Institute for Sports Medicine Frankfurt Main

1. Risk kinds of sport:

Tennis, Squash, Badminton

2. Function:

Attraction condition within the origin range of the hand and fumbling straining tendons at the exterior of the elbow.

3. Injury mechanism:

- Overstressing (kind of sport specific)
- Overstressing outside of the sport (increased working on the PC/Mouse, reconditioning, garden and housework)
- Wrong technology when exercising the sport (special back hand)
- degenerative changes in the tendons beginning range, already existing

4. Symptoms:

- Pain at the elbow exterior when grabbing and when raising articles (typically painful: Raises the coffee cup, pain when hand vibrating)
- Pain radiant emittance into the lower arm externallaterally
- Hardening the lower arm musculature
- Pressure pain within the tendons beginning range (elbow exterior)
Other pain causes:
- Complaints come from the neck spinal column
- Complaints come from the shoulder
- Nerve compression syndrome (pressure on the nerves by restricting in the channel or tissue swelling)
- local inflammation
- Elbow instability
- Elbow arthrosis

5. First measures:

- Terminating the stress
- Cooling
- Indulgence
- Dressings

6. Diagnostics:

Test which can be accomplished:
Hand of the arm concerned with the palm flat on the table put. The middle finger against resistance raise. A pain provocation at the elbow exterior points on the illness.
A physician should be consulted in each case, since the complaints could come also e.g. from the neck spinal column (see there). In addition it must be avoided that the complaints become chronic.
- Roentgen
- if necessary ultrasonic investigation
- if necessary nuclear spin tomography
- if necessary additional investigation by the neurologist

7. Therapy: Caution! Frequently lengthily!!!!!

a) Conservative therapy
- Indulgence
- Physiotherapy (under expert guidance and additionally with the therapist co-ordinated self-exercises)
- Medicines (anti-inflammatory, decongestant)
- Ointment dressings
- Pressure from the outside on the muscle (e.g. Epispange - must be ordered medically)
- Injections with and without Cortison
- Shock wave therapy
- Depending upon findings (decrease of the complaints) slow structure of stress (kind of sport specific)
b) Operational therapy
During failure of the conservative treatment measures, if necessary operational therapy (separation/groove of the tendons concerned of the bone, Denervation)

8. Physiotherapie:

- different techniques of massage (transverse friction, Stäbchenmassage)
- Electrical therapy
- Stretch and strengthening of the musculature concerned, as well as the antagonists
- Cooling's application to the tendons beginning range
- Thermal treatment of the lower arm musculature

9. Prevention:

- Warming up before beginning of the sporty stress without sport equipment
- Warming up with sport equipment (hit)
- Stretching particularly hands flexor end extensor
- Strengthening the hands flexor end extensor
- Examination of the play technology (e.g. racquet attitude etc.)
- Examination of the racquet material (grasp strength, covering, racquet weight etc.)

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