External humeral epicondylitis
Definition.
A chronic injury disorder characterized by localized slight heat and pressure pain in the lateral tendons of the elbow and pain in the lateral epicondyle of the humerus when making wrist extension and grip and forearm rotation activities. The common name tennis elbow refers to the painful inflammation of the tendons on the outside of the elbow. The pain is caused by repetitive force on the muscles responsible for the dorsal extension of the wrist and fingers. The patient may experience pain on the outside of the elbow when gripping or lifting objects with force.
Tennis elbow is a classic example of overuse syndrome. Studies have shown that the wrist extensors, especially the radial carpal short extensors, are under very high tension when performing wrist extension and exertion to the radial side, and are prone to overstretching some of the fibers at the musculofascial junction, creating a slight tear.
Symptoms
1, elbow pain most of this disease is slow onset, the symptoms of tennis elbow at the beginning, just feel the outside of the elbow joint soreness and slight pain, the patient feels pain from the activity above the elbow joint, pain sometimes can be radiated upward or downward, feel soreness and discomfort, reluctant to move.
2, can’t hold heavy hands can’t grip things with force, grip shovel, carry pot, wring towel, play sweater and other sports can make the pain aggravated.
3.The pressure pain is generally limited at the humeral epicondyle, sometimes the pressure pain can be dissipated downward, sometimes there is even mild pressure pain and activity pain on the extensor tendon.
4. There is no local redness or swelling, and elbow extension and flexion are not affected, but the forearm can be painful when rotating activities. In severe cases, pain can be caused when the fingers are straightened, the wrist is extended or when chopsticks are held. The pain is relieved when the extensor muscles are relaxed during elbow flexion and forearm rotation in the posterior position. In a few cases, the pain is aggravated during rainy days.
Etiology
The tendons of the wrist extension contract and tense when gripping something (such as a tennis racket). Excessive use of these muscles can cause degeneration, degeneration and tearing of the tendons proximal to these muscles, causing the symptoms commonly referred to as tennis elbow.
The causes of tennis elbow include.
1, incorrect technique when hitting tennis balls, improper size of tennis racket or improper tension of tennis racket string, incorrect golf grip or swing technique, etc.
2. Excessive arm activities such as tennis, badminton, baseball pitching, other jobs such as shabu-shabu, chef cutting, butcher chopping, rowing, hammering or screwdriving, etc.
Risk factors for the development of tennis elbow are.
1.Playing tennis, golf or baseball
2. Repetitive wrist extension in a fist-clenched position
3, muscle imbalance
4.Decreased flexibility
5.Ageing
Diagnosis
The main symptoms of tennis elbow include pain and pressure on the outside of the elbow joint, pain radiating along the forearm to the hand, forearm muscle tension, inability to fully straighten the elbow joint, and stiffness or limited movement of the elbow or wrist joint.
People susceptible to tennis elbow
1. Tennis, badminton and baseball players. This disease is common in this type of athletes, especially in tennis players, from which the name tennis elbow is derived. Because tennis players have to repeatedly swing the racket, it is easy to cause the muscle tendon near the elbow joint to tear, which leads to the onset of tennis elbow.
2, housewives, bricklayers, carpenters, repairmen and other people who repeatedly use their elbows to work. These people tend to use their elbows frequently, so the chance of elbow damage increases, which can cause some tendons and soft tissues attached to the elbow joint area to tear, leading to the onset of tennis elbow.
3, middle-aged and elderly. This group of people because of age, the body functions tend to weaken, tendon fiber degeneration, aging, injury often can not quickly recover, so the chances of developing tennis elbow is also higher.
Treatment
1.Non-surgical treatment.
(1) Rest: Avoid activities that cause pain and do not exercise until the pain disappears, especially tennis.
(2) Ice: Apply ice to the outside of the elbow for 1 week, 4 times a day, 15-20 minutes a time. Do not wrap the ice around a towel and do not let the ice touch the skin to avoid frostbite.
(3) Medication: Aspirin or non-steroidal anti-inflammatory painkillers (such as ibuprofen, etc.).
(4) Protective gear: Use a compression and resistance brace on the forearm, which can limit the force generated by the forearm muscles.
(5) Heat therapy: Use heat therapy only when returning to physical activity (sports), and heat therapy should be applied prior to pull therapy and sports preparation activities.
(6) Pulling therapy: When the acute pain disappears, start gently pulling the elbow and wrist as prescribed by the doctor, do not produce pain, hold the pulling state for 10 seconds and repeat 6 times.
(7) Strength exercises: train to strengthen the wrist extension muscles as prescribed by the doctor.
(8) Gradual return to exercise: Begin to exercise the arm movements (such as pumping in tennis, golf swing, painters’ movements, etc.) required for the sport (work activity) as recommended by the physician.
(9) Cortisone local closure: Injection of cortisone drugs in specific areas of the elbow joint can reduce inflammation and pain. The injection site, time interval, and number of times required are high and very demanding, and should be carried out carefully by experienced physicians.
The main cause of tennis elbow is overuse. Too many movements or sports cause an overload on the tendons of the wrist extensors, resulting in inflammation, degeneration, or pain, and even range of motion is affected, that is, tennis elbow. It is estimated that half of the tennis players suffer from this condition. Golfers, plumbers, painters, gardeners and accountants who always carry briefcases are all common groups with tennis elbow.
2.Surgical treatment
In case of advanced or persistent tennis elbow, after six months to one year of regular conservative treatment, the symptoms are still severe and affect life and work. The purpose is to remove necrotic and unhealthy tissues, improve or rebuild local blood circulation, and heal tendons and bones.