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Background Lateral epicondylitis, also known as tennis elbow, is the most common elbow pain in the adult age group. Purpose To evaluate common extensor tendon (CET) vascularity with superb microvascular imaging (SMI) before and after extracorporeal shock wave therapy (ESWT) and ultrasound (US) treatment in patients with lateral epycondylitis and to compare the effects of two different treatments on tendon vascularity. Material and Methods Patients with lateral epycondylitis were divided into two groups; 30 patients were treated with ESWT (group 1) and 30 patients were treated with therapeutic US (group 2). We performed a high-frequency (14-MHz) linear array transducer to evaluate tendon anatomy and vascularity before and after treatment in both groups. Results The decrease in Patient-Rated Tennis Elbow Evaluation (PRTEE) score after treatment was statistically significant compared to pre-treatment for both groups ( P < 0.001). Likewise, the decrease in visual analog scale (VAS) score after treatment was statistically significant compared to pre-treatment for both groups ( P < 0.001). A significant difference was found between the CET SMI values of group 1 and group 2 after treatment, according to the chi-square test ( P < 0.001). In the post-treatment VAS and PRTEE comparison of both groups, the score reduction in group 1 was higher than in group 2, and this decrease was statistically significant ( P < 0.001). Conclusion We can evaluate CET vascularization with the SMI method as a new potential diagnostic tool in comparing the effectiveness of different treatments in cases of lateral epicondylitis.

Background Resistance exercise can be defined as the percentage of maximal strength (%1 repetition maximum) used for a particular exercise. Shear wave elastography (SWE) is a robust and novelty imaging technique that provides information regarding tissue stiffness. Superb microvascular imaging (SMI) is a non-irradiating technique that can provide quantitative measurement of muscle blood flow non-invasively. Purpose To compare the acute effects of low- and high-velocity resistance exercise on stiffness and blood flow in the biceps brachii muscle (BBM) using SWE and SMI. Material and Methods This prospective study included 60 healthy men (mean age=28.9 years; age range=26–34 years). BBM stiffness was measured by using SWE at rest, after low- and high-velocity resistance exercise, and muscle blood flow was also evaluated by SMI. Resistance exercise was performed using a dumbbell with a mass adjusted to 70%–80% of one-repetition maximum. Results The stiffness values increased significantly from resting to high- and low-velocity resistance exercises. There was no significant difference between the elastography values of the BBM after the high- and low-velocity resistance exercise. The blood flow increased significantly from resting to high- and low-velocity resistance exercises. Blood flow increase after low-velocity exercise was significantly higher compared to high-velocity exercise. Conclusion While muscle stiffness parameters and blood flow significantly increased from resting after both high- and low-velocity resistance exercises, blood flow significantly increased after low-velocity exercise compared to high-velocity exercise. This can mean that metabolic stress, an important trigger for muscle development, is more likely to occur in low-velocity exercise.