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Lateral epicondylalgia

Yao-Hong Guo, Ta-Shen Kuan, Kuan-Lin Chen, Wei-Chih Lien, Pei-Chun Hsieh, I-Chieh Hsieh, Szu-Hao Chiu, Yu-Ching Lin
OBJECTIVES: To compare the effects of two different injection sites of low doses of botulinum toxin type A with steroid in treating lateral epicondylalgia. DESIGN: Double-blind, randomized, active drug-controlled trial. SETTING: Tertiary medical center. PARTICIPANTS: Twenty-six patients with lateral epicondylalgia for more than six months were recruited from hospital-based outpatient population. A total of 66 patients were approached, and 40 were excluded...
September 22, 2016: Archives of Physical Medicine and Rehabilitation
Laurent Vigouroux, Benjamin Goislard de Monsabert, Chris Hayot, Philippe Androuet, Éric Berton
Previous studies suggested that a pronounced weakness of the extensor muscles relative to the flexor muscles could increase the risk of occurrence of lateral epicondylalgia. This study investigates this hypothesis by estimating the ratio of extensor to flexor muscle capacities among healthy non-players (n = 10), healthy tennis players (n = 20), symptomatic players (n = 6), and players who have recovered from lateral epicondylalgia (n = 6). Maximum net joint moments in flexion or extension were measured during seven tasks involving the voluntary contraction of wrist and fingers...
September 5, 2016: Sports Biomechanics
Joseph R Maccio, Sarah Fink, Richard Yarznbowicz, Stephen May
BACKGROUND: lateral epicondylalgia (LE) is a musculoskeletal diagnosis that causes pain and dysfunction in the lateral aspect of the elbow. Mechanical diagnosis and therapy (MDT) is an orthopaedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained end-range movement. There has been no investigation of the association between MDT and patients diagnosed with LE. CASE DESCRIPTION: this report presents three patients matching the currently accepted diagnostic criteria for LE, two with a diagnosis of lateral epicondylitis (tennis elbow) from a medical doctor...
July 2016: Journal of Manual & Manipulative Therapy
Luke James Heales, François Hug, David Alan MacDonald, Bill Vicenzino, Paul William Hodges
BACKGROUND: Lateral epicondylalgia is a common musculoskeletal disorder and is associated with deficits in the motor system including painful grip. This study compared coordination of forearm muscles (muscle synergies) during repeated gripping between individuals with and without lateral epicondylalgia. METHODS: Twelve participants with lateral epicondylalgia and 14 controls performed 15 cyclical repetitions of sub-maximal (20% maximum grip force of asymptomatic arm), pain free dynamic gripping in four arm positions: shoulder neutral with elbow flexed to 90° and shoulder flexed to 90° with elbow extended both with forearm pronated and neutral...
June 2016: Clinical Biomechanics
Chung-Yuan Hsu, Ko-Hung Lee, Hsin-Chia Huang, Zi-Yu Chang, Hsing-Yu Chen, Tsung-Hsien Yang
Radial bone adjustment manipulation treatment may be effective to reduce pain rapidly in lateral epicondylalgia patients and the pathological tension in the biceps brachii muscle is highly concerned. To prove this hypothesis, we conducted a randomized controlled trial and included 35 patients with lateral epicondylalgia for more than 2 months. Either manipulation treatment (n = 16) or acupuncture (n = 19) was given to these patients for 2 weeks and all patients' symptoms were followed up for 8 weeks after treatment...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Luke J Heales, Michael J G Bergin, Bill Vicenzino, Paul W Hodges
BACKGROUND: Lateral epicondylalgia (LE) refers to pain at the lateral elbow and is associated with sensory and motor impairments that may impact on neuromuscular control and coordination. OBJECTIVE: This review aimed to systematically identify and analyse the literature related to the comparison of neuromuscular control of forearm muscles between individuals with and without LE. METHODS: A comprehensive search of electronic databases and reference lists using keywords relating to neuromuscular control and LE was undertaken...
April 22, 2016: Sports Medicine
Brooke Kaye Coombes, Matheus Wiebusch, Luke Heales, Aoife Stephenson, Bill Vicenzino
OBJECTIVE: To examine the acute effects of isometric exercise of different intensities on pain perception in individuals with chronic lateral epicondylalgia. METHODS: Participants performed three experimental tasks completed in a randomised order on separate days: control (no exercise) and isometric wrist extension (10×15 s) at load 20% below (infra-threshold) and 20% above (supra-threshold) an individual's pain threshold. Self-reported pain intensity (11-point numeric rating scales (NRS)), pressure pain threshold and pain free grip were assessed by a blinded examiner before, immediately after and 30 minutes after task performance...
February 17, 2016: Clinical Journal of Pain
Raquel Mora-Relucio, Susana Núñez-Nagy, Tomás Gallego-Izquierdo, Alma Rus, Gustavo Plaza-Manzano, Natalia Romero-Franco, Alejandro Ferragut-Garcías, Daniel Pecos-Martín
The purpose was to evaluate the interexaminer reliability of experienced and inexperienced examiners on location and classification of myofascial trigger points (MTrPs) in two epicondylar muscles and the association between the MTrP found and the diagnosis of lateral epicondylalgia (LE). Fifty-two pianists (some suffered LE) voluntarily participated in the study. Three physiotherapists (one inexperienced in myofascial pain) examined, located, and marked MTrPs in the extensor carpi radialis brevis (ECRB) and extensor digitorum communis (EDC) muscles...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
E Burns, L S Chipchase, S M Schabrun
BACKGROUND: Lateral epicondylalgia (LE) is a musculotendinous condition characterized by persistent pain, sensorimotor dysfunction and motor cortex reorganization. Although there is evidence linking cortical reorganization with clinical symptoms in LE, the mechanisms underpinning these changes are unknown. Here we investigated activity in motor cortical (M1) intracortical inhibitory and facilitatory networks in individuals with chronic LE and healthy controls. METHODS: Surface electromyography was recorded bilaterally from the extensor carpi radialis brevis (ECRB) muscle of 14 LE (4 men, 41...
August 2016: European Journal of Pain: EJP
L J Heales, B Vicenzino, D A MacDonald, P W Hodges
Lateral epicondylalgia (LE) is associated with a reduced wrist extensor muscle activity and altered biomechanics. This study compared the coordination between forearm muscles during gripping in individuals with LE and pain-free controls. Intramuscular electrodes recorded myoelectric activity from extensor carpi radialis brevis/longus (ECRB/ECRL), extensor digitorum communis (EDC), flexor digitorum superficialis/profundus (FDS/FDP), and flexor carpi radialis (FCR), bilaterally, in 15 participants with unilateral LE and 15 pain-free controls...
December 1, 2015: Scandinavian Journal of Medicine & Science in Sports
Nagarajan Manickaraj, Leanne M Bisset, Michael Ryan, Justin J Kavanagh
BACKGROUND: Individuals with lateral epicondylalgia (LE) have delayed upper limb reaction time (RT); however, it is unknown if the mechanisms of this dysfunction are related to neural processing or the affected forearm muscles. The aim of this study was to examine the timing of processes that occur before and after forearm muscles are activated during the RT task. METHODS: Eleven LE (42 ± 11 yr) and 11 healthy controls (42 ± 11 yr) performed rapid wrist extension in response to an audio cue...
April 2016: Medicine and Science in Sports and Exercise
Jason Outrequin, Farshid Moshiri, Rahim Khorassani Zadeh
INTRODUCTION: Chronic Lateral Epicondylalgia (CLE) is potentially associated with a significant reduction of the patient's quality of life; its treatment by manual Deep Transverse Friction (DTF), although widely accepted, lacks standardization. The purpose of our study was to evaluate the efficacy of the MyoDK device, which allows deep transverse pressure (DTP) monitoring, for treatment of CLE. MATERIALS AND METHODS: This is a single centre observational study for treatment of CLE by the MyoDK device...
October 2015: Journal of Clinical and Diagnostic Research: JCDR
Wei Dong, Hans Goost, Xiang-Bo Lin, Christof Burger, Christian Paul, Zeng-Li Wang, Fan-Lin Kong, Kristian Welle, Zhi-Chao Jiang, Koroush Kabir
BACKGROUND: There are many injection therapies for lateral epicondylalgia but there has been no previous comprehensive comparison, based on the Bayesian method. METHODS: The MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for appropriate literature. The outcome measurement was the pain score. Direct comparisons were performed using the pairwise meta-analysis, and network meta-analysis, based on a Bayesian model, was used to calculate the results of all of the potentially possible comparisons and rank probabilities...
August 2016: British Journal of Sports Medicine
Leanne M Bisset, Bill Vicenzino
No abstract text is available yet for this article.
October 2015: Journal of Physiotherapy
Michael Joseph Gerard Bergin, Rogerio Hirata, Christian Mista, Steffan Wittrup Christensen, Kylie Tucker, Bill Vicenzino, Paul Hodges, Thomas Graven-Nielsen
OBJECTIVE: Lateral epicondylalgia presents as lateral elbow pain provoked by upper limb tasks. An experimental model of elbow pain provoked by movement/muscle contraction and maintained over several days is required to better understand the mechanisms underlying sustained elbow pain. This study investigated the time course and pain location induced by nerve growth factor (NGF) injection into a wrist extensor muscle, and whether movement and muscle contraction/stretch provoked pain. METHODS: On Day 0 twenty-six painfree volunteers were injected with NGF (N = 13) or isotonic saline (randomized) into the extensor carpi radialis brevis (ECRB) muscle of the dominant arm...
November 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Brooke K Coombes, Luke Connelly, Leanne Bisset, Bill Vicenzino
AIM: To determine the cost-effectiveness of corticosteroid injection, physiotherapy and a combination of these interventions, compared to a reference group receiving a blinded placebo injection. METHODS: 165 adults with unilateral lateral epicondylalgia of longer than 6 weeks duration from Brisbane, Australia, were randomised for concealed allocation to saline injection (placebo), corticosteroid injection, saline injection plus physiotherapy (eight sessions of elbow manipulation and exercise) or corticosteroid injection plus physiotherapy...
June 2, 2015: British Journal of Sports Medicine
Luke J Heales, Paul W Hodges, Bill Vicenzino
INTRODUCTION: Musculoskeletal ultrasound (MSUS) imaging is used to investigate features of tendinosis. Recent studies have reported tendon pathology not only in the symptomatic tendon but also in the contralateral asymptomatic tendon of animals and humans with unilateral Achilles tendinopathy. This study assessed the symptomatic and contralateral asymptomatic tendon in unilateral lateral epicondylalgia (LE) for features of tendinosis and compared with a pain-free control. METHODS: Twenty-nine participants with clinically diagnosed unilateral LE and 32 pain-free controls (matched for age, sex, and arm dominance) underwent a blinded bilateral MSUS examination of the common extensor tendon using a standardized protocol...
November 2015: Medicine and Science in Sports and Exercise
Tom A Ranger, Wendy M Braybon, Craig R Purdam, Jill L Cook
CONTEXT: Lateral epicondylalgia, pain at the lateral elbow, is commonly associated with extensor carpi radialis brevis tendinopathy. The radial head, which abuts the extensor tendons and is elliptical in shape, may affect the extensor tendons during pronation of the forearm. Cadaverous studies have shown that the radial head may act as a cam in pronation, to offer a mechanical advantage to the common extensor tendon and to mitigate load on the origin of the extensor carpi radialis brevis tendon...
February 2015: Journal of Sport Rehabilitation
Consuelo B Gonzalez-Suarez, Valentin C Dones, Karen Grimmer, Kerry Thoirs, Steven Milanese, Alvin Atlas
INTRODUCTION: Despite reports on the association of radial nerve (RN) size and lateral epicondylalgia (LE), Filipino normative values on RN size in healthy elbows are not established. An association with upper extremity anthropometric measurements is likewise not reported. METHODS: Musculoskeletal ultrasound measurements of the RN at the level of the lateral epicondyle (RN-LE), posterior interosseous nerve at the level of the radial head and supinator (PIN-RH and PIN-sup), and superficial RN (SRN) in the elbows of healthy Filipinos were made in Manila from January-September 2011...
October 2015: Muscle & Nerve
Joseph M Day, Heather Bush, Arthur J Nitz, Tim L Uhl
STUDY DESIGN: Descriptive, laboratory-based, cross-sectional study. OBJECTIVES: To describe scapular musculature strength, endurance, and change in thickness in individuals with unilateral lateral epicondylalgia (LE) compared to the uninvolved limb and the corresponding limb of a matched comparison group. BACKGROUND: Reported poor long-term outcomes for the nonsurgical management of individuals with LE suggest a less-than-optimal rehabilitation process...
May 2015: Journal of Orthopaedic and Sports Physical Therapy
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