Elastic Elbow
Tennis Elbow
Symptoms
The elbow pain outside (lateral epicondyle).
Point tenderness over the involved epicondyle important to the bone on the outside of the elbow.
Gripping and movements of the wrist hurt, especially wrist extension and lifting movements.
Activities in which the muscles that extend the wrist (for example, pour a jar or a gallon of milk, lifting with the palm facing down) are typically painful.
Morning stiffness.
Etiology
The risk factor is age epicondylitis. The peak incidence is between 30 to 60. No differences in incidence between men and women or the association between tennis elbow and hand dominance has been demonstrated.
The pathophysiology of lateral epicondylitis is degenerative. No inflammatory changes chronic degenerative origin extensor carpi radialis brevis (ECRB) muscle samples are identified in surgical pathology. It is unclear whether the disease is affected by previous injection of corticosteroids.
Among the tennis players, is believed to be caused by "the repetitive nature of hitting thousands of balls tennis that lead to small tears in the tendons of the forearm occurs in the elbow.
Pinky extender The site also has a small medial elbow origin may be affected by this condition. Muscular involves expanding the fifth finger and wrist extension that allows the adaptation of a nap or watch the wrist usually associated with a racket swing. In most cases, the extensor muscles become painful due to the decomposition of the tendon over-extension. form Incorrect or movement can be a boost to turn around and around the wrist to create a moment in this county instead of the elbow or rotator cuff. This results time of increasing pressure of impact forces to act on the tendon causes irritation and inflammation.
The following argument is offered by developers speculative [who?] In theory the excessive use of pain: The extensor carpi radialis brevis has a small house and do not transmit large forces through tendon during repetitive writing. It has also been implicated as vulnerable in the shear stress on all movements of the forearm.
While it is commonly said that tennis elbow is caused by repetitive stress / burnout, is a speculative theory etiology with limited scientific support is probably exaggerated. Other Risk factors for lateral epicondylitis include speculative taking tennis later in life, unaccustomed vigorous physical activity, reduced reaction time and speed and repetitive eccentric muscle contractions (controlled lengthening of a muscle group).
Exams and Tests
Diagnosis is made by signs and symptoms, which tend to both discrete and features. Must be a sensitive point in the origin of the extensor carpi radialis muscle epicondyle Side (original CERC). It should also be pain and passive wrist flexion with wrist extension against resistance (Cozen test), both tested with elbow extended.
A simple test at home can do to determine if you have a tennis elbow. Stand behind a chair, put his hands on the chair back with palms down, and try to raise the chair. If this causes pain on the outside of the elbow, the culprit is more likely that tennis elbow.
MRI usually show fluid in the original CEF. It can also be a defect in this tissue. Use the word "tear" to refer to this defect can be misleading. The word "tear" means damage and needed repairs probably inaccurate and inadequate for this degenerative enthesopathy.
Depending on the severity and number of injuries the tendon that build small, CERC may not be able to heal completely. Nirschl defined four stages of lateral epicondylitis, which shows the establishment of game damage permanent in step 2. The steps are:
Inflammatory changes are reversible
cause pathological changes irreversible muscle CERC
The rupture of origin CERC muscle
minor changes such as fibrosis or calcification
Treatment
In generally, the evidence base for intervention is low.
the non-specific palliative treatments include:
Nonsteroidal antiinflammatory drugs (NSAIDs): ibuprofen, naproxen or aspirin
Heat or ice
The contra-clamp or "tennis elbow strap" to reduce tension on the lateral epicondyle of the elbow to reduce pain and provocation to protect against further damage.
The treatment of vibration can be used to relieve pain and inflammation with the local treatment of vibration devices (Tenease) available for domestic use.
Rest is the tennis player of choice treatment when pain first appears, the rest leave small tears the insertion of the tendon to heal. Tennis players treat severe cases of ice (although the effectiveness of ice in clinical research question) anti-inflammatory drugs, soft tissue massage, stretching and ultrasound therapy.
In recalcitrant cases, surgery may be indicated. Many techniques have been described with open approaches, percutaneous or arthroscopic. Most techniques to relieve tension in the radial extensor muscle brevis, degenerative remove tissue and promote healing.
Other treatments with limited scientific support include:
Acupuncture
injection blood (possibly supplemented by apheresis)
Botulinum toxin
extra-corporeal shock wave (lithotripter)
Thermotherapy
Immobilization forearm and elbow with a splint for two to three weeks
Local injection of cortisone and anesthetic
Low level laser therapy
Occupational therapy especially for stretching and strengthening the extensor muscles of the wrist.
Physiotherapy
platelet-rich plasma
pulses of ultrasound to break the fabric scar, promote healing and increase blood flow in the region
Sclerotherapy
Trigger Point Therapy
Clinical trials addressing many of the proposed curative treatment, but the quality of these trials is generally poor.
A study says that acupuncture combined with electrical stimulation is beneficial, but evaluation studies are inconclusive.
A recent presentation at a scientific meeting Twist describes the protocol of Tyler, an intervention physiotherapy. Although the study has not yet issued a check to the allegations in the newspaper.
Cortisone injections
In four trials comparing corticosteroid injection to placebo (lidocaine) injection showing no effect of steroids. Complications of repeated steroid injections include skin problems such as hypopigmentation and atrophy of fat.
And stretching exercises
There are several recommendations for prevention, treatment and prevention of recidivism are largely speculative, including:
Progressive stretching and strengthening exercises to prevent irritation of the tendon again;
Gradual strengthening involving the use of weights or elastic Theraband to increase pain free grip strength and forearm strength;
Players Sports snowshoes are also often are invited to strengthen the rotator cuff, scapulothoracic and abdominal muscles by Physiotherapists to help reduce any overcompensation in the extensor of the wrist during gross shoulder and arm movements;
soft tissue release or simply Massage can help to reduce muscle tension and reduce stress on the tendons and
Strapping the forearm can help realign the muscle fibers and redistribute the load.
The use of a racket designed to cushion the effect of fire.
There is little evidence to support the value of these interventions for prevention, treatment or prevention of recurrent epicondylosis side.
See also
Golfer's elbow
The RSI
Radial tunnel syndrome
References
^ Tennis elbow, cricketers and even household can obtain, an article in the Times of India dated September 4, 2004
^ abc What is tennis elbow? BBC Sport Academy website
^ F. Runge zur Genese und Behandlung in Schreibekrampfes. Berliner Klin Wochenschr. 1873, 10:245248.
^ Top of HP. "Lawn-Tennis Elbow." BMJ. 1883, 2:557.
^ Kaminsky SB, Baker CL (December 2003). "Lateral epicondylitis of the elbow. Surgical techniques of superior hand and 7 (4): 17,989. Doi: 10.1097/00130911-200312000-00009. PMID 16518219.
Abc ^ Boyer MI, Hastings H (1999). "Lateral tennis elbow:" Is there no science "Journal of shoulder surgery?. And elbow 8 (5): 48,191. doi: 10.1016/S1058-2746 (99) 90081-2. PMID 10543604.
Tennis Elbow ^ MedlinePlus Medical Encyclopedia
^ EMedicine from WebMD
L ^ Bisset, Paungmali A, B Vicenzino, E Beller (July 2005). "A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylitis lateral "British Journal of Sports Medicine 39 (7):. 41122, 41122 discussion doi: 10.1136/bjsm.2004.016170 PMID 15976161 …
^ relief of pain by stimulating vibration, Lundeberg et al, The Journal of Pain, 1984
^ P Manias, Stasinopoulos D (January 2006). "A pilot controlled clinical trial testing the effectiveness ice as a supplement to the exercise program for the management of lateral elbow tendinopathy "British Journal of Sports Medicine 40 (1): .. 815 doi:. 10.1136/bjsm.2005.020909 PMID 16371498.
^ How to treat tennis elbow from the BBC website Sport Academy
Safran MR ^ I MI. Surgical treatment of epicondylitis side: a systematic review. Clin Orthop Relat Res 2007; 463.98 to 106.
^ Mishra A, T Pavelka (November 2006). "The treatment of chronic tendinitis the elbow with platelet-rich plasma buffer. The American Journal of Sports Medicine 34 (11): 17,748. doi: 10.1177/0363546506288850. PMID 16735582.
^ J Cowan, S Lozano-Calderón, D-rings (August 2007). Quality of Prospective randomized controlled trials. Analysis of trials of treatment for lateral epicondylitis as an example "The Journal of Bone and Joint Surgery 89 (8): 16. 939 doi:. 10.2106/JBJS.F.00858 PMID 17671006 ..
^ Jiang ZY, Li CD, Guo JH, Li JC, Gao L (November 2005). observation [Controlled electro-separated moxibustion combined with the cake for the treatment of epicondylitis] "(in Chinese). Zhongguo Zhen Jiu 25 (11): 7634. PMID 16335198.
↑ New York Times article with the video Tyler Twist of the Protocol.
^ Haines T, Stringer B (April 2007). "Corticosteroid injections or rehabilitation were not more effective to wait and see for tennis elbow in one year on Evidence-Based Medicine 12 (2): 39. doi:. 10.1136/ebm.12.2.39 PMID 17400631 ..
Stasinopoulos ^ D, Stasinopoulou K, Johnson MI (December 2005). "An exercise program for the management of lateral elbow tendinopathy. British Journal of Sports Medicine 39 (12): 9447. doi: 10.1136/bjsm.2005.019836. PMID 16306504.
More
Wilson, the best MC (September 2005). "Common problems the overuse of the tendon: A review and recommendations for treatment, "American Family Physician 72 (5):. PMID 16156339 http://www.aafp.org/afp/20050901/811.html 8118 …
EV
Soft tissue disorders / arthritis / arthropathy, connective tissue (M65-M79, 725 to 727)
Capsular
Synoviopathy
Synovitis / Tenosynovitis (Calcific tendinitis, stenosing tenosynovitis, de Quervain's syndrome Finger) ganglion transient synovitis
osteochondromatosis (synovial osteochondromatosis) plica syndrome
villonodular synovitis (giant cell sheath tumor of the tendon)
Bursopathy
Bursitis (Olecranon, prepatellar, subacromial trochanteric), cysts (cyst Baker)
No capsular
Fasciopathy
Fasciitis: Plantar necrotizing eosinophilic nodular
Fibromatosis / contracture
Peyronie's Disease Dupuytren's contracture, plantar fibromatosis aggressive fibromatosis knuckle pads
Tendinopathy /
Enthesopathy / enthesitis
upper limb (shoulder capsulitis, rotator cuff, golfer's elbow, tennis elbow)
the lower extremities (iliotibial band syndrome, patellar tendinitis, Achilles tendinitis, heel spurs, metatarsalgia) bone spur
Other / General tendinitis tendinosis
common navigation systems: Anat, non-congenital joint disease / strain / dorsopathies / arthropathy, soft tissue, congenital signs of the same name, proc
Navigation DRCT + muscular system DF: Anat / hist / physiological, genetic or acquired myopathy myopathy / neoplasia, symptoms, signs + / proc with the same name
EV
Inflammation
Acute
Plasma derived mediators
Bradykinin complement (C3, C5a, MAC) coagulation (Factor XII, Plasmin, Thrombin)
Derived cell mediators
preformed: Lysosome granules vasoactive amines (histamine, serotonin)
synthesized on demand: cytokines (IFN-, IL-8, TNF, IL-1) eicosanoids (Leukotriene B4, Prostaglandins) Nitric oxide Kinins
Chronicle
Macrophages, epithelioid cell granuloma giant cell
Process
Traditional: Pain Heat Redness tumor (pain) Laes functionalist
Modern acute phase reaction or fever vasodilatation increases vascular permeability exudate Chemotaxis leukocyte extravasation
specific types
Nervous
Central nervous system (encephalitis, myelitis) Meningitis (Arachnoiditis) SNP (neuritis), eyes (Dacryoadenitis, scleritis, keratitis, choroiditis, retinitis, chorioretinitis, blepharitis, conjunctivitis, iritis, uveitis) ear (otitis, labyrinthitis, mastoiditis)
Cardiovascular
Carditis (Endocarditis, Myocarditis, Pericarditis) Vasculitis (arteritis, phlebitis, capillaritis)
Respiratory
upper (sinusitis, rhinitis, pharyngitis, laryngitis) minus (tracheitis, bronchitis, bronchiolitis, pneumonia, pleurisy) mediastinitis
Digestive
the mouth (stomatitis, gingivitis, stomatitis, glossitis, tonsillitis, Sialadenitis / mumps tract, cheilitis, pulpitis, Gnathitis) (esophagitis, gastritis, gastroenteritis, enteritis, colitis, enterocolitis, duodenitis, ileitis, Caecitas, Appendicitis, Proctitis) accessory (Hepatitis, cholangitis, cholecystitis, pancreatitis) peritonitis
Integumentary
Hidradenitis Cellulite Dermatitis (Folliculitis)
Musculoskeletal
Arthritis Dermatomyositis soft tissue (Myositis, Synovitis / tenosynovitis, bursitis, enthesitis, fasciitis, capsulitis, epicondylitis, tendinitis, panniculitis)
Osteochondritis, osteitis (spondylitis, periostitis) chondrite
Urinary
Nephritis (Glomerulonephritis, pyelonephritis) Ureteritis Cystitis Urethritis
Reproduction
Women: Salpingitis Endometritis oophoritis parametritis cervicitis vaginitis vulvitis mastitis
male: Orchitis Epididymitis Prostatitis Balanitis Balanoposthitis
pregnancy or the newborn: Chorioamnionitis Omphalitis
Endocrine
Insulitis hypophysitis Parathyroiditis thyroiditis adrenalitis
Lymphatic
Lymphangitis Lymphadenitis
Categories: Inflammations | Overuse injuries | Tennis terminology categories soft tissue disordersHidden |:: Portal Tennis / Total | All articles marked with phrases written specifically weasel | Articles with weasel specifically marked phrases written in March 2009 About the Author
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