Description of tennis elbow
Tennis elbow is actually a disease muscle and tendon insertions elbow, which affects approximately 3% of the population. This disease occurs in both men and women at the same scale.
The transition tendon to the bone are evident inflammatory changes localized to the outer side of the lower cusp of the upper arm bone (humerus radial epicondylus). Overloading are especially muscles that bend the wrist (wrist extensors) and the muscles flipping hand, palm upward (Supinator).
These pains are called tennis probably because of more frequent occurrence among athletes, but they can occur in any action when congestion occurs.
It ranks among entesopathy, which is the name for pathological changes in tendons tendons, ligaments and joint capsules to bone.Located in the area of insertion of extensors of the hand and fingers, while the greatest pain is reported by the contraction of extensor forearm (extensors), upon palpation on the outer cusp of the humerus (radial epicondylus), while turning the forearm, palm upward (supination), while handshake, while resistance against the wrist (resistive extension) and in opposition to the third finger (resistive extension).
Although this disease physicians considered minor indisposition, can have very serious consequences in patients. The cause of tennis elbow is the most frequently overloaded, but can occur even after various injuries or in connection with the disorder in the cervical spine.
There are two forms of this disease, and acute and chronic.
Acute arises often in unusual or physically demanding single work (chopping wood, plaster casting, typing on a computer ….), Which involves a malfunction. Overloaded muscles are rotating hand palm up, fingers and wrist extensor and brachial biceps muscle (m. Biceps brachii), which are clamped on the outer bump of the humerus.
Chronic form is caused by long-term overloading, toxic or metabolic effects or goes at this stage due to improper treatment of an acute condition. Problems persist longer than six weeks and can no longer lead to structural changes, such as scars or degenerative changes.
Risk factors for tennis elbow
In the acute form, the risk of any long, physically demanding activities to which you are accustomed. If you want to do some sport, Christmas cleaning, and so do not overdo it with the intensity and duration. Even working at the computer, clicking on the mouse and typing on a keyboard may not be without consequences.
Risk factors for chronic forms of tennis elbow can affect, for example, by reducing the training load and incorporating various compensation exercises (for athletes), respectively. changing work habits (people working manually and monotonous). For example, it is advantageous to change hands during operation or alternating with colleagues at different sites. After developing structural change leads to failure of blood supply and metabolism and muscles begin to atrophy.
Prevention of tennis elbow
It is important to avoid unilateral actions challenging. If you spend any sport, careful training coach and thorough stretching all the muscles.
Upon completion of training are appropriate relaxation exercises and stretching. As a precaution they can also use epicondylární tapes that are applied to activities which are increasingly strained forearm muscles.
Above the first symptoms of tennis elbow you definitely should not shrug off. Immediately it is necessary to limit any activity that causes pain and visit an orthopedist!
Signs and symptoms of tennis elbow
The first symptom is pain on palpation on the outer side of the elbow joint. Another discomfort develops when the grip, carrying loads (shopping bag, child, etc.), and when you lift the cup or small object. Pain may radiate to the forearm, fingers, arm or up into the shoulder joint.
Characteristic for tennis elbow is that calm the pain subside and struggled to returning. Often people with this disease often falls subjects of hand and gradually decreasing muscle strength.
One of the symptoms can also be a swelling outer side of the elbow joint, redness, and an elevated temperature in this area.
Patients holds the elbow slightly flexed (Semiflex) and this causes restriction of mobility. When the subconscious investigation of one limb also begin to develop a replacement physical mechanisms that can cause other problems, eg. Cervical spine.
Diagnosis of tennis elbow
The first thing a doctor will be interested after what you walk into his office, will definitely history.The questions will be directed to your job, sporting activities and hobbies that you pursue.Furthermore examined by palpation pain on the outer side of the elbow and probably performsstress test third finger. This simple test involves trying to stretch a mediator against resistance. If this test is positive, it causes considerable pain at the elbow joint.
Tennis elbow can mimic diseases such as entrapment syndromes, cervico-brachial syndrome, trauma, systemic diseases or articular body, therefore it is necessary to conduct further investigations. Commonly used X-ray of the elbow joint, which can detect various spurs, projections or change calcification.
Ultrasound can visualize swelling, degenerative changes or rupture, but the ultimate method of imaging techniques used to diagnose this disease is undoubtedly magnetic resonance.
Treatment of tennis elbow
While not a complicated treatment is very time consuming and can not do without the active cooperation of the patient. Methods of treatment are divided into treatment conservative and surgical.
conservative treatment
If your doctor has indicated this kind of treatment, it is necessary to adhere to the sleep mode and limb definitely overload.
If you do decide to work or play sports, you should limit activity that causes pain, for example, the use of orthoses or Epicondylar tape that partially stabilize joints and tendons facilitate the work at the site.
To reduce pain are also recommended ice packs or headscarves dressing and very painful tennis elbow may even indicate and plaster splint. Such immobilization should not last too long, because it leads to shortening, contractures of muscles to atrophy.
Perhaps the biggest role in the conservative treatment of physiotherapy plays. It focuses on maintaining, respectively. increase joint range, stretching the muscles and restore muscle strength again. They are applied also various exercises that accelerate the healing process. In addition to these manual techniques are also used methods of physical therapy. They are most often indicated ultrasound, electrotherapy, laser thermotherapy and cryotherapy.
In addition, however, the patient can not do even without drugs. Doctors prescribe variousanalgesics in the form of pills and ointments. If the therapy is unsuccessful, approaches to treatment with corticosteroids and injections.
Surgical treatment
This form of treatment is indicated in chronic conditions after unsuccessful conservativetreatment or relapse after penetration.
When surgery is usually accesses general anesthesia. The procedure itself takes about 30 minutes and hospitalization period is around three days. After surgery, the arm is fixed for about 14 days at a right angle and immediately after removing the splint is necessary to start with rozcvičováním.At this point it is again important physiotherapy. First, you need to stretch the shortened structures and to restore the full extent of the elbow joint, and after that, it accesses the same exercises as the conservative treatment. Incapacity is around two months and after 3-4 months should already be quite right limb.
Still, do not forget to care about the scar. Suitable daily promašťování that accelerate healing, andmassaging the scars that prevent adhesions structural layers near the scar (skin, subcutaneous tissue, fascia, muscle, periosteum).
How can I help myself
The first principle is to limit any activity that causes painful stimuli. Of course, you can buy a commercially available analgesic, but you should definitely not put off seeing a doctor.
Complications of tennis elbow
Most complications occur in connection with conservative treatment. Analgesics can causeindigestion, uncomfortable rash ointment again and injections can be dragged bacterial infection.
Without risk, however, is not a surgical treatment. Exceptionally, it may be damaged during the intervention of one of the muscles, causing subsequent failure momentum. It can also cause paralysis, bleeding, inflammation, poor healing, or of hypertrophic or keloid scars.
In the investigation of one limb may overload the cervical spine.
Other names: entesopathy, lateral epicondylitis of the humerus, inflammation of the external epicondyle of the humerus