FEATURED TOPIC - TENNIS ELBOW

Lateral epicondylitis, also known as 'Tennis Elbow' is a common ailment amongst far more than just tennis players. The causes of tennis elbow are many and varied, with tennis actually being on of the lesser common. This installment of the Featured Topic includes two articles on the subject from our content partners. On this page you will find Article 2, which deals more with the many potential causes of tennis elbow.

ARTICLE 2: TENNIS ELBOW QUIZ


Tennis Elbow Answer

  1. Direct Blunt Trauma
    Direct blows may cause inflammation of the tendon or the myotendonous junction. These are perhaps the easiest of the etiologies to treat. Unfortunately it is also probably the least common.


  3. True overuse
    Unfamiliar or non-routine overuse, routine overuse after time off, change of tool, change of working position etc. are all possible causes of tennis elbow. To determine this etiology takes careful questioning and a skeptical attitude, as there is a real urge to take the easy solution. Again treatment is relatively easy. The patient changes what they are doing or how they are doing it and the therapist treats the local pathology.


  5. C5/6 biomechanical dysfunction
    This has been postulated to cause tennis elbow or tennis elbow type pain in a variety of ways. These include:
    • Pain referral: A careful scanning examination may reveal the presence of a small palsy. Sensation testing in particular may help, demonstrating hypoesthesia in the C5 or 6 dermatome.
    • Interruption of axoplasmic flow and consequent tropic malnutrition and increased vulnerability to otherwise innocuous stresses: Much more difficult to demonstrate and it may be possible only by excluding other possibilities. There should be a biomechanical dysfunction at C5/6 and there may be evidence of segmental facilitation.
    • A minimal palsy resulting in either weakness and/or neuromuscular incoordination and subsequent tendon injury: See a.
    • Segmental facilitation with hypersensitivity of the tenoperiosteal attachment: There will be a biomechanical dysfunction at C5/6. There should also be hypertonicity in the local spinal muscles and possibly in those muscles derived from this segment particularly the wrist extensors. Also look for hyperesthesia in the dermatome. A quick test is to retest the positive isometric wrist extension with the head held in varying positions. If there is a complete relief of pain when the head position is altered, there is no local pathology and segmental facilitation is the sole cause of the pain. More usually however, there is partial relief of pain indicating segmental facilitation combined with local pathology.

Continue to answers 4-6

 

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