Medial Epicondylalgia (Golfer's Elbow) Treated by Eccentric Exercise

Abstract

Background Eccentric exercises have been successfully used in the treatment of Achilles and patellar tendinopathies, as well as lateral epicondylalgia. No studies have explored the same treatment for medial epicondylalgia (golfer's elbow). Methods Twenty consecutive adults with a clinical diagnosis of medial epicondylalgia were treated with eccentric exercise over 3 months in this prospective case series. The programme was based on home training. There were 11 women and nine men, with a mean age of 47 years, and a mean duration of symptoms of 19 months. At baseline, at 3 months and after a mean of 11 years, pain was assessed by three independent visual analogue scales (VAS) and grip strength using a Jamar dynamometer (Sammons Preston Inc., Jackson, MI, USA). At the 11‐year follow‐up, patients also reported their satisfaction on a 100‐mm VAS and completed the Disabilities of Arm, Shoulder and Hand questionnaire. Results Pain decreased significantly in all measured variables at both assessment occasions (all p < 0.0001). Grip strength in the affected arm/hand increased significantly after 3 months (p = 0.009). Discussion Twelve weeks of eccentric training reduced pain and increased grip strength in patients with medial epicondylalgia. It is a safe, uncomplicated and cost‐effective method, with only a minimum contribution from a physiotherapist.

Applying EMG technology in medial and lateral elbow enthesopathy treatment using Myo motion controller

“…Table 1 presents information on the disease of the patients. Among five patients there was one person (P3) whose injured hand is non-dominant, which is a less frequent case [25, 27, 29].…”

“…It consists of physiotherapy, administration of anti-inflammatory medication, corticosteroid injections, or platelet-rich plasma injections. Physiotherapy includes the stretching of wrist extensors, the improvement of blood flow in tissues, eccentric exercises therapy (exercises in which muscles work more during extension than during flexion) [26, 27], stabilizing the elbow part and wrist, and various methods of physical therapy [23, 28]. Corticosteroid injections are a solution that brings short-term relief.…”

An Exploratory Analysis of a Treatment Based Classification Algorithm to Treat Patellar Tendinopathy

“…Several researchers have demonstrated positive results with the use of a 12-week protocol. [18][19][20][21][23][24][25]38,39 Jonsson and Alfredson 40 compared an eccentric exercise group to a concentric exercise group for the treatment of "jumper's knee" and reported nine out of 10 participants who completed the study were "satisfied" and discharged with a mean Visual Analogue Scale (VAS) of 23 out of 100 and a VISA-P score of 83 points with the use of a 12-week eccentric exercise protocol. Similarly, Purdam, et al 24 reported a mean VAS score of 28.5 points at discharge for participants who performed eccentric exercises on a decline board, compared to a mean VAS score of 72 points at discharge for participants who performed traditional squat eccentric exercises for 12 weeks.…”

“…[18][19][20][21][22][23][24] For many patients, however, compliance is difficult due to the length of the treatment, muscle soreness, and/or the pain experienced with treatment. 18,23,25 Other concerns with the protocol, such as tendon rupture rates, are not well understood as researchers do not always report treatment complications. Upon return to activity, participants who complete the protocol also report a high recurrence rate.…”

“…The use of manual therapies and tendon classification have been proposed as a means to improve the treatment of tendon pain 12,13 due to the high rate of tendon pathology recurrence 15,26 and patient non-compliance. 23,25 Researchers have proposed that many patients classified with tendinalgia may not actually have a true tissue pathology that must be addressed with tissue remodeling 13 and that classifying patients based on their response to sub-therapeutic doses of intervention techniques may improve patient outcomes. 9,13 Thus, it is important for clinicians to consider alternative examination and treatment strategies to better identify and treat these patients.…”