may be necessary if conservative measures have failed. In this case, a cortisone injection may be helpful or some prescription level anti-inflammatory meds. Surgery is very rare and controversial, and I have only seen one case, though with a good result.
A site about the different types of tendonitis and treatment - http://www.itendonitis.com/
Another article about lateral epicondylitis - http://www.stockton.edu/ospreys/ATCommonLatEpi.htm
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