DESCRIPTION

The tennis player elbow ó epicondilitis is an injury of the muscles and sinews in the external side face of the elbow, which comes from a sobreuso or from repetitive efforts at this level. The repeated contraction of the muscular fibres of the forearm generates a tension located in the points of insertion of the sinews in the bone of the elbow.

MECHANISM OF THE INJURY

- Side Epicondilitis.

The most frequent upper extremity injury in the tennis is the side injury of elbow, resulted from an excessive or repetitive effort on the sinews chest expanders of the forearm, in particular those of the muscle short chest expander of the carpus. More frequent in the player amateur, the injury is usually a result of a reverse with bad skill (to strike the ball to counterblow, loading the energy only in the forearm, instead of in the whole arm from the shoulder), or of a powerful one I extracted of smatch in the one that they get together pronación (palm down) and rapid push-up of the doll, loading all the effort in the above-mentioned sinews chest expanders of the forearm.

- Medial Epicondilitis.

It is less frequent, and it happens of typical form with activity flexora and pronación simultaneous of the doll, as it can happen:

• 1) at the end of the volea, when the player flexiona quickly the doll to take the racket ahead.
• 2) in the first phase of the saque, when all the effort is located in the medial textiles of the elbow.
• 3) the called "golfer's elbow" that happens in the right elbow of a player of skillful golf when it carries out a defective swing with the rigid trunk.
• 4) the called "elbow of swimmer", who happens for lack of skill in some swimming styles, especially back.

It must be born in mind that the epicondilitis does not limit herself to players of tennis, golf, baseball or swimmers, but it is possible to give in any activity that puts the medial or side compartments of the elbow under similar repetitive efforts (martillear, use of screwdrivers, or enclosed computer work, etc.)

SIGNS AND SYMPTOMS

Of general form, in every epicondilitis pain can be evident on having held or to seize objects, lacking in force in the forearm, and pain to the pressure in the elbow, in the points of insertion of the sinews. Also, there exists a series of specific signs that will depend on the concrete type of epicondilitis.

REHABILITATION

The medial or side epicondilitis is frequent, and she usually produces incapability. The treatment reoutfitter is successful, but it is convenient to hope that the pain should have yielded or minimally before beginning the rehabilitation. In general, all the more time the pain lasts, longer is going to be the period of finished recovery.

In general, the rehabilitation process can split into 3 phases:

PHASE 1. Basically, Disminuír the inflammation and the pain. it consists of rest, I fry local (ice) and, if it is necessary, anti-inflammatory.

PHASE 2. To improve the flexibility, and to increase the force.
Soft exercises of muscular contraction consisting of push-up, extension and rotation of doll. The following sequence usually follows:

• 1) Doll extension.
• 2) Doll push-up.
• 3) Combined doll push-up - extension.
• 4) Pronación/Supinación of the forearm.
• 5) Extension of the fingers.
• 6) Exercises of push-up of fingers with a ball.

PHASE 3. To improve the muscular force, to support and to improve the flexibility, and to return gradually at the level previous to sports activity. Sometimes, in this phase, it is convenient to do modifications in the team.
Ej: a bad racket can have contribuído to the development of the epicondilitis.

HE GUIDES FOR THE SELECTION OF THE RACKET

1) Material - Those of graphite are considered to be the best as for control of vibration and torsion.

2) Size - those of average size are preferred (95-110 square inches). The biggest can obtain better blows, but they do the most capable arm to injuries. Also, the size of the handle has to be exact to the hand of one to prevent the excessive doll movement.

3) Cordage - synthetic Nylon, with recordage at least 1 time a year. As for the tension, it is convenient to support it in the low limit more than in the high place, what diminishes the vibration transmitted to the arm.

WHAT DOCTOR CAN TREAT ME?

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