Steemit Learning Challenge-S22W2; Tennis Elbow
AssalamuAlaikum & Greetings Everyone!
AssalamuAlaikum & Greetings Everyone!
It's me @amjadsharif
From #pakistan
From #pakistan
Q.1 - What's tennis elbow? Write in your own words after getting knowledge from the lesson post. (Note: don't add special tests or investigations in this question. Write the answer precisely).
Tennis Elbow:
Tennis elbow, medical known as lateral epicondylitis, is an inflammation of the outside part of the elbow that causes tenderness. Although the title of this issue suggests it only happens to Tennis players, it can happen to anyone who uses forearm muscles constantly. It develops from overuse or over stretching of the tendons and muscles around the elbow, adept to wrist and fingers flexor muscles.
Causes:
The main cause of tennis elbow is the developing of micro tear on the tendons of the forearm due to repetitive stress. This can happen due to various activities, including:
- Sports: Repeated movements of the back of the racket in tennis or other games.
- Manual Work: The sustained processes of painting, carpentry, or typing among other activities.
- Household Tasks: for jobs that require lifting heavy objects, gardening or any task that requires use of gripping and twisting movements.
If these actions recur constantly, rips begin in the tendons and cause pain because of the inflammation.
Symptoms:
Tennis elbow symptoms are usually drawn out in their beginning and may go unnoticed at first. Common signs include:
- Pain: Stinging or burning pain in the lateral part of the elbow with possible extension to the forearm and the wrists.
- Weak Grip: Reduced strength or ability to grip objects, inability to hold things properly or problems with handshake or twirling movements like turning a jar lid.
- Tenderness: The skin of outer elbow may get swollen and along with swelling, outer elbow may have some sensitivity to touch, if pressed then it would be more sensitive.
- Stiffness: Pain and weakness of the elbow muscles, especially when waking up in the morning or lifting any weight at all and stiffness of the joint.
The pain may increase during certain activity like picking up a cup, shaking hands or even writing.
Types:
While tennis elbow is often categorized as one condition, it can manifest differently based on the severity and the affected area:
- Acute Tennis Elbow: This is an abrupt manifestation of the signs, especially after an exercise or injury has been there. Usually, it is successfully treated with sleep and basic care.
- Chronic Tennis Elbow: This is especially the case where this condition takes several months. Tendinosis can quite often be attributed to persistent stress on the tendon without sufficient time for repair.
- Referred Pain: Certain types of pain that a patient may feel in their elbow may not be emanating from the elbow but may be symptoms of a problem in the patient’s neck or shoulder. This type can also give the diagnostician quite a lot of trouble since it is not easy to distinguish it from other forms of the certain disease.
Tennis elbow is an annoying trail that any sports person may encounter though avoidable through wrong techniques and regular breaks. In cases of patients with the symptoms early intervention and reduction of stoke rates of repetition can enhance their recovery.
Q.2 - How would you diagnose a tennis elbow? Any clinical investigation or assessment tests?
Tennis Elbow and Assessment Study:
Tennis elbow, also referred to as lateral epicondylitis, is an overuse injury of the tendons attached to the lateral epicondyle of the humerus. It is prevalent among the persons who frequently apply wrist and forearm such as tennis players, those who involve in manual work and also computer operators. Here is a detailed article on its diagnosis, special tests, and physical therapy management for the condition.
1. Diagnosis:
History
- Symptoms: The symptoms normally manifest as pain on the lateral aspect of the elbow which increases gradually with gripping, lifting or wrist actions. The pain might extend from the elbow down to the wrist and is coupled with a reduced grip strength.
- Activity-Related Factors: The condition is associated with activities that create repetitive micro-trauma to the wrist extensor tendons during activities such as sports, especially tennis, typing, or use of hand tools.
- Onset: The pain tends to be chronic, arising from mild discomfort to considerable pain over several days and weeks but may be elicited by a particular activity or strain.
Physical Examination
- Palpation: Direct tenderness is observed over the lateral epicondyle particularly at the point where ECRB muscle arises.
- Pain Reproduction: It is generally provoked by performing such actions as resisted wrist extension, resisted middle finger extension and passive wrist flexion.
- Range of Motion: Slight tenderness that is NOT constant and NOT severe, usually does not interfere with activity the only movement that may cause tenderness is the wrist extension and supination.
- Grip Strength Testing: It is normally lower because of the effect of pain on grip.
2. Special Tests:
Cozen’s Test
- Procedure: The patient flexes their fingers, moves their wrist, and opposes the force that the examiner put on the patient’s hand.
- Result: Positive test is confirmed if pain is felt at the lateral epicondyle.
Mill’s Test
- Procedure: Examiner actively flex’s patient wrist flexors by holding patient’s forearm with one of his/her hand and the patient’s finger with the other hand and then fully extending the elbow and then fully flexing the wrist with patient’s fingers.
- Result: Positive result is if the patient feels pain in the lateral part of the elbow.
Maudsley’s Test
- Procedure: The patient raises their arm and pushes back against their dull resistance each time the examiner pushes down on the middle of the patients’ folded hand.
- Result: Pain at the lateral epicondyle establishes the diagnosis.
Grip Dynamometry
- Procedure: Use a dynamometer to assess the patients grip strength.
- Result: The affected arm shows decreased grip strength as compared to the other, non-affected arm.
Imaging (If Required)
- X-ray: To help exclude bone spurs, arthritis or other bony changes.
- Ultrasound: It is used to evaluate tendon degenerative abnormalities or rupture.
- MRI: Used only in chronic cases or if other pathology is suspected as the cause of proximal lateral ache.
3. Physical Therapy Interventions:
Tennis elbow requires physical therapy, which encompasses pain management as well as regaining normal function of the affected tendon with a view of avoiding further injuries. For systematic management, interventions are divided into phases.
Phase 1: Pain Relief and Inflammation management are other important aspects to treat or manage a disease or condition:
- Rest: Change or avoid anything that may make it worse.
- Ice Application: Place an ice pack to the lateral elbow for about 10-15 minutes every 2-3 times a day in case of pain and inflammation.
- Bracing: This can be accomplished through employment of counter force brace to compartamentalized the tendons of extensors during these activities.
- Electrotherapy: Treatments including TENS, and the use of ultrasound can go a long way in reducing pain and enhancing tissue healing rates.
- Medication: Pain can be treated by NSAIDs as the doctor may prescribe.
Phase 2: Muscle Strectching and Strengthening
Stretching Exercises:
- Wrist Extensor Stretch: Hold the affected arm with teh palm facing down and then using the opposite hand, bend the wrist slightly forward. Hold for 20-30 seconds.
- Forearm Supination Stretch: Flex the wrist and turn the hand after 135 degrees in a palm up position for about 15 to 20 seconds.
- Eccentric Loading: Perform wrist extension exercise using light weights or rubber bands while making slow lifts and must pay special attention to controlled lowering of wrist.
- Grip Strengthening: Roll a soft ball or use a handgrip trainer in order to strengthen the muscles of the forearm.
- Isometric Exercises: Avoid any wrist flexion or bending motions during the workout in order to not stretch the tendon during usage of the muscles.
Manual Therapy:
- Soft Tissue Mobilization: Gradual manipulation of the concerned part with the view of enhancing blood circulation and the tendons flexibility.
- Joint Mobilizations: Use the elbow joint to allow proper biomechanics and offload overall tension and compression on the tendon.
Phase 3: Functional Rehabilitation
- Proprioception Training: Incorporate such exercises as ball catching or putting the patient on wobble board to enhance his or her body balance.
- Progressive Loading: Slowly add resistance and intensity to progress, to build the tendons/muscle even more.
- Ergonomic Training:: Encourage proper works or sports activities and movements in order to minimize the pressure on the elbow.
- Activity Modification: Ammenities **Limit or avoid movements or tools that were used during the every day activities that may cause relapse.
Additional Therapies:
- Extracorporeal Shockwave Therapy (ESWT): Orb is also beneficial for chronic cases where the tendon may be given a signal to generate the materials used for its production.
- Dry Needling: May help to reduce pressure on the trigger points as well as add more blood supply to the tendon.
- Corticosteroid Injections: Are prescribed for chronic pain but are effective only in the short run.
- Platelet-Rich Plasma (PRP) Therapy: New therapy in the treatment of tendinitis in chronic condition.
This four pronged approach of managing tennis elbow is efficient in that it can successfully facilitate patients’ restoration to appreciable function that is free from pain.
Q.3 - 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.
In this course the exercises that I had learnt. From the six aspects of life mentioned by Covey, I chose three that I felt would work in order to try them out. The activities performed today involved ball squeezing finger stretch, and wrist flexor stretch.
1. Ball Squeezing
Everybody who tried this exercise should consider it as one of the most efficient exercises to gain more grip strength and coordination of fingers. I decided to take a soft ball and place it in my palm and then apply a lot of pressure on it. I held the squeeze for about 10 seconds then I let it go. I did this process for 10 times. This was not a difficult task at all and quite entertaining, which made me develop my grip force and the flexibility of the fingers.
2. Finger Stretch
In terms of finger flexibility, there is no better exercise than the finger stretch. My hand was straight and I began to bend and unclench my fingers. This motion was repeated about 15 times. It was basic but effective especially for those who spend most of their time on the computer.
3. Wrist Flexor Stretch
This exercise was aimed at the improvement of the amount of range movement within the wrist joint. I employ only one if my hand to hold the back of the other palm and pull it backward until I was able to observe some muscles stretch out at the wrist. I did this for about 15 seconds and then switched my hands. I performed this washout 10 times on each of my hands. <,) It produced a nice elasticity of the wrist muscles and was really soothing to the skin.
Experience
I also observed that these exercises as well helped in the physical and mental health of a person. The ball squeezing exercise really helped me develop grip strength irrespective of the fatigue level I was in. The other two exercises also helped in increasing flexibility of the hands and wrist such as the finger stretch and the wrist flexor stretch.
These given exercises if done on regular basis will definitely show a great improvement in the hands and wrist muscles. I did not get a chance to record myself sharing images, GIFs, or videos this time but I like the idea of having someone record you as you practice to document progress and using it for practice.
Q.4 - Share your review after performing these exercises either on yourself, healthy individual or patient.
In the present study, I implemented three activities: Ball Squeezing, Finger Stretch and Wrist Flexor Stretch and assessed the efficacy. These exercises are basically associated with strengthening and flexibility exercises of hand, fingers and wrist motions. Here I want to tell my story and what I has seen.
1. Ball Squeezing
Squeezing the balls can be a span in physical training activities mainly used to build the muscles of the hands and fingers. I did this exercise with medium soft ball. At first, I sensed that my fingers, and hands got tired a bit while typing, but after a few days, the grip strength improved considerably. It seems to be most effective for those that use the computer often or those whose hands are weak.
2. Finger Stretch
The finger stretch exercise was helpful to explore the flexibility of the fingers through a series of progression in finger stretch exercise for awhile. The exercise is uncomplicated and can be completed in any place and at any time. I attempted to make my fingers stay out longer to an extent that this slightly produced numbness on my fingers. Over time I stretched the hand more and got used to it and the flexibility of the fingers increased. However, now it is especially important to do this which is helpful for people with stiffness of the fingers or limited finger dexterity.
3. Wrist Flexor Stretch
In fact, the flexibility of the wrist and the exercise proved very beneficial for increasing mobility in the wrist. When getting to this particular stretch, there was a little discomfort in the wrist region but eased after sometime. I noticed that most persons with wrist pain or stiffness get a lot of value out of this exercise especially athletes or writers .
Overall Impression
By doing these exercises, I also realized a marked change in the muscles of my hands, fingers, as well as wrists flexors. These exercises can help a healthy person, a patient who has escaped a carpal tunnel syndrome, arthritis, or hand injury surgically or otherwise.
Daily performance of these exercises in correct form will not only improve the strength and flexibility of the hand but will also improve simplicity of easily performed tasks. These exercises should be a part of the daily practice especially for people who have complaints of hand or wrist pain.
My Invitation:> @josepha, @simonnwigwe, @ninapenda, @fantvwiki
Thank You Teacher @ashkhan for this wonderful lecture.
Thank you for understanding the lesson and sharing your assignment; I hope that you will enjoy this week's lesson and try to implement it in your life if you see any such case.
Observations
Task 1 (3/3)
You have shared a great knowledge about tennis elbow, its symptoms, cause, it's types. That's good you explain the types of tennis elbow. I appreciate your effort.
Task 2 (2.7/3)
In the second question, you tell us about how you have to assess a patient by doing physical examination, history taking, special tests and investigations. One thing I mentioned in this week posts to not share extra knowledge in any question. There was no need to add treatment options when I asked only about diagnosis method. Please be careful next time. Good.
Task 3 (4/4)
You try the finger stretches, wrist flexor stretch, and ball squeezing exercises. You did the finger stretches, wrist flexor stretch, ball squeezing correctly. Always remember to apply heat pack in chronic condition and ice in acute before performing exercises to relax the muscles and reduce stiffness. I appreciate your efforts.
Overall you made a great attempt to answer all the questions. I appreciate your efforts. But next time try to avoid the above written suggestions. Keep learning and try to implement your knowledge to the people suffering from tennis elbow or any type of wrist. Thank you.
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