Lateral Epicondylitis Rehabilitation (PowerPoint)

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By Christina Davis, Adam
Griffiths, and Tyler Smith
   What is Lateral Epicondylitis?
   Who gets it?
   Pathomechanics
   Injured Athlete
   Functional Tests
   Rehabilitation Program
   Prevention
   Questions
             What is Lateral
   Lateral epicondylitis
    (a.k.a Tennis Elbow)
    is a degenerative
    condition of the
    tendon fibers that
    attach on the bony
    (epicondyle) on the
    outside (lateral side)
    of the elbow. The
    tendons involved are
    responsible for
    anchoring the
    muscles that extend
    or lift the wrist and
    Who gets it ? Mechanism of
   Tennis elbow occurs as a result of repeated
    extension (bending back) of the wrist against
    resistance. This may be from activities such as
    tennis, badminton or squash but equally from
    activities such as brick laying, excessive use of
    a screwdriver and computer typing.
   Repetitive forceful
    forearm supination
    and pronation
   Overuse or weakness
    of the extensor carpi
    radialis brevis and
    longus muscles
   The extensor tendons
    become damaged
    when they roll over
    the lateral epicondyle
   Contributing factors-
    poor technique, weak
    shoulder and wrist
             Injured Athlete
   After taking a few years
    of rest, Anna Kournikova
    has decided to return to
    pro tennis. After a
    month of vigorous
    training Anna begins to
    experience an irritating
    pain on the lateral side
    of her elbow. She is
    referred to expert
    rehabilitation specialists,
    Christina, Adam, and
        Functional Tests
   1)Mills' test
   Positive signs are pain and weakness
   2)Tennis elbow test
   Positive signs are pain and weakness
Goals of Rehab program
   Reduce pain and inflammation.
   Identify possible causes of injury.
   Stretching and strengthening.
   Gradual return to activity
Rehabilitation Program
                         Day 1
   NSAIDs (Non- Steroidal Anti-Inflammatory Drugs)
   Ultra sound – Continuous 3MHz
   Massage Therapy- heats up the area, reduces friction
   Ice -15 minutes on, off for 15, up to 6 times a day
   Stretching
   Maintain Cardio
   Exercises – no weight – Light practice – Avoid Backhand
   Taping/ Bracing during activity
                   Day 8
   Ultra sound – Continuous 3MHz
   Teach Self-massage method
   Maintain Cardio
   Stretching before/ after practice
   Exercise- Increased weight – 3lbs
   Use of Wrist Roller
   Practice- Avoid Backhand
   Ice after activity
   Taping/ Bracing
   Avoid actions that trigger pain
                  Day 14
   Ultra sound – Continuous 3MHz
   Self- massage
   Maintain Cardio
   Stretching before/ after practice
   Exercise – Increased weight – 5lbs
   Increased Practice Intensity
   Ice after activity
   Taping/ Bracing
   Avoid actions that trigger pain
                    Day 21
   Pain is gone
   Continue Strength Exercise/
   Ice after game/practice
    when soreness occurs
   Use taping/ bracing
   Return to Play

*Use of Acupuncture or
  Cortisone shot if condition
  does not get better
   Tweak technique – Use entire body
    instead of just wrist when using
    backhand stroke
   Use a brace
   Use lighter racket
   Continue stretch/ strengthening