lateral epicondylitis or ... epicondylalgia

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lateral epicondylitis or ... epicondylalgia

Postby Sillevis » Tue Sep 13, 2011 9:45 am

Is there an inflammatory process in those cases that present with pain at the lateral elbow? We should embrace the term epicondylalgia and this has consequences for the general treatment approach. How will this change our treatments?
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Re: lateral epicondylitis or ... epicondylalgia

Postby Maddox » Thu Sep 22, 2011 11:07 am

Well "itis" refers to an inflamation of... This inflammation is usually the result of an overuse injury, such as is whats typical of epicondylitis. "algia" refers to pain. In the case of epicodlylalgia does not purely by definition refer to an "injury mechanism", just referring to pain. For the "itis", treatments can be a little more conservatie to prevent any further injury. In dealing with the "algia", treatments can be a little more aggressive- especially with exercise, to help the patient push through a pain/guarding response.
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Tendonitis vs Tendonosis

Postby Jbeas » Fri Sep 23, 2011 4:00 pm

What would be the Best clinical examination to differentiate between a tendonitis from a tendonosis?
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Re: lateral epicondylitis or ... epicondylalgia

Postby Sillevis » Fri Sep 23, 2011 4:26 pm

I think that the discussion gets away from the point I was trying to make. The current best evidence identifies that there is no inflammatory process in these patients, however there is evidence of infiltration of angiofibroblasts identifying that there is a degenerative change in the tendon (tendinosis). The question now remains how do we treat this?
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Re: lateral epicondylitis or ... epicondylalgia

Postby kman » Sun Oct 09, 2011 6:00 pm

Decrease the pain addressing the local tissues, segmental innervation and the potential need to centrally "de"-sensitize. (Hit the reset button on their pain cycle)

Then, as with any degenerated tissue including bone, muscle, (ligament?) and nerve, put it to work. (Wolf's law)

Begin with sub-maximal/comfortable functional movements or tissue specific exercises using high amounts of repetition with low resistance. Later, progress the strength and endurance of the dysfunctional musculature above and beyond previous baseline levels using the overload principle.
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Re: lateral epicondylitis or ... epicondylalgia

Postby Sillevis » Wed Oct 12, 2011 4:03 pm

How would you decrease the pain? This always seems to be the main issue and limiting factor to have normal function. Would you prefer eccentric over concentric contraction when you initiate the strengthening process?
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