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Epicondylitis (Tennis elbow)

Tendinopathy of the insertional lateral epicondyle (lateral epicondylitis) or medial epicondyle (medial epicondylitis) is a typical syndrome that in most cases, is caused by pathogenesis of overload and frequently affects athletes (tennis elbow) or professionals who use repetitive movements with the 'forearm (dentists, massage therapists).

Rehabilitation treatment and prognosis depend on the clinical phase in which you are: acute, chronic-relapsing, chronic-persistent. The rest and the suspension of gestures that are evoking the pain is the first absolute indication in the treatment of this disease.

The first phase of the rehabilitation protocol is focused on pain relief through physical therapy (laser, tens and ice daily applications) and the resolution of the muscular contraction that determines the tendinopathy through decontracting massage therapy of forearm muscles, deep transverse massage of tendon flexor and extensor muscles (especially in the distal portion, near epicondyle). It is important to inform the patient that pain, being of functional origin, will not disappear entirely but will persist even during the later stages of rehabilitation until full rebalancing of the tendon and muscle.

The next phase of the rehabilitation protocol is characterized by the strengthening of the epicondylus and epitrochlear muscles such as the short radial extensor carpi, the anconeus, the extensor carpi and the common extensor of the finger, mainly eccentrically, both manually and with the use of rubber bands and ballast. Very important at this stage is the rebalancing of the muscles flexed/extensors of the wrist and shoulder muscles (especially external rotation) to allow better control and stabilize the movement of the forearm.

After the complete remission of symptoms and the use of a specific tutor, the rehabilitation program ends with the last phase on the sports field, with the introduction of preparatory exercises, catching objects for neuromotor control and sport specific technical exercises for a gradual recovery the complex gestures and education to the right habits for the prevention of re-injury.

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