Lateral epicondylitis, commonly known as tennis elbow, affects the extensor carpi radialis brevis and is prevalent among tennis players due to overuse. Symptoms include pain, tenderness, and stiffness, with diagnosis aided by ultrasound or MRI, and treatment options range from NSAIDs and physiotherapy to surgical intervention. Medial epicondylitis, or golfer's elbow, arises from the common flexor origin and is treated similarly but involves different mechanisms and special tests.

1. Lateral epicondylitis
- Dr.DHARANI MAVURU

2. • The most common tendinopathy, with pain arising from origin of extensor
carpi radialis brevis at lateral epicondyle.
• Tennis players are more prone, where mostly occur with history of racquet
use.

3. Mechanism of injury
• During awkward stroke
during game of tennis.
• Overuse of elbow in day
to day activities like pulling,
lifting, pushing, etc.

4. Clinical features
• Pain
• Tenderness
• Slight swelling
• Radiation towards the elbow
• Early morning elbow stiffness.
• Aggravating factor: lifting any objects.
• Full ROM is seen.

5. Special tests
• Maudsley’s test
• Mill’s test.
• Cozen’s test

6. MILLSTEST

7. MAUDSLEY’STEST

8. COZEN’STEST

9. Diagnosis
• Ultrasound
• MRI Scan.

10. Treatment
• Conservative treatment.
• Operative treatment.

11. Conservative treatment
• NSAID’s
• Hydrocortisone acetate

12. Physiotherapy
1. Cryotherapy
2. Tennis elbow Splint
3. Sling – elbow in flexion, forearm in supination.
4. Electrical stimulation – sinusoidal stimulation 20 minutes.
5. Ionotophoresis
6. Diapulse , ultrasound,TENS
7. Efflaurage , kneading
8. AROM
9. Resistive exercises
10.Mobilization.

15. Operative treatment
Extensor muscles from the origin are stripped.
• An above elbow slab with elbow 900 flexion- 10 days.
• Elbow – mobilized after that.
• PRE
• AROM- after 4 weeks

16. Physiotherapy after surgery
• Reduce pain and inflammation
• Limb elevation & AROM- distal joints
• Slow PROM –elbow
• Shoulder mobilization
• AAROM- ELBOW
• Ultrasound ,TENS, diapulse
• Functional movements
• Gradually progress to PRE
• DURATION : 5-6 weeks

17. Medial epicondylitis

18. • The tendinopathy, with pain arising from common flexor origin of
medial epicondyle.
Mechanism:
• Caused when a golfer hits the ground instead of ball- providing
valgus strain on elbow

19. Special tests
• Reverse Cozen’s test.

20. Treatment
• Conservative
• Operative
Operative: common flexor origin tendon is excised.