Arm, Elbow, Wrist & Hand Injuries/Conditions

lateral epicondylitis

Printed From: CyberPT - Your Online Physical Therapy Resource
Category: Patient Forum
Forum Name: Arm, Elbow, Wrist & Hand Injuries/Conditions
Forum Description: Patients can post questions and experiences about arm, elbow, wrist & hand injuries/conditions.
URL: http://www.cyberpt.com/ptforum/forum_posts.asp?TID=177
Printed Date: Nov 26 2024 at 11:09pm
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Topic: lateral epicondylitis

Posted By: Ask a PT
Subject: lateral epicondylitis
Date Posted: Jul 08 2008 at 5:06pm

Ask a PT

156 Posts

Posted - 06/23/2008 : 13:51:48 Show Profile Reply with Quote
Our user asked: "I have tennis elbow. I've already gone to the orthopedic doctor and was diagnosed. I haven't played tennis in 10 weeks. This problem has been off and on for a year. I've had 2 cortizone shots, PT and now rest. I am currently wearing a wrist splint to limit wrist movement. I haven't gone to a PT yet because of insurance. I am wondering if I can do the exercises I know already (from previous PT)even though my elbow is still tendor. Since the splint (2 weeks) there has been an improvement. The pain is less spread out and just located on that one spot. I'm worried that any exercises while still sore is contraindicated. I stretch, ice message, use heat and massage regularly. I have access to a theraband and weights/machines at my fitness club. I am familiar with a variety of excercises just wondering when I can start strengthening."

Ask a PT Response: "It sounds like you are doing the proper things and things are coming along. The worst thing for you to do would be to do too much too soon, especially since your condition is improving. What I generally would do for my patients with your condition would be to prescribe gentle isometric strengthening exercises (Isometric exercises are a type of strength training in which the joint angle and muscle length do not change during contraction). These exercises will assist a patient in helping to maintain strength and hopefully not result in further irritation of the the affected muscle(s)/tendon(s). (ie. isometric wrist ext- putting one hand on top of the other hand and using the hand which is on the bottom, contract your wrist muscles and push up on to the top hand, no movement should occur with the wrist which is contracting). Once my patient's pain levels has reduced and condition has improved, I will then progress to isotonic strengthening with light weights or resistive strengthening with a light tensile thera tubing. Pain is always a factor- if there is moderate to high levels of pain experienced when or after performing the strengthening exercises, the weight is either reduced or the exercise stopped until the patient can work up to the weight or exercise. Good luck with your rehabilitation and thanks for using CyberPT."

Replies:

Posted By: Ask a PT
Date Posted: Jul 08 2008 at 11:32pm

Our user asked: "

thank you. I will start doing some of the isometric stuff right away. I'm still getting a little pain when I extend my wrist while my elbow is straight but not when it's bent at 90 degree angle. No pain during flexion or pronation or supernation.

What about deep massage with a massage therapist? I found massaging on my own really helped but it would be a lot easier to have someone else do it. When I massage I dig in there and get those trigger points then ofcourse I ice immediately afterwards. That type of massage I doubt I'd get through PT ( at least I hadn't in the past)."

Ask a PT Response: "The wrist extensors are usually involved with tennis elbow. Therefore, it would not be unusual to experience some pain with active wrist extension with your elbow straight. Soft tissue mobilization or myofascial release is an appropriate treatment option when treating tennis elbow. These forms of manual therapy are in my treatment plan when treating patients with this condition. However, each therapist has his or her own treatment approach and that may be why you may not have received the manual therapy in the past. I hope things continue to improve for you. Thanks again for using CyberPT."