injuries poisoning
Lateral Epicondylitis
Treatment of Lateral Epicondylitis
Rest, ice, nonsteroidal anti-inflammatory drugs (NSAIDs), extensor muscle stretches Modification of activity Tennis elbow (counterforce) brace Later, resistive exercises Treatment involves a 2-phased approach. Initially, rest, ice, NSAIDs, and stretching of the extensor muscles are used. Occasionally a corticosteroid injection into the painful area around the tendon is needed. When the pain subsides, gentle resistive exercises of the extensor and flexor muscles in the forearm are done followed by eccentric and concentric resistive exercises. Activity that hurts when the wrist is extended or supinated should be avoided. Use of a tennis elbow (counter force) brace is often advised. Adjusting the fit and type of racket used can also help prevent further injury. Although surgery is not usually needed, surgical techniques to treat lateral epicondylitis involve removing scar and degenerative tissue from the involved extensor tendons at the elbow. Surgery is usually considered only after at least 9 to 12 months of unsuccessful conservative treatment; patients should be advised that surgery may not provide satisfactory relief of symptoms. 1. Flatten putty on table. 2. Flex (curl) fingers and place on putty. 3. Extend and abduct (spread) fingers. 4. Perform 3 sets of 10 repetitions, 1 time a day. 5. Special Instructions a. Start with least resistance putty (ie, yellow). b. Can also perform exercise using rubber band for resistance around fingers. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Grasp and gently squeeze towel roll with both hands. 2. Twist towel in alternating directions. 3. Perform 3 sets of 10 repetitions, 1 time a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Place forearm on table with the hand palm down, off the edge of the table. 2. Move wrist up into extension. 3. Slowly flex wrist down to starting position. 4. Perform 3 sets of 10 repetitions, 1 time a day. 5. Special Instructions a. Focus on lowering (eccentric) phase with a count of 4 to flex wrist down to starting position and a count of 2 up for wrist extension. b. Start with least resistance (ie, a soup can) or simply against gravity. c. Can also perform exercise with band resistance. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Place forearm on table with the hand palm up, off the edge of the table. 2. Curl wrist up into flexion. 3. Slowly lower and extend wrist to starting position. 4. Perform 3 sets of 10 repetitions, 1 time a day. 5. Special Instructions a. Focus on lowering (eccentric) phase with a count of 4 to extend wrist down to starting position and a count of 2 up for wrist flexion. b. Start with light resistance (ie, a soup can) or simply against gravity. c. Can also perform exercise with band resistance. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Position involved hand palm up. 2. Grasp fingers on involved hand with the other hand. 3. Keep elbow straight on involved arm. 4. Pull hand and fingers gently into extension. 5. Hold exercise for 30 seconds. 6. Perform 1 set of 4 repetitions, 3 times a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Begin with the elbow straight. 2. With the uninvolved hand, grasp thumb side of hand and bend wrist downward into wrist flexion. 3. To increase the stretch, bend wrist toward small finger and pull, curling fingers into more flexion. 4. Hold each exercise for 30 seconds. 5. Perform 1 set of 4 repetitions, 3 times a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 