What is epicondylitis and how does it appear?
Lateral epicondylitis or “tennis elbow” is a degenerative process that is generated in the lateral epicondyle of the radius, due to excessive use of the epicondylar musculature. This disorder is caused by microtrauma in the proximal insertion of the wrist extensors, which cause a vascular phenomenon of abnormal repair. There is often a history of repetitive activities for the patient, which are often related to their occupation. (Chaustre Ruiz DM, 2011)
The pain is usually localized to the epicondyle, but in severe cases it can radiate widely. Pressure pain in the epicondyle, resisted wrist extension and stretching of the epicondylar muscles are typical. It is a pathology that presents a great demand for care, with a prevalence of 4-7% and occurs mainly between 30 and 50 years of age without prevalence of sex. The diagnosis is eminently clinical, and a logical management that is based on the reduction of repetitive activity and physical means. In the field of tennis, up to 50% of all players also experience some form of elbow pain, with 75 to 80% of these ailments attributable to lateral epicondylalgia.
Lateral epicondylitis commonly affects the tendon of the extensor radialis longus carpus muscle or the tendon of the common extensor of the fingers. In the diagnosis of work-related lateral epicondylitis, the history of activities or occupations that cause pain in the lateral part of the elbow in the patient should be considered.
Why does it cause pain and what is its injury mechanism?
The physical load factors commonly involved in elbow tendinopathies are repetition, strength, and posture. Repetition includes work activities involving flexion and extension, cyclic pronation and supination of the elbow, and wrist extension and flexion that generates loads to the elbow and forearm region. Strength is exposure to strenuous work, involving the extensor or flexor muscles of the forearm, which generates loads on the elbow and forearm. The elbow posture is given by the activities or professions that require an action of flexion and extension, pronation and supination of the forearm either individually or in combination with the extension and flexion of the wrist. (Gómez Vélez DF, 2012)
The existing literature establishes a relationship between the handling of tools weighing more than 1 kg, handling weighing more than 20 kg at least 10 times a day and repetitive movements for more than 2 hours a day and the appearance of lateral epicondylitis. (Van Rijn et al, 2009)
What are the most common symptoms?
There are some characteristic symptoms, which may make you suspect suffering from epicondylitis:
Functional impotence when extending the wrist and supinating the forearm.
Pain of great intensity in the outer part of the elbow.
Pain when palpating the area of the epicondyle.
Pain with movements that involve a load. Also, in professionals, when making backhand movements in tennis or paddle.
Pain that does not remit or with rest, local cold or anti-inflammatory.
Telerehabilitation as a means to treat lateral epicondylitis
We could talk about the surgical treatment that epicondylitis has when conservative treatment is not effective or the infiltrations that are used to alleviate the symptoms of the pathology but, as always, from TRAK we are going to focus on the therapeutic exercise treatment that can be performed to relieve and lead epicondylitis to healing.
Manual therapy and eccentric strength training are the two methods of physiotherapeutic treatment that present greater beneficial effects and, in addition, their cost-benefit ratio is very favorable. (Landesa-Piñero, 2022)
5 FOOLPROOF TRAK EXERCISES FOR THE SLC
Here we present the 5 exercises of our platform most used by our physiotherapists when treating Whiplash:
1. Stretching for epicondylitis
2. Self-resisting eccentric
3. Eccentric with dumbbell