Principles of Treatment:
- Activity Modification: refer to P.R.I.C.E link
- Specialized Manual Therapy Techniques: Both lateral epicondylitis and medial epicondylitis present with pain to palpation at the insertion of the tendon at the medial or lateral epicondyle of the humerus. There is pain and significant soft tissue knots in the muscles of the forearm. These knots are the result of micro-trauma during activity which results in scar tissue. Scar tissue is considered dysfunctional if it binds onto adjacent healthy tissue and prevents normal movement of that healthy tissue. Techniques such as ART and Graston Technique are used to release these adhesions. Please check out those links as well.
- Altered Biomechanical Forces: It is crucial to identify any abnormal forces that may be occurring while playing tennis, golf or simply performing household activities. Working with a swing coach to identify problems is an important first step. Simply changing your grip can have a substantial impact on the pain that you experience while playing tennis or golf. Avoiding pain is crucial as pushing into the pain only perpetuates the syndrome and will prevent proper healing. We may utilize taping techniques or advise you to use an elbow splint in order to stabilize the tendon during activity or during functional retraining exercises.
- Stretching: Stretching exercises are used to increase the length and elasticity of your tissues. We utilize passive and dynamic stretches as well as the neurological principles of reciprocal inhibition to hasten your recovery. We utilize self-mobilization techniques on styrofoam rolls or use “The (massage) Stick” as part of a home exercise program to break adhesions. Consistency with a program of self mobilization and stretching is crucial to reformat and rebuild scar tissue.
- Strenthening: We use graded and controlled resistance exercise to reconditon the tendon. We also use the principles of eccentric exercise training to recondition and stimulate healing. Eccentrics are contractions in which the muscle elongates against resistance ie slowly lowering your hand while holding a dumbbell. Scientific evidence supports the use of eccentrics. Please refer to The Missing Link link.
- Home Exercise Program: The rest is up to you! Compliance with your home exercise program is paramount to a speedy recovery.