Physiotherapy for Tennis and Golfer’s Elbow
Tennis and Golfer’s Elbow is also referred to as lateral and medial epicondylitis of the elbow, respectively. Both conditions can be managed with physiotherapy as the initial form of treatment.
Medial epicondylitis is less common and is more difficult to treat. Both conditions are most often caused by overuse injuries due to repetitive loads and microtrauma. They can also be caused by one incident that is acute in nature. Patients can present with rest pain and activity pain that is caused by inflammation and/or tendinosis. Some patients can also get partial to complete tearing of the tendons on the medial or lateral side of the elbow joint which is associated with weakness. Patient who do not respond to physiotherapy, injections and bracing should undergo advanced imaging to assess for such tears.
Patients with suspected tennis elbow should undergo xrays and MRI exams to confirm the diagnosis. The objective of the MRI is to rule out related conditions and to determine whether a tear in the lateral extensor tendons or medial flexor-pronator tendons is present. In patients who have golfer’s elbow and associated numbness or tingling in the arm, nerve conduction velocity tests are also indicated.
Principles of Physiotherapy for Tennis and Golfer’s Elbow
Activity modification, rest, passive stretching, bracing and the use of anti-inflammatories comprises the treatment strategy for this condition. Counter-force bracing, shock-wave therapy, and kinesiology taping has also been shown to be effective. There is also evidence for the use of adjuvant treatments such as corticosteroid or platelet-rich plasma injections to manage this condition. The majority of cases can be managed with physiotherapy.