The epicondyle is the external bony projection of the humerus at the elbow. This is where several tendons are inserted, grouped under the name of epicondylar.
1) A LITTLE ANATOMY:
The epicondyle is the external bony projection of the humerus at the elbow. This is where several tendons are inserted, grouped under the name of epicondylar. These musculotendinous complexes essentially participate in the extension of the wrist and fingers, as well as in the supination of the forearm.
On the projection located inside the humerus, the epitrochlea (or medial epicondyle), are inserted the epitrochlear muscles, responsible for the flexion of the wrist and the fingers, as well as the pronation of the forearm.
2)WHAT IS ELBOW EPICONDYLALGIA?
This term refers to any pain encountered on these two bony reliefs, generally related to the inflammation or irritation of one or more of the tendons inserting there.
The terms “epicondylitis”, or “tennis elbow” for one, and “epitrochleitis”, or “golfer’s elbow” for the other are commonly used, although these names are not always appropriate to the situation. .
3) WHAT ARE THE LESION MECHANISMS?
This type of pathology is characterized by micro-tears or small lesions in one or more tendons or their insertion on the bone. The lesions are linked to repeated micro-traumas, creating progressive irritation of the structure.
If the body, usually able to repair itself, is no longer able to do so due to stress, these tears multiply, and cause pain due to inflammation and weakening of the tendon.
The circumstances of appearance are therefore regularly the same:
Intensive practice of a sport, in particular those involving repeated shocks (e.g. tennis, golf, etc.)
Sudden change in training volume or intensity
Poor motor control and muscle weakness
Bad technique in the sporting gesture
4) WHAT ARE THE SYMPTOMS?
This type of injury can appear gradually or following a specific event. The intensity of the problem will produce more or less severe symptoms. Among these are:
A precise and localized pain on the epicondyle, which can radiate in the forearm
Pain that gets worse with exertion and usually subsides with rest
A stiffness in the forearm
In more severe cases, this pain can also be constant and present even at rest.
5) IS IT SERIOUS?
Like the majority of tendinopathies, these are rather frequent pathologies which are generally got rid of quite easily and quickly during early treatment.
However, they can become problematic and more difficult to treat when they have been present for a longer time, and when the intensity is high. In the event of mistreatment, it is not uncommon to observe subjects retaining pain for months or even years!
6) IS SURGERY AN OPTION?
The surgical procedure remains exceptional and will only be considered in the event of repeated failures of conservative treatments or in the event of complications linked to the absence or poor initial treatment.
7) CAN I CONTINUE TRAINING? WHAT REFLEXES SHOULD I TAKE?
Epicondylalgia, whether lateral or medial, needs to be taken seriously from the start in order to avoid complications and aggravations.
At the onset of the first symptoms, a temporary cessation of activities that cause pain is recommended. These activities can be replaced with others that unload the tendon, such as cycling and swimming.
Finally, refrain from overusing ice and anti-inflammatories, as these modalities generally interfere with the healing of structures.
Then, it is the importance of the symptoms and the improvement of the situation that will determine the duration of the relative cessation of the activity.
The best option should be discussed with your doctor.
8) HOW DOES THE REHABILITATION TAKE PLACE?
The physiotherapy sessions start by paying attention to the painful symptomatology of the subject. The interrogation, the clinical examination as well as the use of medical imaging (ultrasound) will allow the therapist to identify the cause of the problem in order to be as effective as possible in its management.
Respecting the symptomatology, the work will focus on:
The work of joint mobility and tissue flexibility
Gradual rehabilitation of the joint and tendons
Global and specific muscle strengthening (strength, neuromuscular control, stability, etc.)
Re-athletics and getting back into sport (with technical work if necessary)
9) WILL I RETURN TO MY PRE-INJURY LEVEL?
This pathology, although having a favorable prognosis, needs to be taken seriously from the start.
However, provided you follow the instructions and recommendations provided by your surgeon and your therapist, you will return to a normal sports activity.
10) WHAT CAN I DO TO SPEED UP THE PROCESS?
You are the main actor of your rehabilitation!
In order to speed up the healing process, be sure to follow the recommendations of the health professionals with whom you work.
Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!