PODCAST – Tennis Elbow


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Study Guide

Short Answer Quiz

Instructions: Answer each question in 2-3 sentences.

  1. What is the difference between lateral epicondylitis and lateral epicondylosis?
  2. What muscles contribute to the common extensor tendon?
  3. How can gripping an object contribute to tennis elbow?
  4. Describe the typical pain presentation of a person with tennis elbow.
  5. Why is the extensor carpi radialis brevis often the most affected muscle in tennis elbow?
  6. What assessments can a therapist use to diagnose tennis elbow?
  7. Describe the key manual therapy techniques used to treat tennis elbow.
  8. What is the purpose of deep cross-fiber friction techniques like Graston in treating tennis elbow?
  9. Explain the importance of self-care in managing tennis elbow.
  10. What medical interventions are commonly employed for tennis elbow when conservative treatment fails?

Answer Key

  1. Lateral epicondylitis involves inflammation of the common extensor tendon at the lateral epicondyle, while lateral epicondylosis refers to the degeneration of the tendon in later stages when swelling subsides.
  2. The muscles that contribute to the common extensor tendon are the extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris.
  3. Gripping requires isometric contraction of the wrist extensors, particularly the extensor carpi radialis brevis, to stabilize the wrist against the flexing force of the finger flexors. Prolonged gripping can lead to overuse and strain in these muscles, contributing to tennis elbow.
  4. Individuals with tennis elbow typically experience pain and tightness on the lateral side of the elbow, just distal to the lateral epicondyle. The pain worsens with activities involving wrist and finger extension, gripping, and sometimes even with passive wrist flexion.
  5. The extensor carpi radialis brevis is crucial for stabilizing the wrist during gripping activities, making it particularly susceptible to overuse and strain in tennis elbow.
  6. Therapists can assess tennis elbow through active and passive range of motion testing of the wrist and fingers, manual resistance testing, and palpation of the common extensor tendon and lateral epicondyle.
  7. Key manual therapy techniques for tennis elbow include fascial spreading, longitudinal and cross-fiber strokes, pin and stretch, joint mobilization of the carpals, and addressing potential contributing factors in the neck, upper back, and shoulder.
  8. Deep cross-fiber friction aims to create controlled inflammation in the degenerated tendon. This attracts fibroblasts to the area, promoting collagen synthesis and facilitating tissue repair.
  9. Self-care is crucial for managing tennis elbow. This includes avoiding aggravating activities, regularly stretching the wrist and finger extensors, applying ice for inflammation, and using ergonomic modifications like wider pens with rubber grips to reduce strain during gripping tasks.
  10. Medical interventions for tennis elbow may include prescription anti-inflammatory medications, cortisone injections, prolotherapy injections (including PRP), and in severe cases, surgical debridement of degenerated tissue or tendon repair.

Essay Questions

  1. Discuss the biomechanics involved in the development of tennis elbow, explaining how both repetitive microtrauma and macrotrauma can contribute to this condition.
  2. Elaborate on the role of wrist extensor muscles in stabilizing the wrist joint during gripping activities and how this contributes to the development of tennis elbow.
  3. Compare and contrast the manual therapy and medical approaches to treating tennis elbow, highlighting the strengths and limitations of each approach.
  4. Describe a comprehensive rehabilitation program for a patient with tennis elbow, including the different stages of recovery and the rationale behind each intervention.
  5. Explain how patient education and self-care strategies are essential components in the successful management of tennis elbow and the prevention of recurrence.

Glossary of Key Terms

  • Lateral Epicondylitis: Inflammation of the common extensor tendon at its attachment on the lateral epicondyle of the humerus, commonly known as tennis elbow.
  • Lateral Epicondylosis: Degeneration of the common extensor tendon at the lateral epicondyle, often occurring in later stages of tennis elbow after inflammation has subsided.
  • Common Extensor Tendon: A tendon on the lateral side of the elbow where several wrist and finger extensor muscles originate.
  • Myofascial Trigger Points (TrPs): Hyperirritable spots within a muscle or its fascia that can produce pain locally and refer pain to other areas.
  • Isometric Contraction: A type of muscle contraction where the muscle length remains constant while tension increases.
  • Concentric Contraction: A type of muscle contraction where the muscle shortens while generating force.
  • Eccentric Contraction: A type of muscle contraction where the muscle lengthens while generating force.
  • Fibroblasts: Cells responsible for producing collagen and other components of the extracellular matrix, crucial for tissue repair.
  • Prolotherapy: An injection-based therapy that aims to stimulate the body’s natural healing process by inducing a mild inflammatory response.
  • Platelet-Rich Plasma (PRP): A component of blood that contains a high concentration of platelets, growth factors, and other bioactive proteins that promote tissue healing.