Steemit Learning Challenge-S22W2; Tennis Elbow"

What's tennis elbow? Write in your own words after getting knowledge from the lesson post

Tennis elbow is another name of lateral epicondylitis which is the medical condition related to musculoskeletal problem which affects muscles and tendons of effective forearm leading to pain in elbow and forearm because of causing swelling at lateral epicondyle.

Types of tennis elbow or lateral epicondylitis

Following are the types of tennis elbow or lateral epicondylitis;

• First of all there can be acute tennis elbow in which person faces a sudden trauma or injury at elbow or forearm muscles or tendons.
• Secondly there is another type which is chronic tennis elbow which is caused by repetition of strain or over usage of muscles and tendons of forearm for longer time period and this condition develops with time.

Causes

Following are the causes due to which this condition can occur;

• First of all it can be caused due to repetition of movement at wrist and forearm like continuous gripping, twisting or lifting which leads to swelling of your tendons or muscles.
• Secondly if there are poor biomechanics or you are using wrong technique when you are playing tennis or golf then due to unnecessary strain at your muscles or tendons of forearm this condition can trigger.
• Age can also be a secondary cause because due to occurrence of wear and tear process in body your tendons and muscles can become inflammed or irritated and any heavy lifting or heavy workout can make you more prone to this injury.

Symptoms

• patient suffering from this injury will complain that he or she is feeling sharp burning pain or sensation at outside or lateral side of elbow.
• Upon asking patient will explain that pain is radiating to forearm and wrist so pain pattren is radiating and is in downward direction.
• Patient will also complain about feeling of fatigue and weakness and loss of gripping and lifting of small object even.
• Patient will also complain that he feels restricted movement in his elbow or forearm and increase in stiffness due to which he is facing problem in any movement of wrist and forearm.
• Patient will also complain about presence of visible swelling and redness at outside of elbow.

Treatment

Following is the treatment protocol you can give to this patient;

• As there is presence of inflammation and pain accompanied with redness that's why applying icing each day twice for at least 10 minutes is good and should be the first thing for giving treatment.
• There should be a start of treatment with general gentle exercises and stretching for the improvement in mobility, flexibility and for strengthening muscles of forearm and wrist.
• Patient can also use medications including painkillers and anti inflammatory drugs upon instructions of doctor for getting temporary relief in pain and reduction in swelling.
• Patient must use braces for giving support and for causing reduction in strain at forearm tendons and muscles.

How would you diagnose a tennis elbow? Any clinical investigation or assessment tests?

For making diagnosis of tennis elbow they are some steps you need to go through;

Clinical Assessment

• First of all we will start our clinical assessment by asking about current and past medical history of patient in which we will ask from patient about demographic data,about his symptoms, duration and severity like what are aggravating and relieving factors of his symptoms.
• Secondly we will ask about any history of injury at effective area and then occupation of patient that is it relates to repetitive use of forearm or wrist.
• Thirdly we will assess his location where he is complaining about presence of symptoms and we will determine if there is any weakness, tingling or numbness present upon asking from patient.

Physical Examination

• In physical examination we will start from inspection in which through our eyes we will observe elbow, forearm and wrist for checking any sign of deformities,redness or swelling if it is present.
• In physical examination through palpation we will check tenderness by pressing gently at outside of elbow which is bony bump we feel at lateral side of elbow.
• In physical examination we will then evaluate all movements of elbow including flexion,extension pronation and supination etc that are ranges of motion completed or not.
• In physical examination we will also assess strength of muscles particularly for extensor carpi radialis brevis.

Special Tests

• Dr will resist or restrict extension of wrist when patient will perform it and during it lateral epicondyle will be palpated by doctor for checking sign of tenderness which will indicate that cozen's test is positive.
• Dr will ask the patient to flex his wrist and extend his elbow and in case patient is complaining that he is feeling more pain and tenderness at lateral epicondyle then it will indicate that Mills test is positive.
• Dr will resist extension of middle finger of patient when he will perform it and if he is complaining that his pain at outside of elbow is increasing then it is an indication that Maudsley test is positive.

Imaging Studies

• Ultrasound is an important imaging test which is useful for evaluation of any inflammation or damage sign to tendon and muscle structures of forearm or elbow.
• Magnetic resonance imaging is important for assessing that how much tendon is damaged or inflammed.
• Through electromyography muscles electrical activity can be ruled out for checking entrapment of nerve due to inflammation in that area but this is a secondary test not primary test used for this condition.
• X-ray can also be used as a secondary test for checking if there are any fracture of minor or major level present at elbow which is causing inflammation.

Diagnostic criteria

Clinical evaluation	10%
Physical examination	20%
Special tests	50%
Imaging studies	20%

Try to practice at least 3 exercises that you have learned from the lesson. Share images, gifs or videos while practicing preferably gifs or videos

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Wrist flexor stretch