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How Physical Therapy Can Help Tennis Elbow

Lateral Epicondylitis, otherwise known as tennis elbow, involves the muscles in the forearm and wrist that attach to the lateral epicondyle. These muscles are designed to extend the wrist, stabilize the elbow and rotate the forearm. Although this problem can occur in anyone, it is more common with individuals that overuse their forearm muscles repetitively with motions that mimic a tennis player swinging a racquet, hence the name. Sometimes this issue can occur without cause or reason and this is referred to insidious onset. Most of the time, the cause is degenerative with micro tears of the muscle. When the extensor muscles of the forearm and wrist are weakened, very small tears in the muscle pull away from the lateral epicondyle and can cause pain and inflammation.

Many people that get tennis elbow are between 30-50 years old and do not engage in sports but have jobs that require repetitive use of the forearm such as painters, plumbers, carpenters, auto-mechanics, cooks, and butchers.

Common signs and symptoms involve pain or burning on the outer forearm with palpation or motion and weakness in grip strength. Motions that aggravate the elbow are rotation and bending the wrist back, similar to motions used by a carpenter using a wrench or a hammer, or a tennis player swinging a racquet. A doctor can use an x-ray, MRI or EMG to diagnose lateral epicondylitis. Treatment would include but is not always limited to conservative methods such as physical therapy, non-steroidal anti-inflammatories (NSAIDs), topical steroids or wearing a brace. Other treatment options can include a corticosteroid injection or sometimes surgery. The outcome of reducing pain long-term with use of corticosteroid injection has poor outcomes with pain returning about 6 months later with continued pain.

It is important for an individual to utilize conservative options prior to surgery due to the many treatment options available. Physical therapists utilize gentle exercises and stretching, joint mobilizations, massage, ultrasound, electrical stimulation, iontophoresis, ice or heat, kinesiotaping and other available treatment options to reduce pain. Patients treated in physical therapy can expect to be treated for up to 3 months and sometimes if needed up to 6 months. If left untreated, tennis elbow can lead to chronic pain and the potential need for surgery. Research shows positive outcomes with conservative treatment methods versus steroid injection or surgery, therefore physical therapy is a good treatment option prior to other treatment options.

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