What is it? Lateral epicondylitis is inflammation and micro trauma of the wrist extensor muscles caused by muscle overload and/or repetitive strain. Muscle strain and inflammation are often caused by poor biomechanics of sport (commonly tennis) or ergonomics (computer work).
Clinical Diagnosis
1) Pain with of specific wrist extensor muscles.
2) Pain with passive stretch to wrist extensors with elbow extended.
3) Pain palpation of proximal wrist extensor muscle belly at lateral forearm and/or its attachment at the lateral elbow.
Treatment Phase (Treatment goals)
Phase 1 (Control applied loads/Promote healing)
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Rest from activities that aggravate (computer work, gripping with palm down, sports).
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Elbow splint; functional wrist bracing; forearm band.
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Decrease pain/inflammation/edema via ice, compression, non-steroidal anti-inflammatories (oral or injection).
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Gentle stretching of wrist extensors first with elbow bent, then with elbow straight.
Phase 2 (Regain ROM)
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Use of heat modality prior to activity to increase circulation, decrease muscle stiffness.
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Continue wrist extensor stretching.
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Strengthen wrist flexors, pronators. Strengthen shoulder and elbow joint muscles at first avoiding end range elbow extension.
Phase 3 (Regain Strength)
Take a look at this video clip of the view from the first lookout point.
Illustrated here are wrist extension, wrist flexion and pronation/supination respectively with 2# weight.
(Must be a Road Runner Hawaii Customer to View Video)
Phase 4 (Return to Activity/Prevention of Reoccurrence)
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Sports specific training. Including eccentric training of wrist and elbow joint muscles.
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Biomechanical or ergonomic assessment and alteration if necessary.
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Maintenance exercises for flexibility and strength.
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