Lateral Epicondylitis

by Keith Weinhold - Date: 2006-12-27 - Word Count: 378 Share This!

A common injury of the elbow is lateral epicondylitis or "tennis elbow." This problem is seen in people who perform repetitive motion activities with overuse of the wrist and elbow. Contributing factors may include increased forces for lifting or grasping or significant increase in repetitions over a short period of time. Some degree of underlying muscle flexibility and strength problems are usually present before onset of this problem.

Lateral epicondylitis is microtrauma and subsequent inflammation to the tendon area of the wrist extensors. It is characterized by a gradual or rapid onset of painful gripping, tenderness over the lateral aspect of the elbow and pain with stretching of the wrist extensors. Testing of the wrist and elbow will reveal pain with resisted wrist extension, pain with passive stretching into a flexed position of the wrist and pain with palpitation of the lateral epicondyle area. Careful examination must be used to rule out other painful conditions that may cause similar symptoms.

Conservative treatment is usually preferred for this problem. Symptom control may be attained through NSAID's and physical agents such as ice, iontoresis, or phonophoresis. Bracing the wrist may be used in some cases to limit the stresses contributing to onset. Activity modification must also be incorporated to avoid inflammation-increasing activities. In chronic conditions, cross-friction massage may be used at the lateral epicondyle to break up scar tissue and prevent calcification of the tendon.

Once symptoms have been controlled, a regime of exercises may be incorporated into the rehabilitation process including strengthening exercises of the wrist and finger extensors as well as grasping. These strengthening exercises should include eccentric and concentric muscle contractions. In the beginning, repetitions should be high and resistance low. Postural reeducation and instruction in proper lifting technique should also be a part of the plan of care. Ultimately, there may need to be some modification in the activities that contributed to the onset of symptoms. This can be accomplished through ergonomic evaluation or appropriate instruction in different techniques to perform the activity.

Early detection, thorough examination, careful control of the inflammatory phase, and long-term strengthening and activity modification are essential in the care of lateral epicondylitis. If all of these steps are followed, lateral epicondylitis is a manageable and treatable problem. Contact Excel Physical Therapy for more information.

Related Tags: excel, injury, therapy, rehabilitation, nebraska, omaha, physical, lateral, epicondylitis

Keith Weinhold is a Physical Therapist a Excel Physical Therapy of Nebraska. To register for a FREE newsletter, visit

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