Epicondylitis: Therapeutic Exercises

Who I am
Joe Dispenza
@joedispenza
SOURCES CONSULTED:

wikipedia.org

Author and references

Introduction

L'epicondylitis is a very annoying painful condition, which however with specific implementation therapeutic exercises and the use of other remedies of physiotherapy it can improve tremendously, until healing.



This article will cover some of the main ones exercises for epicondylitis; however, first, also for a better understanding of the content, he will review the aforementioned musculo-articular pathology.

epicondylitis

What is Epicondylitis?

Also known as tennis elbow, epicondylitis is one insertional tendinopathy, which affects the tendons of origin of the wrist extensor muscles and causes pain on the lateral (outer) portion of the elbow.

The precise site of pain is on the lateral epicondyle of the humerus; after all, it is here that the tendon origins of the wrist extensor muscles, ie the anatomical structures from which the painful symptoms arise, find their connection.

More than the inflammation of the tendons, epicondylitis is characterized by the degeneration of tendon tissue; this explains why it is more correct to call it an insertional tendinopathy, rather than one tendonitis (the suffix –ite, in medicine, indicates inflammatory processes).



Causes of Epicondylitis

Epicondylitis is a fundamental tendinopathy functional overload.

Indeed, it is the result of one imbalance between stimulation and the ability to recover the suffering muscle-tendon tissues.

Undoubtedly, the exasperated repetition of movements such as thewrist extension (which calls into question the wrist extensors) and the rotation of the wrist against resistance.

In addition, the power take-off (i.e. when you hold an object using your fingers and palm), especially with theforearm in pronation.

Who is at Risk of Epicondylitis?

Epicondylitis is widespread in sports, but not only.

Sports at risk are all those in which a grip is foreseen, especially with the forearm in pronation, and the stimulation of the wrist in extension.

Outside the sports field, various professional categories are at risk of epicondylitis, including electricians, butchers or musicians.

Symptoms of Epicondylitis

The most characteristic symptom of epicondylitis is the pain in the side of the elbow (epicondyllaggia).


Classical activities and situations that evoke such pain are firmly grasping an object (power take-off), extending the wrist against resistance, lifting an object with the forearm in pronation and simple palpation.


More severe epicondylitis causes pain with any manual activity, even if this does not involve a PTO or a significant extension of the wrist.

Generally, epicondylitis pain appears gradually: initially, it is mild and occurs only during critical movements; with time, however, especially if no treatment is used, it becomes more and more intense and persistent (even not particularly critical movements provoke it).

For further information: Epicondylitis or Tennis Elbow: Causes, Symptoms and Treatment

Exercises

Without a doubt, the therapeutic exercises for epicondylitis they are a valid ally in the management of this annoying tendinopathy.

They are a cornerstone of the treatment of physiotherapy, together with manual therapy.

The exercises for epicondylitis that the scientific literature reports as useful are varied and have different objectives: some are aimed at muscle strengthening, while others atmuscle stretching (stretching).

Primarily, the target muscles are the wrist extensors and supinators of the forearm; some treatment plans, however, also include exercises for the muscles involved in the ulnar and radial deviation of the wrist, the brachial biceps and the brachial triceps.


Exercises for Epicondylitis: Who Are They For?

Therapeutic exercise is essential (and strongly recommended) when epicondylitis has been in progress for at least 3 months or is the protagonist of continuous relapses.


However, it is also beneficial in people with recently onset epicondylitis (which has been in existence for a few weeks), who do not have a past history of elbow problems.

It should be noted that, in the first circumstance, it is strongly recommended to rely on specialized figures in the medical-health sector (orthopedist, physiatrist, physiotherapist), in order to receive adequate and personalized information based on the present problem.

Exercises for Epicondylitis: A Protocol for Everyone?

Exercises for epicondylitis have no particular contraindications; after all, these are simple strengthening and stretching exercises, which can be performed in total safety even at home.

The problem, however, is another: epicondylitis is one difficult condition to cure, because it can depend on numerous favoring factors; this implies that each patient represents a separate case and therefore needs a tailor-made physiotherapy treatment, custom.

Hence, a rehabilitation protocol valid for a certain individual within a certain clinical picture will not be as appropriate for another person with a different clinical picture, although both suffer from lateral elbow pain.

Customization of epicondylitis exercises is critical for precise and highly focused healing action.

All this serves to underline, once again, the importance of relying on specialized figures in the medical-health sector (orthopedic, physiatrist, physiotherapist).

Epicondylitis Exercises: What Equipment Do You Need?

The most common epicondylitis exercises require:

  • Un handlebars of a few kilograms, easily available both online and in physical sporting goods stores;
  • Un rubber band of low or medium-low resistance (it would be ideal to have both a circular rubber band and a rubber band with free ends);
  • Un mat (not essential), for free body exercises.

To understand: the movements of the elbow, forearm and wrist

To better understand how epicondylitis exercises are performed correctly, it is necessary to know the movements of the elbow, forearm and wrist.

The elbow can carry out the movements of:

  • Flexion, in which the forearm essentially closes on the upper arm, and
  • Extension, which is the return movement from flexion (hyperextension of the elbow is not possible).

The forearm can perform the movements of:

  • Supination, which consists in orienting the palm of the hand upwards with a parallel position between the radius and ulna, e
  • Pronation, which consists in orienting the palm of the hand downwards with a crossed arrangement between the radius and ulna.

Finally, the wrist can perform the movements of:

  • Flexion, in which the palm of the hand approaches the forearm, and
  • Extension, in which the back of the hand approaches the forearm;
  • Ulnar deviation, in which there is a reduction in the angle between the hand and ulna (the little finger approaches the forearm);
  • Radial deviation, in which there is a reduction in the angle between the hand and the radius (the thumb approaches the forearm).

Muscle Strengthening Exercises

Muscle strengthening exercises for epicondylitis target the wrist extensors and forearm supinators.

Strengthening of the Extensor Muscles of the Wrist

Financial year 1

The first step concerns the position: the subject must sit near a table so as to rest the forearm of the affected limb in the prone position (palm facing downwards), with the elbow flexed at about 90 ° and the hand that protrudes from the edge.

At this point, holding a dumbbell weighing a few kg (1-3 kg), obviously with the hand of the affected limb, he must extend the wrist by 30 ° to maintain the position for the indicated time.

A possible variant involves the use of an elastic with free ends tied around the hand and fixed under the foot.

How much to do it? Experts recommend 2-4 sets of 30-90 seconds each.
Between one series and another there is a maximum recovery of 1 minute.

Exercises 2

The first step concerns the position: the subject must sit near a table so as to rest the forearm of the affected limb in the prone position (palm facing down), with the elbow flexed at about 90 ° and the hand protruding from the edge.

At this point, holding a dumbbell weighing a few kg (1-3 kg), obviously with the hand of the affected limb, he must perform alternating movements of flexion and extension of the wrist, all in an extremely controlled way.

A couple of important precautions are: the extension of the wrist must not exceed 30 °; the flexion must not be excessive.

How much to do it? Experts recommend 2-4 sets of 10-15 repetitions each.
Between one series and another there is a maximum recovery of 1 minute.

Financial year 3

The previous exercise can be reproduced with a circular rubber band.
The use of the elastic offers an important advantage: it allows to provide different stimuli to the wrist extensor muscles, thanks to the fact that it is possible to change the position of the forearm depending on where the elastic is fixed.

While standing, the subject can:

  • Attach the elastic under the foot and perform some extension-flexion cycles of the wrist (obviously the other end of the elastic is closed in the hand of the affected limb).
  • Attach the elastic to the side (the ideal would be to attach it to the part of the limb that does not work) and perform some extension-flexion cycles of the wrist.
  • Attach the strap at the top and perform wrist extension-flexion loops.

How much to do it? Experts recommend 2-4 sets of 10-15 repetitions each.
Between one series and another there is a maximum recovery of 1 minute.

Strengthening the Supinator Muscles of the Forearm

Financial year 1

First, the subject must tie the end of an elastic band to the hand of the affected limb and fix the other end to a contralateral support (i.e. positioned on the side opposite the limb to be trained).

Then, from standing, with the forearm of the limb connected to the elastic in a prone position and the elbow of the same flexed at 90 °, he must perform alternating pronation-supination movements of the forearm (that is, he must bring the palm of the hand up and then bring it back down).

How much to do it? Experts recommend 2-4 sets of 10-15 repetitions each.
Between one series and another there is a maximum recovery of 1 minute.

Stretching exercises

Stretching exercises for epicondylitis target the supinator muscles of the forearm and the extensor muscles of the wrist.

Forearm and Wrist Extensor Supinator Muscles Stretching

Financial year 1

Standing, with the arm flexed at 90 ° and the elbow extended, the subject must completely flex the wrist of the painful limb, helping himself to maintain the position with the other hand (which must be applied on the back of the one in flexion).

To emphasize the stretching of the target muscles, it is good practice to rotate the bend of the elbow upwards (shoulder external rotation), all while continuing to keep the wrist and trunk fixed.

This same exercise can be performed with the painful limb resting on a table, taking care to make the wrist protrude from the edge (so as to allow its flexion).

How much to do it? Experts recommend 3 sets of 30-60 seconds of holding each.
Between one series and another there is a maximum recovery of 1 minute.

Financial year 2

In the quadrupedal position, with the elbows extended, the subject must fix the entire back of the hand of the painful limb on the floor (while the other continues to serve as support).

By fixing the hand in this way, he flexes the wrist and puts the arm in pronation, the two basic conditions for stretching the wrist extensor muscles and the supinator muscles of the forearm.

Once the hand is fixed, it must go backwards with the body, so as to favor the stretching of the target muscles (it is advisable to stagger the hand that serves as a support, the one that does not work so to speak, bringing it further forward than the other).

Also in this case, to further emphasize the stretching of the target muscles, the shoulder extra-rotation is indicated, a movement which, in these conditions, causes the bend of the elbow to look forward.

How much to do it? Experts recommend 3 sets of 30-60 seconds of holding each.
Between one series and another there is a maximum recovery of 1 minute.

Audio Video Epicondylitis: Therapeutic Exercises
add a comment of Epicondylitis: Therapeutic Exercises
Comment sent successfully! We will review it in the next few hours.