Lateral and Medial Epicondylitis
Lateral and Medial Epicondylitis are commonly referred to as Tennis elbow and Golfer’s elbow. They are similar conditions that cause pain where the tendons of the forearm muscles attach to the bony protrusion on either side of the elbow.
Tennis elbow is characterized by pain on the outer side of the elbow, while Golfer’s elbow affects the inner side. This condition is generally seen in people who repeatedly use their wrists and clench their fingers. Tennis/golfer’s elbow can come on gradually or suddenly.
Massage therapy has been shown to reduce local pain, reduce swelling, improve circulation and improve mobility to the affected area. Massage can promote tissue healing by increasing blood flow and increasing tissue extensibility.
A combination of several types of massage techniques are used by an experienced therapist at differing times during the treatment.
1. Soft tissue massage along the common wrist extensor muscle belly can help to promote relaxation and increase tissue extensibility
2. Deep friction massage is typically performed across the common wrist extensor tendon. The friction coming from the massage stimulates the production of collagen within the damaged tendon area. Deep friction massage is thought to assist the remodeling phase of an already degenerating tendon and to reduce scar tissue formation.
3. Myofascial techniques addressing the common wrist extensors are applied to relieve pain and improve soft tissue extensibility.
In a randomized clinical trial, deep friction massage is being compared with steroid injection for treating tennis elbow. Patients were randomized to receive one of the three treatments: group 1 with splinting and stretching, group 2 with a cortisone injection, and group 3 with lidocaine injection with deep friction massage. And after a six-month follow-up, it shows that patients that undergone deep friction massage have a significant improvement on their Visual Analog Scale (VAS) pain score, Disabilities of the Arm, Shoulder and Hand (DASH) score and grip strength.
Overall, the results show that deep friction massage is effective in treating tennis elbow especially to patients who have failed other nonoperative treatments such as cortisone injections. Yi, R., et. al (2018)
Symptoms of tennis/golfer’s elbow include:
- Pain and tenderness at the elbow, sometimes traveling down the forearm. This persistent forearm pain worsens with certain movements.
- Persistent aching and morning stiffness in the elbow
- Stiffness of the elbow
- Pain when making a fist or pain gripping an object
- Weakness in the hands or wrists or pain when bending the wrists while straightening your elbow
- Numbness or tingling in the fingers
- Pain that occurs when raising your hands or straightening your wrists
Tennis and golfer’s elbow can be caused by multiple things, such as:
- Racket sports, golf, and throwing sporting activities
- Carpentry and mechanic work
- Weightlifting
- Forceful, repetitive occupational activities
- Typing
- Painting
- Plumbing
- Knitting
- Many, many more
Diagnosis:
A massage therapist is not legally allowed to diagnose any type of condition. Diagnosis is outside of our scope of practice. For a diagnosis, a doctor will take a medical history and perform a physical exam. Sonograms, MRIs, X-rays and other imaging tests might be needed if the doctor suspects that something else is causing the symptoms.
If you have any type of idiopathic pain, please consult your medical professional for a workup and diagnosis.
https://pubmed.ncbi.nlm.nih.gov/28719982
A COMPREHENSIVE REHABILITATION PROGRAM FOR TREATING LATERAL ELBOW TENDINOPATHY – PMC (nih.gov)
https://www.mayoclinic.org/diseases-conditions/golfers-elbow/symptoms-causes/syc-20372868