4. further manual examinations for differential diagnostics | PhysiotherapyKrankengymnastics for tennis elbow

4. further manual examinations for differential diagnostics

• Manual therapeutic examination of the elbow joint for movement restrictions. This can be indirectly caused by the sparing, but can also be directly partly responsible for the inflammation of the extensor tendons at the elbow.
• Manual examination of the shoulder and wrist.
• Manual examination of the cervical spine for dysfunctions and irritation of nerves, often the segments C6-TH1 (6th cervical vertebra – 1st thoracic vertebra) are affected. This can lead to pain radiating into the elbow region or to the intensification of an already existing pain symptomatology.

As the last important point of the physiotherapeutic evaluation I would like to mention the evaluation of the posture. A persistent incorrect posture of the patient, which shows itself in “hunched backs”, protruding shoulders and inwardly turned upper arms (predominantly sedentary lifestyle), can be a contributing factor to the development of the clinical picture by changing the tension of the muscles and decreasing the pain threshold due to the constant stress posture.

Prognosis

Acute epicondylitis usually sounds like, with mild and physical measures:

• Cold, (more rarely heat applications),
• Electrotherapy (tens or ultrasound),
• MTC = Medical TapingKinesiotaping, (see treatment in stage 2/3).
• Tendon transverse frictions (possibly from approx. 5th day of the symptoms) and local medicinal applications such as ointments with anti-inflammatory agents, disappear within a few days to approx. 3 weeks.
• Even in highly acute cases, relief may be achieved by a temporary immobilization of the splint with accompanying physiotherapy.
• In addition, an epicondylitis brace or tennis bracelet can be given after possible immobilization.

  It is important that the bracelet or tennis bracelet is fitted exactly, as it is useless if it slips or is placed incorrectly. The brace relieves the muscle attachment of the muscle to which the brace pad is attached and can still be worn during strenuous activities even after the acute phase has subsided.

• Information: The therapist explains the clinical picture to the patient and discusses with him/her the possible cause, the expected course and the therapeutic options.
• In any case, it makes sense to eliminate the possible cause of epicondylitis, i.e.
• Examination and conversion of the workplace according to ergonomic aspects (sometimes it is sufficient to change the mouse on the PC to the other hand or to use a vertical mouse)
• The use of a relieving forearm splint on the PC, height adjustment of chair or desk, the use of a cordless screwdriver for IKEA furniture
• Suspension of stressful activities such as tennis, gardening, playing the piano, possibly short-term sick leave due to high occupational stress, etc. to achieve pain relief.
• Fear of reduced performance and frustration due to possible unsuccessful treatment attempts can promote the chronification of the disease pattern. For this reason, information about the prognosis, targeted acute treatment to avoid chronification and the involvement of the patient in the therapy process are very important, especially in the acute phase of tennis elbow.