Common Extensor Origin (Tennis Elbow)

AbstractLateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30–68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.

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“Tennis Leg”: A State-of-the-Science Review

Workplace Health & Safety ◽

10.1177/2165079920961966 ◽

2021 ◽

pp. 216507992096196

Author(s):

Sandra J. Domeracki

Keyword(s):

Web Of Science ◽

Occupational Injury ◽

Tennis Elbow ◽

Historical Context ◽

Tendon Injury ◽

Related Case ◽

Work Related ◽

Search Terms ◽

Working Age ◽

History Of

Background: Tennis leg (TL), a musculotendon injury to the gastrocnemius, has been associated with the eponymous sport since 1883. This article examines the historical context of TL as a sports compared with an occupational injury. This was juxtaposed with the history of tennis elbow, a tendon injury to the upper extremity also associated with sport. Methods: Bibliometric databases (PubMed, Web of Science [WOS], Hathi Trust) were keyword-searched; relevant citations were investigated in depth. Results: The search yielded 71 citations for TL (PubMed). The majority ( n = 43) were key word linked to sport terms; only one was linked to work-related search terms. Furthermore, none of the top four cited publications (Web of Science) alluded to work-related risk factors in TL in full textual analysis. Hathi Trust yielded the earliest work-related case, reported in a non-biomedical source. Tennis elbow was more frequently reported ( n = 189 citations in PubMed) and more frequently linked ( n = 193; 9.7%) to occupational search terms. Conclusion/Application to Practice: The history of TL, juxtaposed with tennis elbow, demonstrates how nosology can influence but does not wholly explain disease attribution, potentially to the detriment of taking into account occupational causality. The lack of recognition of occupational factors revealed in this literature search was notable because TL occurred most commonly in males of working age. By providing perspective on how historical context and nosology can affect the conceptualization of disease, this review may help inform prevention, treatment, and regulatory policy.

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Identifying and Evaluating Vocation-Related Neuro-Musculoskeletal Deficiencies in Professional Musicians: A Review

Applied Sciences ◽

10.3390/app11052035 ◽

2021 ◽

Vol 11 (5) ◽

pp. 2035

Author(s):

Joseph Mizrahi

Keyword(s):

Myofascial Pain ◽

Tennis Elbow ◽

Traumatic Injury ◽

Lateral Epicondylitis ◽

Upper Extremities ◽

Upper Body ◽

Professional Musicians ◽

Shoulder Muscles ◽

Repetitive Movements ◽

Tunnel Syndrome

A combination of factors exposes musicians to neuro-musculoskeletal disorders, which lead to pain and damage. These involve overuse due to long playing hours, containing repetitive movements under stressful conditions, usually performed in an unnatural posture. Although the evoked disorders are usually non-traumatic, they may often lead to prolonged or even permanent damage. For instance, in upper string players, these include bursitis and tendinopathies of the shoulder muscles, tendonitis of the rotator cuff, injury at the tendon sheaths, medial or lateral epicondylitis (also known as tennis elbow), myofascial pain, and wrist tendonitis (also known as carpal tunnel syndrome, or De Quervein’s syndrome). In cases of intensive performance, a traumatic injury may result, requiring drastic means of intervention such as surgery. It should be pointed out that the upper body and upper extremities are the most commonly affected sites of playing musicians. This review provides a description of the playing-related motor disorders in performing musicians, and of the methodologies used to identify and evaluate these disorders, particularly for violinists and other upper string players.

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How one treats lateral epicondylitis – a survey among Brazilian orthopedists

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04445-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Rafael Fuchs Lazarini ◽

Renato Arouca Zan ◽

João Carlos Belloti ◽

Ildeu Afonso de Almeida Filho ◽

Luiz Fernando Sartori Centenaro ◽

...

Keyword(s):

Surgical Treatment ◽

Tennis Elbow ◽

Lateral Epicondylitis ◽

Hand Surgery ◽

Initial Therapy ◽

Cross Sectional Study ◽

Imaging Method ◽

Cross Sectional ◽

Imaging Tool ◽

Management Protocol

Abstract Background Lateral epicondylitis (LE), also known as tennis elbow, is the most common painful elbow condition. It affects approximately 1–3% of adults. There are various possible treatments described in the literature, but evidence to support a gold standard management protocol is lacking. Therefore, the objective of this study was to evaluate how Brazilian orthopaedists diagnose and treat lateral epicondylitis and compare these results with the available evidence. Methods This is an observational, analytical, cross-sectional study. A questionnaire was prepared to obtain information from the participants with eight specific questions (2 on diagnosis and 6 on treatment). These questions were answered voluntarily by participants at 3 major congresses of orthopaedists in Brazil in 2018. The results were analysed in accordance with the overall number of responses and were evaluated among groups according to subspecialty. Results We obtained a total of 501 questionnaires. Of these, 33 were excluded. The mean age was 38.67 years. The majority of respondents (91%) were male. We obtained 26.7% from specialists in hand surgery (Hand group), 36.5% from subspecialists in shoulder and elbow (Shoulder and Elbow group), and 36.8% from generalists in orthopaedics or from other subspecialties (General Orthopaedists group). For diagnosis, 24.4% did not initially request any imaging method. The most requested exam was ultrasonography (54.9%). The most prominent indication for initial treatment was physical therapy. For refractory cases, 78.3% of the respondents preferred doing a local infiltration. The most commonly used substance for local infiltrations was corticosteroids (89.6%). With respect to the surgical treatment option, 75.8% of those who recommend it prefer open techniques, and 24.2% prefer arthroscopic treatment. Of the total respondents, 12.8% did not recommend surgical treatment for LE. Conclusion Among Brazilian orthopaedists, the Cozen test is most frequently chosen, and ultrasound is the most commonly used imaging tool. Nonsurgically, oral nonsteroidal anti-inflammatory drugs (NSAIDs) plus physiotherapy is the most popular initial therapy, and corticosteroids are the most popular type of infiltration agent. Most surgeons recommended surgery after 6 months of nonsurgical treatment, and 75.8% preferred the open technique.

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Effects of intralesional platelet-rich plasma in the patients with lateral epicondylitis of elbow

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v12i3.43326 ◽

2019 ◽

Vol 12 (3) ◽

pp. 138-141

Author(s):

Mohammad Tariqul Islam ◽

M. A. Shakoor ◽

Afsana Mahjabin ◽

Md. Ali Emran

Keyword(s):

Visual Analogue Scale ◽

Daily Living ◽

Analogue Scale ◽

Tennis Elbow ◽

Platelet Rich Plasma ◽

Lateral Epicondylitis ◽

Activity Of Daily Living ◽

Evaluation Tool ◽

Plasma Injection ◽

The Difference

Lateral epicondylitis (tennis elbow) is a major cause of musculoskeletal pain involving common extensor origin of the forearm. This study was done to determine the effects of platelet-rich plasma on 15 patients with lateral epicondylitis. Selected patients were given intralesional platelet-rich plasma injection, activity of daily living instructions and paracetamol. Patients were assessed every 14 days interval by visual analogue scale, and the patient rated tennis elbow evaluation. Treatment response according to visual analogue scale and patient rated tennis elbow evaluation tool, the difference of improvement was found in respect to time, from pretreatment W1 (just before 1st Intervention) score to W11 score in every alternate week (p<0.005). This indicates that intralesional platelet-rich plasma is effective in the patients with lateral epicondylitis of elbow.

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Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

Advances in Orthopedics ◽

10.1155/2012/387829 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Nicola Massy-Westropp ◽

Stuart Simmonds ◽

Suzanne Caragianis ◽

Andrew Potter

Keyword(s):

Tennis Elbow ◽

Autologous Blood ◽

Lateral Epicondylitis ◽

Contralateral Limb ◽

Cortisone Injection ◽

Autologous Blood Injection ◽

Blood Injection ◽

And Function ◽

Prospective Longitudinal ◽

Extensor Carpi Radialis

Purpose. This study explored the effect of autologous blood injection (with ultrasound guidance) to the elbows of patients who had radiologically assessed degeneration of the origin of extensor carpi radialis brevis and failed cortisone injection/s to the lateral epicondylitis.Methods. This prospective longitudinal series involved preinjection assessment of pain, grip strength, and function, using the patient-rated tennis elbow evaluation. Patients were injected with blood from the contralateral limb and then wore a customised wrist support for five days, after which they commenced a stretching, strengthening, and massage programme with an occupational therapist. These patients were assessed after six months and then finally between 18 months and five years after injection, using the patient-rated tennis elbow evaluation.Results. Thirty-eight of 40 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not.Conclusions. Autologous blood injection improved pain and function in a worker’s compensation cohort of patients with chronic lateral epicondylitis, who had not had relief with cortisone injection.

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Lateral Tennis Elbow

Techniques in Shoulder & Elbow Surgery ◽

10.1097/00132589-200001030-00008 ◽

2000 ◽

Vol 1 (3) ◽

pp. 192-200 ◽

Cited By ~ 4

Author(s):

Robert P. Nirschl

Keyword(s):

Tennis Elbow

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