Physical Therapy and Tennis Elbow
Tennis elbow (TE), or Lateral Epicondylitis, is a common orthopedic problem often treated with Physical Therapy. Most often, onset of the problem is not related to playing tennis. Instead, patients relate a history of repetitive gripping, forearm twisting (ie, using a screwdriver), pinching, reaching, stretching, or other hand/wrist activity. Tennis elbow involves problems with the tendons, muscles and bone in the area of the lateral (outside) elbow.
With TE, the severity of the pain can vary greatly from slight ocassional pain to severe pain that would prevent a person from holding a coffee cup. The pain is located in the lateral part of the elbow area and can spread to the wrist or shoulder. Frequently, there is weakness or tightness in the shoulder making such movements as reaching behind the back uncomfortable.
Medical treatment of TE may involve anti-inflammatories, braces, rest or a cortisone injection. A patent who is referred for Physical Therapy should expect an evaluation which includes: a complete history, pain assessment, assessment of movement and appearance, palpation of tender areas and other special tests. The therapist will then discuss the evaluation with the patient as well as the treatment plan. Treatments may involve exercise, various types of massage/tissue mobilization, ultrasound, electrical stimulation or strain-counterstrain (SCS). SCS has been the most effective form of treatment for this problem in my years as a therapist. The hand/wrist is positioned to decrease the tissue stress in the lateral epicondyle. Patients can also be taught a home self SCS program. A patient's home program will also usually involve: heat or ice, rest from aggravating activities, awareness/application of proper use of the upper extremity joints and muscles, a progression of stretching and strengthening exercises. Examples of specific instructions given to patients with TE include: lift more with your palm up then down, keep elbows closer to your body when lifting, make sure your base of support is solid and properly balanced, be aware of your posture and minimize/avoid certain activities, depending on the severity of the TE.
A patient should expect to see some improvement in as little as 3 treatment sessions. Most often, patients are seen for 3 to 6 visits over a 2-4 week period of time. For some, 1 visit is enough. Others with extensive pain and weakness may require up to 12 treatment sessions. As with any medical condition, a patient's overall health and medical status will have an affect on the time needed for recovery. Most patients, in my experience, will make a full recovery.
Almost all insurances offer some coverage of Physical Therapy treatments. It is best for the patient to call their insurance and ask what their coverage is. Once patients understand their options for therapy providers, I greatly recommend they ask questions of the providers such as: "Will I have the same therapist for each visit?" "What is the experience level of my therapist?" "How long will it be before I can begin my therapy?"These are all valid questions that may help put the patient at ease prior to their first visit.
written by: John Ash, PT
P.T. First-Physical Therapy
966 S. 60th st.
West Allis, WI 53214
414-453-6665
Mr. Ash welcomes ALL questions regarding TE
or other muscle, bone or joint problems.
Therapy sessions can be provided at his walk-in clinic or in his Mobile Therapy
Clinic.
