![]() Treadmill walking or Upper body ergometer (UBE) Increase blood flow, soft tissue pliability, and temperature. The provided rehab strategy will specifically include an evidence-based scapular stabilization algorithm integrated with a local treatment approach. Accordingly, the purpose of this clinical commentary is to describe a comprehensive rehabilitation strategy for individuals with lateral elbow tendinopathy. However, no study has outlined a rehabilitation program for LET that includes scapular muscle exercises with sufficient detail for the purpose of clinical replication. Therefore, based on observational studies, expert opinion, and the KCT, scapular muscle performance could be an essential piece for rehabilitation professionals to address in patients with LET. 17 Without proper proximal scapular strength, there is an increased load on distal tissues at the elbow and wrist. ![]() 15, 16 As a result, proximal weakness increases the demand on the distal segment therefore overloading the distal segment. The KCT proposes that during functional arm motions kinetic energy is transferred from proximal to more distal segments of the arm, providing an effective and efficient mode for distal function. One rationale for strengthening scapular muscles in this population is based on the Kinetic Chain Theory (KCT). 12- 14 Therefore, it is reasonable to assume that scapular muscle exercises should be considered as part of a comprehensive rehabilitation program for LET if weakness is present. Recently, researchers have identified shoulder girdle weakness in patients with LET. 10, 11 Moreover, little guidance is available regarding the dosage (including the intensity, duration, frequency, and progression) of exercise prescription. 8 Still, there is not a precise description of what constitutes an evidence-based multimodal treatment program for LET 9 especially when it comes to preventing recurrence of the condition. 6, 7 When critically assessing the literature, best rehabilitation practice supports various forms of the therapeutic exercise and manual therapy for the immediate and short-term improvement in pain and function. 4Īlthough somewhat ambiguous, rehabilitation interventions are typically favored over medications, cortisone injections or surgery as the first method of treatment. 4, 5 In general, systemic risk factors are thought to reduce the tendon capacity to manage load such that routine activities of daily living may be enough to trigger a pathological cycle. Known systemic risk factors include hypercholesterolemia, diabetes, hormonal imbalances, age and genetics. 3 Risk factors for developing tendinopathy are both load related (biomechanical) and systemic. 2 The mechanism of injury is variable but typically results from overloading of the common wrist extensors.Ĭlinically, LET can present acutely in the form of tendonitis, but more commonly presents chronically where degenerative tendon changes, disorganized collagen bundles, scar tissue, and hypervascularity has been identified. ![]() 1 LET, lateral epicondylitis, or tennis elbow is defined as a pathology at or near the lateral epicondyle of the humerus resulting in pain, tenderness, and functional limitations. Lateral elbow tendinopathy (LET) is the most common musculoskeletal elbow tissue injury and can result in significant limitations in function and decreased participation in activities.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |