medial and lateral epicondylitis

Question 1

Affects common attachment of extensor muscles of forearm is?

Answer 1

Lateral Epicondylitis

Question 2

give example of lateral epicondylities

Answer 2

tennis elbow

Question 3

medial 4-7 times more common than lateral
true or false?

Answer 3

false, lateral is more common

Question 4

what are the extensor muscles?

Answer 4

Extensor Carpi Radialis Brevis*
Extensor Carpi Radialis Longus
Extensor Digitorum
Extensor Carpi Ulnaris

Question 5

which extensor muscle is most common for lateral epicondylitis?

Answer 5

Extensor Carpi Radialis Brevis*

Question 6

the extensors muscles are all innervated by?

Answer 6

radial nerve

Question 7

when Lateral epicondylitis can occur without any recognized repetitive injury.

it is called?

Answer 7

insidious

Question 8

what are the Risk factors in racquet sports?

Answer 8

Incorrect technique
Extended duration of play
Frequency of play
Size of handle
Racquet weight

Question 9

Tendinosis is an?

Answer 9

degenerative process

Question 10

what is the gross Pathophysiology of lateral epicondylitis?

Answer 10

Grayish, homogenous, edematous and friable tissue

Question 11

Rate of stretching exceeds tolerance leads to microtears resulting in tendinosis

true or false?

Answer 11

true

Question 12

what are the 4 Histologic Stages of Microtrauma?

Answer 12

Acute inflammatory response
Angio fibroblastic hyperplasia
Structural failure of tendon with partial of complete rupture
Features of stage 2 or 3 plus fibrosis, soft calcification within collagen and hard osseous calcification

Question 13

for patients with lateral epicondylitis are able to hold items
true or false?

Answer 13

false, are unable

Question 14

Pain at lateral epicondyle radiates to?

Answer 14

down extensor mass, occasionally proximally

Question 15

list the physical examination

Answer 15

tenderness at lateral epicondyle
full elbow and wrist ROM
resisted extension
normal sensation
Wrist Extensor weakness 2º pain
Decreased grip strength

Question 16

what can we do for non surgical treatment?

Answer 16

Relative rest
Ice

NSAIDs
Steroid Injection: Short-term relief

Counterforce Bracing (decrease tension on extensors) and wrist splint

PT/Rehab: range of motion, eccentric strengthening

Question 17

list some exercises for tennis elbow relief

Answer 17

eccentric exercise
forearm flexor stretch
forearm pronation
forearm extensor stretch
ball squeeze
hammer curls
triceps stretch

Question 18

what are th Physical Examination Tests?

Answer 18

Cozen Test

Mill’s Test

Middle Finger Extension Test

Question 19

what type of EPA can we use?

Answer 19

Ultrasound/Extracorporeal shock waves (ECSW’s)

Question 20

Golfer’s elbow is?

Answer 20

Medial Epicondylitis

Question 21

what are the flexor muscles?

Answer 21

Pronator Teres
Flexor Carpi Radialis
Palmaris Longus
Flexor Digitorum Superficialis
Flexor Carpi Ulnaris

Question 22

pronator teres is the most muscle related to golfer’s elbow
true or false?

Answer 22

true

Question 23

which tendon becomes confluent with hyperplastic section of anteromedial joint capsule?

Answer 23

flexor

Question 24

what is the biiomechanics for medial epicondylitis?

Answer 24

Repetitive eccentric loading
Wrist flexion, forearm pronation

Valgus stress at elbow

Question 25

what is the pathophysiology of medial epicondylitis?

Answer 25

Peritendinous inflammation

Angio fibroblastic hyperplasia

Irreparable fibrosis or calcification

Ulnar collateral ligament

Question 26

what is the biomechanics for lateral epicondylitis?

Answer 26

Excessive/repetitive use extensors or supinator

Answer 27

Pain along medial elbow Radiation to proximal forearm
Increased pain with resisted pronation and wrist flexion
Tenderness 5-10mm distal and anterior to epicondyle
Normal ROM and Sensation and x-ray
Resisted wrist flexion, forearm pronation, grip may be weak.
Valgus Stress  Ligamentous pain
Concomitant ulnar neuritis

Question 28

extension of the arm and wrist with forame supination is for testing the golfer’s elbow.
true or false?

Answer 28

true

Question 29

what is the non-surgical treatment for Medial epicondylitis?

Answer 29

Rest, 6-12 weeks off throwing
NSAIDs
Wrist flexor and forearm pronator stretching
Night splinting
Therapy: ROM, eccentric strengthening

Question 30

list some exercises for medial epicondylitis

Answer 30

wrist stretches
grip strengthening
forearm pronation and supination
eccentric wrist flexion and extension
mid trap exercise
resisted wrist flexion
resisted elbow flexion and extension