Tennis Elbow (Lateral epicondylitis)
Rehab of the injury

Rehab 1 – Rehab 2 – Rehab 3 – Rehab 4

Description of Tennis Elbow (Lateral epicondylitis)

Lateral epicondylitis (tennis elbow or mouse arm) is an overload injury of the forearm extensors – most often it is the muscles extensor carpi radialis brevis (ECRB) and longus.

Due to repeated loads to their common attachment area, a common tendon at the outside of the elbow caput commune extensorum, abundant fibrous connective tissue forms in the structures with reduced fluid flow (vascularization) as a result. The injury can, as the name suggests, occur in connection with tennis games, but most often the cause is completely different. The overload of the extensor tendons is often seen in connection with office work, cleaning, gardening and factory work with a one-motion type of work

To allow a position where the wrist is in the outer position in relation to the injury, the muscles (ECRB) must be extended by approx. 1.1 cm, and only then the greatest strain on the muscle occurs. This position is equivalent to a backhand stroke in tennis and hence the name tennis elbow

In connection with external (lateral) elbow problems, there are some differential diagnoses that need to be refuted. These include injuries at the neck level (cervical disc herniation C4-C5), active trigger points in the muscle supraspinatus with reference to the lateral elbow and squeezing of the radial nerve in and around the elbow. (Radial tunnel syndrome, Nervus interosseus posterior syndrome (NIPS)).

Symptoms of Tennis Elbow(Lateral epicondylitis)
  • Point tenderness over the outermost bone protrusion on the elbow, (lateral humeral epicondyle).
  • The pain can radiate down into the forearm during and after physical activity.
  • Pain at the grip around objects (eg a coffee cup, tools etc.).
  • Pain in backward bending of the wrist.
Examinations of Tennis Elbow(Lateral epicondylitis)
  • Analysis / inspection / palpation / Motion test range of motion (ROM).
  • Sensitivity test (feeling). (n. radialis).
  • Negative tinel´s test. (6cm below for lat. Epicondyl – n. Radialis).
  • Tennis elbow test. (dorsiflexion (back flexion) of wrist against resistance).
  • Conrad´s test (coffee cup test).
  • Active trigger point in m. Supraspinatus).
  • Passive bending (palm flexion) and inward rotation (pronation) with stretched elbow
Treatment of Tennis Elbow(Lateral epicondylitis)
    • Reduce the activity that creates the load.
    • Thermo / heat therapy
    • Cryotherapy (ice on for 9 min exactly)
    • TENS of forearm flexors.
    • Massage of forearm and upper arm.
    • NSAID gel (over-the-counter) Traumeel (2 tablets 3 g. Daily for 9 days).
    • Ultrasound (continuous / pulsating), 3 Mhz, 0.5-1 W cm2
    • Compression tape at the top of the forearm.
    • Kinesiology tape
    • K-laser.
    • Elbow and forearm stretching 10 times daily.
    • Possibly. surgery (approximately 5-10%) where the muscles are moved from the epicondyle and further down the forearm.
    • Tennis elbow bandage.
    • Wrist tape / splint.
    • Use outward rotation (supination) during lifting.
    • Deep transverse massage to the insertion site (on the tendon at the elbow)
    • Spascupreel (2 tablets 3 g. Daily for 9 days).
    • When acute pain has disappeared, rehab 1 begins

Rehabilitation program for hand and arm (this can aggravate the injury the first 7 – 10 days).

  • Possibly an interval program for resuming the sport.
  • Possibly replacement of equipment or tools.
Rehab of the injury

Rehab 1 – Rehab 2 – Rehab 3 – Rehab 4