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Paper 4
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
With respect to tennis elbow, the most effective and long-lastingtreatment is: Local steroid injectionPhysiotherapyNon-steroidal anti-inflammatory treatmentIntramuscular diclofenacWait-and-see approach
Surgery of the Elbow
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Alan Salih, David Butt, Deborah Higgs
Patients with tennis elbow have tenderness at the common extensor origin, with reproduction of symptoms upon resisted wrist extension with the elbow in extension. Non-operative treatment with anti-inflammatories, counterforce bracing and up to three steroid injections to the site of maximal tenderness can achieve success in up to 95% of cases. The ECRB tendon is invariably affected, though the tendon of extensor digitorum communis (EDC) may also be affected in up to 35% of cases and therefore should not be neglected. Tennis elbow occurs at least five times more commonly than golfer's elbow.
Musculoskeletal and Soft-Tissue Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Tennis elbow causes pain over the lateral epicondyle of the humerus from a partial tear of the extensor origin of the forearm muscles used in repetitive movements (e.g. using a screwdriver or playing tennis).
An evidence-based evaluation of mobile health apps for the management of individuals with lateral elbow tendinopathy using a systematic review framework
Published in Physical Therapy Reviews, 2021
Luke J. Heales, Samantha Randall, Bill Vicenzino, Brooke K. Coombes, Steven Obst
Six apps were aimed at individuals wanting to self-manage their condition [18–22,24]. All six apps provided basic written and visual information implicating overuse of the forearm muscles in the aetiology of LET [18–22,24]. Three apps also suggested that inflammation is related to tendon pain [19,21,24]. All apps suggested that users could contact a health professional to confirm the diagnosis of LET prior to using the app. Three apps provided instructions to aid in self-diagnosis using the Chair test [20–22], where users are instructed to lift a chair from behind with their hands on top of the chair back, palms facing down, and elbows straight. If the action of lifting the chair causes pain on the outside of your elbow, it is proposed a likely indicator of tennis elbow. One app stated that individuals should go to a hospital for assessment by an orthopedic expert and undergo ‘immediate magnetic resonance imaging (MRI)’ [18]. In addition, three apps also suggested the user might need an X-ray or MRI to diagnose LET, but later stated that diagnostic imaging was typically reserved for patients that were not improving with conservative management or to rule out other clinical conditions [20–22].
Ultrasonographic comparison of the lateral epicondyle in wheelchair-user (and able-bodied) tennis players: A pilot study
Published in The Journal of Spinal Cord Medicine, 2021
Vivian Roy, Leah Lee, Michael Uihlein, Ishan Roy, Kenneth Lee
Lateral epicondylosis (LE), previously termed epicondylitis, is a common injury in tennis players and the general population.1 This condition is characterized by degenerative changes in the common extensor tendon due to microtears and scarring from overuse.1 The most commonly affected tendon is that of the extensor carpi radialis brevis (ECRB); however, other extensors such as extensor carpi radialis longus (ECRL) and extensor digitorum communis (EDC) may also be affected.1 The diagnosis is clinical and is often identified as tenderness over the ECRB tendon, 1–2 cm distal and anterior to the lateral epicondyle.1 LE may develop with any prolonged repetitive motion at the wrist, and tennis playing is a known risk factor. According to an epidemiological study of 150 nonprofessional male tennis players, the weekly number of playing hours is the best predictor for LE.2 In this study, the average “pain-free” tennis player spent 5.5 h per week of play time; the average “tennis elbow sufferer” spent 8 h per week.2 In addition, there is evidence that recreational tennis players are more at risk compared to professional players, along with players who use a one-handed backhand as opposed to a two-handed backhand.1,3 Treatment includes rest, occupational therapy (stretching and eccentric strengthening exercises), corticosteroid or platelet-rich plasma injections, and, rarely, surgical intervention such as repair or removal of scar tissue.
Beach tennis injuries: a cross-sectional survey of 206 elite and recreational players
Published in The Physician and Sportsmedicine, 2020
Marco Berardi, Pascal Lenabat, Thierry Fabre, Richard Ballas
The prevalence of tennis elbow in our study is 4.2%. BT players appear to be less affected by this ailment relative to tennis players, where the prevalence is 14% to 41% [6,12]. The length of the racket handle in BT is more or less the same as that of a tennis racket and varies based on grip and hand size. The weight of a racket averages 350 grams in BT, while a string-based tennis racket weighs about 280 g for a novice player and up to 350 g for an experienced player. This difference can be explained by differences in the movements used. While serving and volleying are similar between tennis and BT, there are relatively few strokes below shoulder level in BT, unlike tennis where forehands and backhands are mainly played at this height. BT has a type of hook shot, which is played with a straight arm behind the head, that is not used in tennis. In BT, the standard hold on the racket is a continental (hammer) grip, with fewer grip variations than in tennis.