Patrick McAllister
PT 100 Computer library project
Epicondylitis related sports injuries.
Epicondylitis (Medial or Lateral) ranks as one of the most common sport related injuries,
despite being one of the least recognized and treated. Both involve the inflammation of the
tendons associated with the elbow and both can contribute to chronic throbbing pain for the over
worked or used arms of athletes. Typically Epicondylitis or tendonitis of the elbow is involved
with throwing or swinging motions of the arm repeated over and over to the point weakness,
fatigue, loss of range of motion, and pain.6,7 Degeneration of the tendons can occur if therapeutic
methods are not introduced.
Many athletes are introduced to do the “quick fix” which is the RICE method which is to
Rest, Ice, Compress, and Elevate the injury. This method is great for alleviating the pain and
reducing inflammation but the simple fact is that it just treats the symptoms and not the actual
injury. Cortisone shots, taping methods and braces have also been implemented but again are
only treating the symptoms.4 Both Medial Epicondylitis “golfer’s elbow” and Lateral
Epicondylitis “tennis elbow” have very few methods of successful therapeutic treatments and
even with treatment both have a high chance of reoccurrence. The few methods that have been
relatively successful I will go over next.
As well as maintaining physical fitness during a period of leave from a sport due to
injury, exercise is an essential part of the healing process. Aerobic exercise in particular is very
important because it increases blood circulation and oxygenated blood to the area of injury which
helps promote healing.1,3 In addition to cardiorespiratory training and endurance is the need to
appropriate stretching and strengthening of the area. All though these particular injuries involve
the tendon and not the muscle as much, the muscles are still affected as a result of tendon
degeneration so keeping proper muscle strength in the area can also help promote healing.
Patrick McAllister
PT 100 Computer library project
Epicondylitis related sports injuries.
Ultrasound, electrical stimulation, and massage are the most common interventions used
by physical therapists. Ultrasound is said to increase blood flow which again promotes healing. It
is also said to decrease pain and muscle spasms as well. Electrical stimulation has been linked to
decreases pain also. Massage done in small areas at a time and done without pain is said to
reduce scar formation and promote new blood vessel growth. Massage can be done either before
or after interventions.
Manual therapies have been done and have had relatively higher success rates when done
with the previous interventions described. Manipulation and mobilization are two of the manual
therapies I will describe and are the more preferred methods. Manipulation and mobilization are
used to facilitate movement, decrease pain, and increase soft tissue repair.1,4,6 These methods
also can increase range of motion and flexibility. Manipulation consists of properly positioning
bones and joints and mobilization consists of carefully moving bones and joints into position.4
Strength training is another suggested therapy for both medial and lateral epidcondylitis.
Hand, wrist, forearm, bicep and tricep exercises can all be beneficial but in moderation and only
after pain and inflammation has subsided. Examples of exercises include gripper exercises for
the hands, wrists and forearms, rope exercises (rope pull-ups, hand over hands, weighted wrist
rollers, etc..) for hands, wrists, forearms and upper arms, and any of the types of curls for bicep
and tricep strengthening. Finally there are the two most important preventatives which are
stretching before and after activities and developing/practices good form.1,3 Stretching is selfexplanatory but developing and practicing good form is by far the most important. Despite the
nicknames “golfers” and “tennis” elbow, both can happen during any activity that requires
repetitive motions.3
Patrick McAllister
PT 100 Computer library project
Epicondylitis related sports injuries.
Citations:
1. Djordjevic, Olivera C (07/2012). “Mobilization with movement and kinesiotaping compared
with a supervised exercise program for painful shoulder: results of a clinical trial”. Journal of
Manipulative and Physiological Therapeutics (01614754), 35(6); p. 452.
2. Green S, Buchbinder R, Hetrick SE. Physiotherapy interventions for shoulder pain. Cochrane
Database of Systemic Reviews 2003, Issaez Art. NO.: CD004258. DOI:
10.1002/14651858.CD004258.
3. Hoogvliet P, Randsdorp MS, Dingemanse R, Koes BW, Huisstede BMA. Does effectiveness
of exercise therapy and mobilization techniques offer guidance for the treatment of lateral
and medial epicondylitis? A systematic review. BR J Sports Med. 2013; 47 (17): 1112.
4. Krogh TP, M.D., Fredberg, Ulrich, M.D., PhD., Stengaard-Pedersen K, Christensen, Robin,
M.Sc, Phd., Jensen P, R.N., Ellingsen, Torkell, M.D., PhD. Treatment of lateral epicondylitis
with platelet-rich plasma, glucocorticoid, or saline: A randomized, double-blind, placebocontrolled trial. AM J Sports Med. 2013; 41 (3): 625.
5. Larsen L. Sports Injuries Sourcebook: Basic Consumer Health Info. Detroit, MI:
Omnigraphics;2012.
6. Sauers E. Upper extremity injury history, current pain rating, and health related quality of life
in female softball pitchers. Journal of Sports Rehabilitation. 2011. 02; 20:100-14.
7. Wassinger C, Myers J. Reported Mechanisms of Shoulder Injury During the Baseball Throw.
Physical Therapy Reviews [serial online]. October 2011; 16(5):305-309. Available from:
CINAHL, Ipswich, MA. Accessed September 23, 2013.