Physiotherapy for Medial Epicondylitis - How Does It Work?

Introduction

Medial epicondylitis is commonly referred to as a golfer’s elbow that we all might be heard about. So, it is a painful condition of the elbow and its related muscles resulting in impairment of movements, function, and daily activities. In addition, many sportspersons, including golfers, swimmers, and others, are influenced. As a result, the individual seems devoid of physical performance. Physiotherapy is a physical-based approach that would help in retrieval.

What Is Medial Epicondylitis?

Medial epicondylitis is the inflammation, irritation, and pain of the medial epicondyle, a bony projection present on the inner part of the elbow. The medial epicondyle constitutes tendons attaching muscle and bone; thus, the muscles responsible for movements are affected. The condition is commonly known as a golfer's elbow, while the cause is the recurrent use of the elbow, forearm, and wrist.

Signs of Medial Epicondylitis:

Pain concerning the affected elbow is the most prominent symptom of medial epicondylitis. However, it also presents additional signs:

• Pain in the forearm's inner aspects that aggravates during movements of the hand, wrist, and elbow.

• Tenderness on feeling and handling.

• Muscle weakness due to tension overload.

• Swelling.

• Stiffness of elbow.

• Tingling and numbness are often present and associated with gripping.

• Weakness of the affected hand while handling stuff.

• Pain seems to radiate from the inner part of the elbow to the fingers.

Why Physiotherapy Treatment for Medial Epicondylitis?

Overusing the hand and elbows for tasks would result in medial epicondylitis at times. And this worsens progressively with heightened use of the affected arm. This increasingly suppresses the tendon. Finally, the persistently irritated tendon culminates in a tear as it holds poor blood circulation. So, dysfunctional tendons precipitate severe conditions interfering with sleep and daily functioning. Therefore, it is vital to seek treatment before it becomes critical. It requires strengthening and manual therapy to reinforce the medial epicondyle bone and, thus, the elbow. A physiotherapy intervention is an effective approach to rehabilitation and reinforcement that restores the function and motion of the part. On the contrary, physiotherapy treatment is also applied as rehabilitation to individuals who underwent surgery for the severity of medial epicondylitis.

Principles:

• The primary principle of any physiotherapy approach is the enhancement of recovery.

• With the appropriate aids, initial rehabilitation is on alleviating additional tendon damage.

• The intervention should focus on the contracture, weaknesses, motor control abilities, daily functions, and other concerns.

• In addition, the actual therapist’s goal of rehabilitation should meet the patient’s desires, goals, likes, considerations, and expected outcomes.

• Physiotherapy intervention is based on a patient-centered approach that welcomes patient involvement.

What Are the Physiotherapy Techniques Used for the Management of Medial Epicondylitis?

The physiotherapy approach or physiotherapy rehabilitation for medial epicondylitis is all about increasing muscle strength, healing the tendons, and enhancing endurance. The following are the physiotherapeutic approaches for a person with a golfer’s elbow.

Education: To begin any treatment, knowledge about the condition, treatment approach, and outcome is significant. A physiotherapist provides education on things and makes the patient apprehensive. The changes required during golf throw, swimming, sporting, and other daily activities intended to diminish the risk of injury are acknowledged. These modifications would eventually let the tendons be free of certain forceful pressure.

Pain Management: Pain is the first thing to be concerned about. It could affect the process of restoration over function. The physiotherapist will assist the patient with pain relief through a regimen. On the other hand, it could heal the tendons. These are the most typical means a therapist would advise.

• An ice pack or ice massage.

• A heating pad or heat treatment.

• Ultrasound.

• Iontophoresis- a medical device that delivers medication via mild electrical current.

• Splinting.

• Cessation of sports in cases of severity.

Manual Therapy: Muscle imbalance of shoulders and spine is presented right from elbows as they are connected. So, the therapist applies a variety of manual therapy for the muscles to restore healthy motion. Manual therapy incorporates joint movements, gentle massage, joint mobilization, and stretches, all of which involve the hand, wrist, and elbow.

Stretches: Stretches sound great for preparation before any exercise and prevention of trauma while exercising. Muscle imbalance and tightening happen in cases of medial epicondylitis. Stretches will contribute to the effects like stretching the stiffened muscles and elbow, reducing the pain in the affected arm.

Shoulder-Strengthening Exercises: Strengthening exercises are recommended for the improvement of atrophied (shrunken) muscles and blood flow. So, the therapist advises the following exercises to maintain muscle mass that can be employed at the office or home.

• Isometric exercises for tightening or contraction of muscles even without involving joints.

• Resistance exercises are about weights. It can be lifting or jumping with weights (medicine balls), sandbags, and resistance bands.

Range of Motion Exercise: Range of motion is a measure of a muscle or joint’s capability to complete the full spectrum of movements. So, a range of motion exercise paves the way for stiffness by moving the joints with the whole range of motion a person could. This can be practiced by an individual or a caregiver's guide. Nevertheless, the patient must make an effort at the entire length of motion in case of active exercise for desired results.

Functional Training: Finally, the therapist gets the patient back to the preexisted functions when the improvement of symptoms is notably perceived. He will guide the patient with revamping to be done for the movements and function to prevent further tendon damage.

What Are the Benefits of Physiotherapy Over Medial Epicondylitis?

The benefits of physiotherapy over medial epicondylitis:

• Diminishes pain.

• Reduces inflammation of the tendons.

• Promote tissue healing.

• Promotes muscle mass, alleviating muscle atrophy.

Conclusion

Medial epicondylitis, also referred to as golfer’s elbow, is a condition characterized by overuse injury with the inflammation of the tendons present on the inner region of the elbow. This causes significant pain and tenderness of the elbow joint. Physiotherapy could be an effective therapeutic approach for medial epicondylitis. Physiotherapy for this condition primarily focuses on alleviating pain, restoring physical function, and enhancing healing. The treatment modalities include strengthening exercises, manual therapy, bracing, stretches, pain management, and education.