Joint Manipulation in the Management of Lateral Epicondylalgia: A Clinical Commentary

Vicenzino, Bill; Cleland, Joshua A.; Bisset, Leanne

doi:10.1179/106698107791090132

Cited by 51 publications

(40 citation statements)

References 64 publications

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“…Çe şit li tek nik ler mev cut tur. 36 Kul la nı lan tek nik ler den ba zı la rı Mul li gan mo bi li zas yo nu (MWM), DTFM ar dın dan Mill's ma ni pü las yo nu uy gu la ma sı Cyri ax fiz yo te ra pi, bi lek ma ni pü lasyo nu, ser vi ko to ra sik omur ga ma ni pü las yo nudur. [37][38][39][40] Fiz yo te ra pi, ste ro id en jek si yo nu ve gö re ce li isti ra ha tin LE' te ki et kin li ği ile il gi li en iyi ka nıt la rın ir de len me si ni amaç la yan bir der le me de 30 ça lış ma in ce len miş tir.…”

Section: Ul Tra Son (Us)unclassified

Evidence Based Data for Management of Lateral Epicondylitis: Review

Ölmez¹,

Memiş²

2010

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T Bu der le me de la te ral epi kon di lit (LE) te da vi sin de de nen miş çok çe şit li te da vi yön tem le ri nin ka nı ta da ya lı ve ri le ri nin su nul ma sı amaç lan mış tır. Op ti mal te da vi se çi mi için ka nı ta da ya lı bi limsel ve ri ler kul la nıl ma lı dır. Ay rı ca güç lü ve za yıf ka nıt lar ile ri kli nik araş tır ma la rın plan lan ma sı açı sın dan önem li dir. Coc hra ne Kü tüp ha ne si, dü zen li ola rak gün cel leş ti ri len, ka nı ta da ya lı tıp ve rita ban la rı ko lek si yo nun dan olu şur. Bu der le me de Coc hra ne kü tüp ha ne si ve ri ta ba nın da la te ral epicond yli tis/ ten nis el bow anah tar ke li me le riy le ta ra ma ya pıl dı. Top lam sekiz Coc hra ne der le me si [Coc hra ne Da ta ba se of Syste ma tic Re vi ews (CDSR, Coc hra ne Re vi ews)] sap tan dı: Nons te ro id an tiinf la ma tu ar ilaç lar (NSA İ İ) 2001, kor ti kos te ro id en jek si yo nu ile il gi li der le me pro to ko lü 1999, ortez 2002, de rin trans vers frik si yon ma sa jı 2002, eks tra kor po re al şok dal ga te da vi si (ESWT) 2005, aku punk tur 2002, fiz yo te ra pi ve fiz yo te ra pö tik mo da li te ler il gi li der le me pro to ko lü 1999, cer ra hi 2002. Ay rı ca Coc hra ne kü tüp ha ne si ve ri ta ba nı nın içer di ği 18 non-Coc hra ne [Coc hra ne Da ta ba se of Abs tracts of Re vi ews of Ef fects (DA RE, non-Coc hra ne re vi ews)] der le me de da hil edil di. Der le meler de yer al ma yan di ğer te da vi yön tem le ri ne de kı sa ca de ği nil di. Bu der le me le rin ço ğun dan çı karı lan so nuç bir te da vi nin di ğe ri ne üs tün lü ğü nü des tek le ye cek ye ter li ka nıt yok lu ğu dur. Bu nun se be bi dü şük is ta tis tik sel güç, in ter nal ge çer li lik ve ço ğu ça lış ma da be lir ti len ye ter siz ve ri, kon trol grup la rı nın he te ro jen li ği, so nuç öl çüm le ri, ya kın ma sü re si ve prog nos tik fak tör le rin fark lı lı ğı, hasta sa yı sı az lı ğı ola rak be lir til miş tir. So nuç ola rak yük sek pre va lan sı na ve önem li de re ce de iş gü cü kay bı na rağ men LE te da vi si ko nu sun da gö rüş bir li ği az dır. LE op ti mal te da vi si hak kın da so nuç çı -kar tıl ma sı için iyi plan lan mış yük sek ka li te de ran do mi ze kon trol lü ça lış ma lar ya pıl ma sı ge rek li dir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Te nis çi dir se ği; epikondilit A AB BS S T TR RA AC CT T The aim of this re vi ew is to iden tify the evi den ce ba se da ta abo ut a wi de va ri ety of treat ment mo da li ti es used in la te ral epi cond yli tis (LE). For op ti mal tre at ment cho i ce the evi den ce based sci en ti fic da ta ha ve to be used. Al so the strong and we ak evi den ces are im por tant for plan ning furt her cli ni cal re se arch. Coc hra ne lib rary is re gu larly up da ted col lec ti on of evi den ce ba se me di cal da ta ba se. In this re vi ew the Coc hra ne Lib rary da ta ba se was se arc hed using la te ral epi cond yli tis/ ten nis el bow key words. This se arch yi el ded eight Coc hra ne re vi ews [Coc hra ne Da ta ba se of Systema tic Re vi ews (CD...

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Section: Ul Tra Son (Us)unclassified

Evidence Based Data for Management of Lateral Epicondylitis: Review

Ölmez¹,

Memiş²

2010

Turkiye Klinikleri J Med Sci

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“…[1] Lateral epicondylalgia is prevalent in 1.1-1.3% in men and 1.1-4% in women in the general population. [2] Standard provocation tests used in diagnosing LE are Cozen, Mill and Maudsley tests.…”

Section: Introductionmentioning

confidence: 99%

Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study

Dones¹,

Aguinaldo²,

Pulido³

et al. 2015

Anatomy

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Objectives: The lateral intermuscular septum (LIS) is dense and opaque in gross cadaver dissection. It was suggested as source of pain in elbows with lateral epicondylalgia (LE). The study aimed to measure the length of LIS and to describe the fascia orientation and density of LIS in upper extremities of human cadavers. . Methods:19 upper extremities of 10 formalin preserved human cadavers were dissected using the fascia sparing approach. The LIS was measured from the level of the lateral epicondyle up to the upper arm. The LIS was harvested 5 cm above and below the lateral epicondyle and submitted to a laboratory for histological staining. Prepared slides containing stained LIS were observed under high power microscope. Results:In 17 out of the 19 upper extremities, the LIS attached from the brachioradialis to middle deltoid with a mean of 14.5 (13.8-15.1) cm. 68 out of the 72 fascia images of LIS were linearly oriented in relation to the lateral epicondyle. The LIS was dense on its distal (16/18) and loose (12/16) on its medial sides. Conclusion:The fibers of LIS were linearly arranged near the lateral epicondyle in the upper arm connecting the brachioradialis and the deltoid. The LIS was dense and loose on its distal and medial sides, respectively. Considering the arrangement, connection and density of LIS in the upper arm, the LIS contributes to the inherent tightness of the elbow that may be important in handgrip activities. The connection between brachioradialis and middle deltoid by LIS is important in considering the changes in shoulder movement associated with lateral elbow pain in LE.

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“…1,17 At-risk populations also include those with professions that require repetitive and/or forceful/heavy manual tasks, 44,45,50 nonneutral wrist postures, 45 and repetitive gripping. 9,52,53,55 To date, there is no consensus on the optimal treatment approach for lateral epicondylalgia, which is in large part due to its unclear underlying etiology. 10,52 Because most treatment approaches for lateral epicondylalgia are based on the premise of impairments of the wrist extensor musculature or elbow joint mobility, interventions tend to focus on addressing the elbow region.…”

mentioning

confidence: 99%

“…9,52,53,55 To date, there is no consensus on the optimal treatment approach for lateral epicondylalgia, which is in large part due to its unclear underlying etiology. 10,52 Because most treatment approaches for lateral epicondylalgia are based on the premise of impairments of the wrist extensor musculature or elbow joint mobility, interventions tend to focus on addressing the elbow region. Accordingly, proposed interventions include manual therapy, [51][52][53] iontophoresis, 49 strengthening and stretching of the wrist extensor and forearm supinator musculature, 36 nonsteroidal anti-inflammatory drugs, 33 eccentric training, 38 splinting and bracing, 33 cortisone injections, 12 or a wait-andsee policy.…”

mentioning

confidence: 99%

“…10,52 Because most treatment approaches for lateral epicondylalgia are based on the premise of impairments of the wrist extensor musculature or elbow joint mobility, interventions tend to focus on addressing the elbow region. Accordingly, proposed interventions include manual therapy, [51][52][53] iontophoresis, 49 strengthening and stretching of the wrist extensor and forearm supinator musculature, 36 nonsteroidal anti-inflammatory drugs, 33 eccentric training, 38 splinting and bracing, 33 cortisone injections, 12 or a wait-andsee policy. 46 Bisset et al 10 concluded that more research is required to examine the effects of these interventions.…”

mentioning

confidence: 99%

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Middle and Lower Trapezius Strengthening for the Management of Lateral Epicondylalgia: A Case Report

Bhatt

Glaser²,

Chavez³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Case report. Background Addressing weakness of the shoulder region, especially the rotator cuff and scapular musculature, is often suggested clinically for the treatment of individuals with lateral epicondylalgia. However, to our knowledge, the clinical effectiveness of this approach has not been established. Case Description The patient was a 54-year-old woman with a 5-month history of right lateral elbow pain, whose symptoms were reproduced with clinical tests typically used to diagnose lateral elbow tendinopathy. The patient also demonstrated weakness in her middle and lower trapezius muscles, and the medial border of her scapula, measured with a tape measure, was 11 cm lateral from the spinous processes of the thoracic spine with the patient standing in relaxed stance. Based on improved grip strength and reduced associated elbow pain when tested with the scapula manually corrected in a more adducted position, treatment focused solely on strengthening of the middle and lower trapezius muscles over a 10-week period. Outcomes Following the intervention, the patient presented with improved scapular position, with the medial border of the scapula being 9 cm lateral to the midthoracic spine. The patient's middle and lower trapezius strength improved from 3+/5 and 4−/5, respectively, to 5/5, and her grip strength from 26.1 to 42.2 kg. The patient's scores on the Disabilities of the Arm, Shoulder and Hand questionnaire also improved from 44.2 at the initial evaluation to 0 at the completion of therapy, with the patient being able to perform all of her daily activities in a pain-free manner. Discussion The results of this case report suggest that assessment and treatment of scapular musculature warrant consideration in the management of individuals with lateral epicondylalgia. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2013;43(11):841–847. Epub 9 September 2013. doi:10.2519/jospt.2013.4659

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Joint Manipulation in the Management of Lateral Epicondylalgia: A Clinical Commentary

Cited by 51 publications

References 64 publications

Evidence Based Data for Management of Lateral Epicondylitis: Review

Evidence Based Data for Management of Lateral Epicondylitis: Review

Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study

Middle and Lower Trapezius Strengthening for the Management of Lateral Epicondylalgia: A Case Report

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