Current physiotherapy practice in the management of tennis elbow: A service evaluation

Bateman, Marcus; Whitby, E. V.; Kacha, S.; Salt, Emma

doi:10.1002/msc.1236

Cited by 16 publications

(17 citation statements)

References 18 publications

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“…Some have suggested that a considerable amount of management in sports medicine is not supported by evidence. (26) It is noteworthy that health practitioners have a di cult time deciding between the research-based evidence, patient choice and their own clinical views (25,(27)(28)(29)(30)(31)(32)(33) so it should not be surprising that sports chiropractors are also a icted by this challenge.…”

Section: Discussionmentioning

confidence: 99%

A descriptive study of sports chiropractors

Nelson¹,

Pollard²,

Ames³

et al. 2017

Journal of Science and Medicine in Sport

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BACKGROUND:This paper describes the education and case management pro le of sports chiropractors with the Federation of International Sports Chiropractors (FICS) postgraduate quali cation: International chiropractic sport science practitioner (ICSSP). The ICSSP is the predominant international sports chiropractic quali cation. METHODS:A 39-item web-based survey examining practitioner, practice and clinical management characteristics was distributed via email to all sports chiropractors who hold an ICSSP (n = 240) in 2015. RESULTS:The survey response rate was 64% (n = 154). The average age of the chiropractors was 31-40 years, just over three quarters were male and have been in practice for 5-10 years. The majority of respondents were based in North America.Sports chiropractors treat a wide range of musculoskeletal conditions with multimodal care (active and passive) and treat professional, semi-professional and Olympic athletes. Sports chiropractors have referral and co-management relationships with a range of conventional and allied health providers. CONCLUSIONS:There is often a lack of knowledge and misinformation about the background of sports chiropractors.This study refutes a number of commonly held misbeliefs, and describes a workforce that is well educated, treat high-level athletes, utilise a multimodal approach to management, treat a wide variety of non-spinal musculoskeletal conditions, frequently prescribe rehabilitative exercise, and refer to and comanage with other members of the sports medicine team.

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Section: Discussionmentioning

confidence: 99%

A descriptive study of sports chiropractors

Nelson¹,

Pollard²,

Ames³

et al. 2017

Journal of Science and Medicine in Sport

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“…On day 16, the patient was instructed to begin adding eccentric and isotonic wrist extension and flexion exercises with the goals of building muscle endurance and encouraging proper remodeling of the tendon. The patient was able to complete moderate sets (2-4) and high repetitions (10)(11)(12)(13)(14)(15) at this time. These various types of contractions and exercises were continued for two weeks as weights and frequency progressed slowly.…”

Section: Rehabilitation Protocolmentioning

confidence: 91%

“…[13] In addition to the large variability in treatment options for refractory tennis elbow, there also exists a wide variation in rehabilitation treatment approaches with no certain consistency. [14] Additionally there is no consensus with respect to treatment after regenerative or orthobiologic procedures. [15] Finally, there are no established rehabilitation guidelines at all with respect to rehabilitation after a patient undergoes the Tenex procedure.…”

Section: Introductionmentioning

confidence: 99%

Rapid and Successful Rehabilitation and Return to Play for a D1 Gymnast After Treatment for Lateral Epicondylosis with Ultrasound Guided Percutaneous Tenotomy (Tenex)

Walrod¹,

Turner²,

Pauls³

2020

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Lateral elbow pain is a commonly seen in sports medicine. There are multiple interventions for this chronic condition which may lead to difficulty with successful treatment. There are also multiple rehabilitation strategies employed for treatment. Variations in treatments and rehabilitation protocols can lead to different and sometimes unsuccessful long term outcomes. We present a novel case of a Division 1 college gymnast with recalcitrant lateral elbow pain who underwent percutaneous tenotomy (Tenex) of the common wrist extensor tendon. The athlete was able to return to full Division 1 athletics two months after the procedure. This case is unique secondary to the patient being a high level athlete and his rapid return to the intensity and requirements of competing in Division 1 sports. We also developed a specific rehabilitation protocol that we postulated would be appropriate after this procedure. We illustrate the athlete's rehabilitation in detail. We feel that this specific protocol may have also influenced his rapid and complete return. We anticipate that this specific rehabilitation protocol may potentially guide future rehabilitation protocols after the Tenex procedure for recalcitrant lateral epicondylosis. In addition, this rehabilitation protocol may be considered after the Tenex procedure for additional conditions like medial epicondylosis, achilles tendinosis, patella tendinosis and gluteal tendinosis.

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“…Counterforce braces prevent extensor muscle expansion, creating a new extensor origin and giving the soft tissue time to heal. 8,50 It is possible that the better effect of the counterforce brace on pain in younger adults be the result of better remodeling capability of their musculoskeletal system in comparison to older adults. However, the effect of potential confounding variables like chronicity, the extent of intrasubstance damage, the severity of pain, and the extent of pressure on the tendon from the counterforce cuff should not be underestimated.…”

Section: Effects On Painmentioning

confidence: 99%

“…5,6 Although LET is commonly self-limiting and a waitand-see policy is frequently adopted, 7 many treatment strategies, including physiotherapy exercises, acupuncture, extracorporeal shock-wave therapy (ECSW), laser therapy, dry needling, orthoses, injections, and surgery, have been used to relieve pain, alleviate inflammation, and improve grip strength. 6,8,9 Conservative treatments result in clinical improvements in 75%-90% of subjects with LET. 10 A counterforce brace, which is also known as a "proximal forearm band" or "epicondylitis bandage," is one conventional treatment.…”

Section: Introductionmentioning

confidence: 99%

The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy

Shahabi

Lankarani

Heydari

et al. 2020

Prosthetics &Amp; Orthotics International

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Background: Lateral elbow tendinopathy, also known as “tennis elbow” or “lateral epicondylitis,” is a common disease leading to pain in the lateral side of the elbow and disability during hand gripping. A counterforce brace is one of the most conventional treatments. However, its effects on outcomes remain inconclusive. Objectives: To investigate the effects of counterforce braces on pain in subjects with lateral elbow tendinopathy. Grip strength was reviewed as a secondary outcome. Study design: Systematic review and meta-analysis of randomized controlled trials. Methods: PubMed, Embase, Scopus, Web of Science, CENTRAL, PEDro, ProQuest, RECAL, and RehabData were searched from January 1, 1995, through June 15, 2019. Results: Seventeen studies were included with a total of 1145 participants. A small improvement in pain over the short term (standardized mean difference −0.02; 95% confidence interval: −0.85 to 0.80) and a moderate-to-large improvement in pain in subjects 45 years or younger (standardized mean difference −0.86; 95% confidence interval: −2.45 to 0.72) in favor of the brace versus physiotherapy interventions were found. In contrast, over the long-term physiotherapy interventions (standardized mean difference 1.17; 95% confidence interval: −0.00 to 2.34), wrist splint (standardized mean difference 0.35; 95% confidence interval: −0.07 to 0.76), and laser therapy (standardized mean difference 0.58; 95% confidence interval: −0.44 to 1.59) had better effects on pain improvement versus the brace. Conclusion: The results indicated that physiotherapy interventions compared to counterforce braces have better effects, especially over the long-term. However, counterforce braces may have better effects on pain in younger people (<45 years old) over the short term (<6 weeks). Clinical relevance The results suggest that counterforce bracing is a reasonable strategy to alleviate pain over the short term. However, the subgroup analysis suggests that factors such as age may have a role in their effectiveness.

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Current physiotherapy practice in the management of tennis elbow: A service evaluation

Cited by 16 publications

References 18 publications

A descriptive study of sports chiropractors

A descriptive study of sports chiropractors

Rapid and Successful Rehabilitation and Return to Play for a D1 Gymnast After Treatment for Lateral Epicondylosis with Ultrasound Guided Percutaneous Tenotomy (Tenex)

The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy

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