Resumen. La epicondilitis medial tiene menor incidencia que la lateral, patología que ha sido principalmente descrita en estudios anatómicos y clínicos. Tennis elbow, also known as lateral epicondylitis, is a condition in which the outer part of the . The extensor digiti minimi also has a small origin site medial to the elbow that this condition can affect. The muscle involves the extension of the. La epicondilitis medial tiene menor incidencia que la lateral, patología que ha sido principalmente descrita en estudios anatómicos y clínicos. La información.
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Tennis elbowalso known as lateral epicondylitisis a condition in which the outer part of the elbow becomes painful and tender. It is due to excessive use of the muscles of the back of the forearm. Treatment involves decreasing activities that bring on the symptoms together with physical therapy.
Symptoms spicondilitis with tennis elbow include, but are not limited to, radiating pain from the outside of the elbow to the forearm and wrist, pain during extension of wrist, weakness of the forearm, a painful grip while shaking hands or torquing a doorknoband not being able to hold relatively heavy items in the hand. The term “tennis elbow” is widely used although informalbut the condition mdial be understood as not limited to tennis players. Tennis elbow is a type of repetitive strain injury resulting from tendon overuse and failed healing of the tendon.
In addition, the extensor carpi radialis brevis muscle plays a lateeal role.
Early experiments suggested that tennis elbow was primarily caused by overexertion. However, studies show that trauma such as direct blows to the epciondilitis, a sudden forceful pull, or forceful extension cause more than half of these injuries. Histological findings include granulation tissue, microrupture, degenerative changes, and there is no traditional inflammation.
Longitudinal sonogram of the lateral elbow displays thickening layeral heterogeneity of the common extensor tendon that is consistent with tendinosis, as the ultrasound reveals calcifications, intrasubstance tears, and marked irregularity of the lateral epicondyle.
Histologic studies have demonstrated that this condition is the result of tendon degeneration, which replaces normal tissue with a disorganized arrangement of collagen. Therefore, the disorder is more appropriately referred to as tendinosis or tendinopathy rather than tendinitis.
Colour Doppler ultrasound reveals structural tendon changes, with vascularity and hypo-echoic areas that correspond to the areas of pain in the extensor origin.
The pathophysiology of lateral epicondylitis is degenerative. Non-inflammatory, chronic degenerative changes of the origin of the extensor carpi radialis brevis ECRB muscle are identified in surgical pathology specimens.
Epicondilitis lateral (codo de tenista) – Tennis Elbow
Tennis players generally believe tennis eipcondilitis is caused by the repetitive nature of hitting thousands of tennis ballswhich leads to tiny tears in the forearm tendon attachment at the elbow. The extensor digiti minimi also has a small origin site medial to the elbow that this condition can affect.
The muscle involves the extension of the little finger and some extension of the wrist allowing for adaption to “snap” or flick the wrist—usually associated with a racquet swing.
Most often, lateeral extensor muscles become painful due to tendon breakdown from over-extension. Improper form or movement allows for power in a swing to rotate through and around the wrist—creating a moment on that joint instead of the elbow joint or rotator cuff.
This moment causes pressure to build impact forces to act on the tendon causing irritation and inflammation. Other speculative risk factors for lateral epicondylitis include taking up tennis later epicondilitid life, unaccustomed strenuous activity, decreased mental chronometry and speed and repetitive eccentric contraction of muscle controlled lengthening of a muscle group. To diagnose tennis elbow, physicians perform a battery of tests in which they place pressure on the affected area while asking the patient to move the elbow, wrist, and fingers.
Diagnosis is made by clinical signs and symptoms that are discrete and characteristic. For example, when the elbow fully extended, the patient feels points of tenderness over the affected point on the elbow. X-rays can confirm and distinguish possibilities of existing causes of pain that are unrelated to tennis elbow, such as fracture or arthritis. Rarely, calcification can be found where the extensor muscles attach to the lateral epicondyle.
Where lateral epicondylitis is caused by playing tennis, another factor of tennis elbow injury is experience and ability. The proportion of players who reported a history of tennis elbow had an increased number of playing years.
As for ability, poor technique increases the chance for injury much like any sport. Therefore, an individual must learn proper technique for all epicondiliti of their sport.
The competitive level of the athlete also affects the incidence of tennis elbow. Class A and B players had a significantly higher rate of tennis elbow occurrence compared to class C and novice players.
However, an opposite, but not statistically significant, trend is observed for the recurrence of previous cases, with an increasingly higher rate as ability level decreases. Vibration dampers otherwise known as “gummies” are not believed to be a reliable preventative measure. Rather, proper weight distribution latearl the racket is thought to be a more viable option in negating shock. Evidence for the treatment of lateral epicondylitis before was poor.
In some cases, severity of tennis elbow symptoms mend without any treatment, within six to 24 months. Tennis elbow left untreated can lead to chronic pain that degrades quality of daily living.
There are several layeral regarding prevention, treatment, and avoidance of recurrence that are largely speculative including stretches and progressive strengthening exercises to prevent re-irritation of the tendon  and other exercise measures.
One way to help treat minor cases of tennis elbow is epicondipitis simply relax the affected arm. The rest lets stress and tightness within the forearm slowly relax and eventually have the arm in working condition—in a day or two, depending on the case. Eccentric exercise using a rubber bar is highly effective at eliminating pain and increasing strength. Moderate evidence exists demonstrating that joint manipulation directed at the elbow and wrist and spinal manipulation directed at the cervical and thoracic spinal regions results in clinical changes to pain and function.
Although not yet conclusive, the short-term analgesic effect of manipulation techniques may allow more vigorous stretching and strengthening exercises, resulting in a better and faster recovery process of the affected tendon in lateral epicondylitis. Low level laser therapy, administered at specific doses and wavelengths directly to the lateral elbow tendon insertions, may result in short-term pain relief and less disability. Orthosis is a device externally used on the limb to improve the function or reduce the pain.
Orthotics are useful therapeutic interventions for initial therapy of tennis elbow. There are two main types of orthoses prescribed for this problem: Counterforce orthosis has a circumferential structure surrounding the arm. This orthosis usually has a jedial which applies a binding force over the origin of the wrist extensors. The applied force by orthosis reduces the elongation within the musculotendinous fibers.
Wrist extensor orthosis maintains the wrist in the slight extension.
Tennis elbow – Wikipedia
This position reduces the overloading epocondilitis at the lesion area. Studies indicated both type of orthoses improve the hand function  and reduce the pain  in people with tennis elbow.
Extracorporeal shockwave therapy, while safe, is of unclear benefit. Although anti-inflammatories are a commonly prescribed treatment for tennis elbow, the evidence for their epicondilltis is usually anecdotal with only limited studies showing a benefit. Evidence is poor for long term improvement from injections of any type, whether corticosteroidsbotulinum toxinprolotherapy or other substances.
In recalcitrant cases surgery may be an option. Surgical techniques for lateral epicondylitis can be done by open surgerypercutaneous surgery or arthroscopic surgerywith no evidence that any particular type is better or worse than another. Depending upon severity and quantity of multiple tendon injuries that have built up, the extensor carpi radialis brevis may not be fully healed by conservative epiconxilitis.
Nirschl defines four stages of lateral epicondylitis, showing the introduction of permanent damage beginning at Stage 2. In tennis players, about Tennis elbow is more prevalent in individuals over 40, where there is about a four-fold increase among men and two-fold increase among women.
Tennis elbow equally affects both sexes and, although men have a marginally higher overall prevalence rate as compared to women, this is not consistent within each age group, nor is it a statistically significant difference.
Playing time is a significant factor in tennis elbow occurrence, with increased incidence with increased playing time being greater for respondents under Individuals over 40 who played over two hours doubled their chance of injury.
Those under 40 increased it 3. Runge  is usually credited for the first description of the condition, calling it “writer’s cramp” Schreibekrampf in Major, described as “lawn-tennis elbow”. From Wikipedia, the free encyclopedia. For other uses, see Tennis Elbow video game. Retrieved 21 June The American Journal of Sports Medicine: American Academy of Orthopaedic Surgeons. Accessed 23 January British Journal of Sports Epicondilitia.
Lateral elbow pain epicondikitis. A review of the etiology, occurrence and pathogenesis of “tennis elbow” is presented. Retrieved February 20, In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors. Knee Surgery, Sports Traumatology, Arthroscopy. Journal of Shoulder and Elbow Surgery.
Analysis of trials of treatment for lateral epicondylitis as an example”. The Journal of Bone and Joint Surgery. Archived from the original on An Easy Fix for Tennis Elbow? Br J Sports Mediall. J Orthop Sports Phys Ther. Pain Research and Treatment.
National Institute for Health and Clinical Excellence. This is still a main indication for extracorporeal shockwave therapy”.
Epicondilitis lateral (codo de tenista) – Tennis Elbow
International Journal of Surgery. Retrieved 17 August The Cochrane Database of Systematic Reviews. The American Journal of Sports Medicine.
The Journal of the American Medical Association. Seminars in arthritis and rheumatism.