Tennis Elbow Management
Original Editor - Mariam Hashem
Top Contributors - Mariam Hashem, Kim Jackson, Tarina van der Stockt, Robin Tacchetti, Tony Lowe and Jorge Rodríguez Palomino
Frame work for rehab[edit | edit source]
Management of tennis elbow (Lateral Epicondyle Tendinopathy) is similar in concept and approach to tendon rehabilitation. For the benefit of achieving long term goals, rehabilitation should be a multi-modal perspective and also to meet individual needs. We explored the different causes and associations of Tennis Elbow in the assessment course including, central sensitization, muscle and tendon structural changes and mechanical abnormalities. Hence, there is a need to examine all these aspects in the history taking and objective examination and consider them when designing a rehabilitation programme.
The use of multimodal care has been found to be effective in the management of Lateral Epicondyle tendinopathy[1]. This includes education, exercises, tissue loading management, manual therapy and steroid injection. All of thhese management strategies can be used and tailored depending on the patient's needs, the clinician's clinical reasoning and a shared decision between patient and clinician.
Patient education[edit | edit source]
Educating patiens on their condition, prognosis, management options and self-management may not be effective on the short term and cannot be used as a stand alone measure. However, it has a good long-term effect if used in cobination with other measures for the management of Tennis Elbow[2].
Patient education is defined as ''a planned learning experience using a combination of methods such as teaching, counselling, and behaviour modification techniques which influence patients’ knowledge and health behaviour''[3]. Educating patients on their needs for management helps in reaching a shared-decision, stimulating patient's compliant to treatment and improving self-efficacy[4].
Load management[edit | edit source]
Reduction of load on the tendon is an effective pain management strategy which has to go hand in hand with building tissue resilience to allow for gradual progression to target load by retraining the mechanical properties of the tendon. A good way of altering the load is to ask patient to work under pain threashold on a numerical scale from 1-10 and loading the tendon under the level of exaggerated pain[5].
Pain and swelling will occur in response to increased load- this phase is known as ''reactive tendinopathy''. Reducing pain is essential in this phase by pain management measures and de-loading. Identifying the contributing factors to pain and tendinopathy can help in modifying the loads on the tendon. These factors include sudden increase in load or it can mean applying changes to the way a player holds a tennis raquet or a person lifting an object.
Exercises[edit | edit source]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748997/
Pain management[edit | edit source]
MWM[edit | edit source]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1633771/
Steroid injection[edit | edit source]
Taping[edit | edit source]
Recurrence[edit | edit source]
References[edit | edit source]
- ↑ Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333(7575):939. doi:10.1136/bmj.38961.584653.AE
- ↑ Randhawa K, Côté P, Gross DP, et al. The effectiveness of structured patient education for the management of musculoskeletal disorders and injuries of the extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. J Can Chiropr Assoc. 2015;59(4):349–362.
- ↑ training physiotherapy students to educate patients: a randamized controlled trial
- ↑ Ndosi M, Johnson D, Young T, et al. Effects of needs-based patient education on self-efficacy and health outcomes in people with rheumatoid arthritis: a multicentre, single blind, randomised controlled trial. Ann Rheum Dis. 2016;75(6):1126–1132. doi:10.1136/annrheumdis-2014-207171
- ↑ Load management in tendinopathy: Clinical progression for Achilles and patellar tendinopathy
