Lateral Epicondyle Tendinopathy Toolkit: Section B - Clinical Assessment: Difference between revisions
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== Resources == | == Resources == | ||
*Click to go back to the main page of [[Lateral Epicondyle Tendinopathy (Tennis Elbow) Toolkit|Lateral Epicondyle Tendinopathy (LET) Toolkit.]] | *Click to go back to the main page of [[Lateral Epicondyle Tendinopathy (Tennis Elbow) Toolkit|Lateral Epicondyle Tendinopathy (LET) Toolkit.]] | ||
*Click to continue to [[Lateral Epicondyle Tendinopathy Toolkit: Section C - Outcome Measures]] | *Click to continue to [[Lateral Epicondyle Tendinopathy Toolkit: Section C - Outcome Measures|Section C - Outcome Measures]] | ||
*Click to continue to [[Lateral Epicondyle Tendinopathy Toolkit: Section E - Exercise Prescription|Section D- Exercise prescription]] | *Click to continue to [[Lateral Epicondyle Tendinopathy Toolkit: Section E - Exercise Prescription|Section D- Exercise prescription]] | ||
*Click to continue to [[Lateral Epicondyle Tendinopathy Toolkit: Section F - Manual Therapy|Section F- Manual therapy]] | *Click to continue to [[Lateral Epicondyle Tendinopathy Toolkit: Section F - Manual Therapy|Section F- Manual therapy]] | ||
Revision as of 14:36, 29 October 2022
Original Editor - Nupur Smit Shah
Top Contributors - Nupur Smit Shah, Cindy John-Chu, Kim Jackson, Rishika Babburu and Vidya Acharya
Introduction[edit | edit source]
The purpose of this document is to summarize the clinical assessment of the patient diagnosed with lateral epicondyle tendinopathy.
Initially , the assessment consist of history, objective and subjective examination, chief complains in order to confirm the diagnosis. The tool kit will even include differential diagnosis, the process of identifying causes/risk factors of Achilles tendinopathy and functional examination.
Risk factors[edit | edit source]
Modifiable risk factors
- Lifestyle
- Smoking
- Active individuals/athletic population : Overuse due to repetition of any occupational or recreational activity.
- Reduced grip strength
- Improper tennis grip size or poor back hand technique
- Forceful gripping activity at work
- Inactive /sedentary lifestyle population : decreased loading capacity of the tendon
- Reduced rotator cuff weakness on the same side.
Non-modifiable risk factors
- Age (> 40 years)
- Gender (F>M)[1]
- Metabolic disorders like hyperglycemia
- Cardiovascular risk factors[2]
- Genetics[3]
Assessment[edit | edit source]
Things to look out during the assessment of tennis elbow patient is complete history, subjective examination, objective examination, biopsychological factors and differential diagnosis.
Subjective Assessment[edit | edit source]
- Subjective symptoms
- Symptoms increases during activity.
- Extensor muscles weakness and reduced grip strength
- Pain is usually localized on the lateral elbow or sometimes referred to extensor or supinator groups of forearm.
- History
- Lateral elbow pain which is related to over use.
- Biopsychological factors
- It may involve behavioral or psychosocial factors which in turn contributes to neural sensitivity.
- The evidence states that psychological involvement can increase the symptoms of tennis elbow.[4]
- Objective Signs
| Upper quadrant examination | Factors of contribution |
|---|---|
| Cervical | Neuropathy, Radiculopathy |
| Shoulder | Weakness of rotator cuff, Neuopathic tender points, Myofascial trigger points |
| Elbow , Forearm | Weak grip strengh, Neuropathic tender points, Myofascial trigger points |
| Neurodynamics | Radial bias |
Differential Diagnosis[edit | edit source]
Articular[edit | edit source]
- Radiocapitular arthritis
- Intraarticular synovial plica of radial capitular joint
- Osteochondritis Dessicans[7]
Instability[edit | edit source]
- Posterolateral rotatory instability because of laxity of collateral ligaments[7]
Neural[edit | edit source]
- Abnormal neuro dynamics[8]
- Cervical nerve bias
- Radial tunnel entrapment of posterior interosseus nerve[9]
Imaging[edit | edit source]
- It is done only when the conservative management is not working on the patient.
- Ultrasound and MRI are usually preferred
- It helps to diagnose the extra and intra articular conditions.[10]
Resources[edit | edit source]
- Click to go back to the main page of Lateral Epicondyle Tendinopathy (LET) Toolkit.
- Click to continue to Section C - Outcome Measures
- Click to continue to Section D- Exercise prescription
- Click to continue to Section F- Manual therapy
- Click to continue to Section G- Laser dosage
- Click to continue to Section H-Braces , Splints and Taping
References[edit | edit source]
- ↑ Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology. 2006 Dec 1;164(11):1065-74.
- ↑ Otoshi K, Takegami M, Sekiguchi M, Onishi Y, Yamazaki S, Otani K, Shishido H, Fukuhara S, Kikuchi S, Konno S. Chronic hyperglycemia increases the risk of lateral epicondylitis: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS). Springerplus. 2015 Dec;4(1):1-9.
- ↑ Lenoir H, Mares O, Carlier Y. Management of lateral epicondylitis. Orthopaedics & Traumatology: Surgery & Research. 2019 Dec 1;105(8):S241-6.
- ↑ Bisset LM, Vicenzino B. Physiotherapy management of lateral epicondylalgia. Journal of physiotherapy. 2015 Oct 1;61(4):174-81.
- ↑ 5.0 5.1 5.2 Mallows A, Debenham J, Walker T, Littlewood C. Association of psychological variables and outcome in tendinopathy: a systematic review. British journal of sports medicine. 2017 May 1;51(9):743-8.
- ↑ Karanasios S, Korakakis V, Moutzouri M, Drakonaki E, Koci K, Pantazopoulou V, Tsepis E, Gioftsos G. Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET)–A systematic review. Journal of Hand Therapy. 2021 Feb 27.
- ↑ 7.0 7.1 British Medical Jpurnal.Available from https://www.jhandtherapy.org/article/S0894-1130(21)00039-9/fulltext.(accessed 29th October 2022)
- ↑ Hegmann KT, Thiese MS, Kapellusch J, Merryweather A, Bao S, Silverstein B, Wood EM, Kendall R, Foster J, Drury DL, Garg A. Association between epicondylitis and cardiovascular risk factors in pooled occupational cohorts. BMC musculoskeletal disorders. 2017 Dec;18(1):1-0.
- ↑ The Knee Resource .Available from https://thekneeresource.com/wp-content/uploads/2018/12/Screendem-P-KIrwan-Spondyloarthropathy.pdf. Accessed on 29th October 2022.
- ↑ Karanasios S, Korakakis V, Moutzouri M, Drakonaki E, Koci K, Pantazopoulou V, Tsepis E, Gioftsos G. Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET)–A systematic review. Journal of Hand Therapy. 2021 Feb 27.
