Talk:Tennis elbow

Choice of names

Sorry previous reversion got saved whilst trying to type up the edit summary.

PubMed may be used to indicate the choice of terms biomedical papers tend to use.

• "tennis elbow" = 966
• "lateral epicondylitis" = 932
• "lateral epicondylagia" = 45

So I suspect this makes "lateral epicondylagia" a trivial alternative choice of terminology at just 2.3% of all hits found, and trivial POVs need not be included under NPOV guidelines.

Whilst I agree the presentation is of either pain or weakness on using the arm, this alone is insufficient in choosing naming terminology - we talk about tonsillitis rather than "tonsilagia" and costochondritis vs "costochondralgia" (although the latter may result in some patients attending hospital fearful of being in the middle of an MI). The underlying mechanism would seem to be of a sprain or inflammation as given by the response to NSAIDs and steroid injections (although like other sprains, physiotherapy, if available, is noted by the article to possibly offer a better longterm approach). Any comments/thoughts ? David Ruben ^Talk 18:47, 10 December 2006 (UTC)

I supoose if significance/triviality of minority POV term is disputed, then the opening might include the extra term with "and less commonly lateral epicondylagia" rather than seeming to give it equivalent and thus undue weight.David Ruben ^Talk 19:01, 10 December 2006 (UTC)

solution

The cure for tennis elbow is very simple. Use single dumb bells to strengthen the muscles and ligaments in the arm. Do this every second day for 2 weeks and your tennis elbow will be reduced by 70%. Keep doing it for a month to 8 weeks and it will be cured. No doctor will tell you this because doctors only know how to prescribe painkillers and anti-inflamatories, both of which have the same effect of taking the oil light warning out of your car to solve the problem of a car with no oil. ie painkillers will make it worse in the long term.92.10.42.201 (talk) 21:07, 22 March 2013 (UTC)

This is completely and utterly ridiculous. If you have severe tennis elbow (which I do from fighting), doing any kind of lifting feels similar to your elbow being crushed by a bulldozer. Not only that, but it makes it much worse in the long term. — Preceding unsigned comment added by 64.64.95.88 (talk) 14:47, 20 October 2016 (UTC)

grammar

the grammar on this article is awful. please revise. these are the only sentences i read so the rest of the article could probably use editing as well.

Tennis elbow is a condition where the outer part of the elbow becomes painful and tender knee kap, usually as a result of a specific strain or overuse of such knee .

The Use of Laser Therapy (Low Power or Low Intensity Laser Therapy) is a currently used treatment.

Let's have this in English?

I am a 37 year old electrician that suffers from this condition, is it that hard to write an article that is not full of medical terms? Or is the writer looking to alienate those from outside the medical "profession".Trumpy (talk) 03:31, 4 October 2008 (UTC) 03:29, 4 October 2008 (UTC)

My experience with Tennis Elbow.

Hi, I had several painful occurrences of tennis elbow lasting several weeks. It happened mostly when I used excessive efforts to hit driving backhands with a continental grip. I found out that if I use the eastern or semi western grip, the radius crosses over the ulna bone in my arm and a different set muscles and tendons become more prominent during the stroke and I never get tennis elbow again. I also use a little wrist action with my backhand for extra power and less elbow effort. It works for me so I wanted to share this tip. Anonymous —Preceding unsigned comment added by 70.252.9.111 (talk) 19:08, 10 April 2009 (UTC)

Citation needed

"According to the best available scientific evidence[citation needed], tennis elbow is an idiopathic, self-limiting, enthesopathy of middle age." I deleted this section. According to a number of sources ("Treatment of Lateral Epicondylitis" AFP, September 15, 2007; Clinical biomechanics of the elbow in tennis: implications for evaluation and diagnosis,Kibler, Med Sci Sports Exerc. 1994 Oct, and multiple online sources (mayoclinic, etc)) this is an overuse injury.

From other causes

I got Lateral Epicondylitis from shoveling snow. It was the motion of lifting, turning and twisting my forearm over and over. So it should be noted somewhere in the article that you can get Lateral Epicondylitis even if you don't play tennis as the name would imply. —Preceding unsigned comment added by 68.100.190.138 (talk) 14:46, 28 February 2010 (UTC)

New Additions Cal Poly Pomona Students

I am a student from California Polytechnic State University in Pomona. We are doing a class project for a Kinesiology class called Movement Anatomy and Kinesiology. The project entails group members to research a topic and to use the research to update a page in Wikipedia. Our topic is Tennis Elbow, obviously. The sections in which we have added new information are: Introduction, symptoms, Prevalence, Prevention, Examination and Tests and Treatment. This is an ongoing process which means that we are still editing and adding information. —Preceding unsigned comment added by Sltruong (talk • contribs) 21:47, 15 October 2010 (UTC)

Recent edits

A recent reversion [1] removed the distinction in the section heading between 'manual' and 'physical' therapies. The claim is that manual therapies ARE physical therapies. I am ok with this idea, except then I think the section heading should be 'Manual therapies' instead of 'physical therapies' and should be wikilinked. This is because Wikipedia's 'physical therapy' article is about the profession of 'physiotherapists', whereas the 'manual therapy' article describes the therapeutic approach and describes the MANY providers (right now the section heading is more of a plug for physiotherapists). For example: the first sentence in the 'physical Therapy' article is "Physical therapy (or physiotherapy), often abbreviated PT, is a health care profession." Here in this epicondylosis article we have used 'physical therapy' to describe a form of therapy that is provided by MANY health care profesionals. Rather than overhaul the physical therapy article to discuss the approach rather than the profession, or have a misleading section heading, perhaps mentioning both manual and physical therapies in the section heading, or using an introductory sentence (like what was removed in the reversion) is an easier solution? I think one introductory sentence mentioning who provides the therapies that are about to be discussed in the section is helpful, especially if the section heading is left as a misleading reference to a profession rather than a form of therapy.

On a similar note; the reversion removed a source for the statement: "manual therapy is usually provided by physios, chiros, physiatrists, OTs, DOs" with the reasoning that the review was not about elbow conditions. I realize it is not about elbows, it is the best source I can find at the moment for the statement of who provide manual therapies.Puhlaa (talk) 14:40, 25 September 2011 (UTC)

Note: I have also re-added some of the info from the systematic review Re: cervical mobilization and lat. epicondylosis. I agree with qualifying the findings, but the general trend favoured the addition of c/s mobilization, why hide that?Puhlaa (talk) 15:01, 25 September 2011 (UTC)

We do not state medications are usually provided by physicians every time we mention a medication or that surgery is usually provided by surgeons. There is no need for this bland statement. We do not link the headings. Physicial therapies is a clearer term. Doc James (talk · contribs · email) 23:28, 25 September 2011 (UTC)

I have shortened the heading to "physical" to address your concern and link "manipulation therapy". Doc James (talk · contribs · email) 23:32, 25 September 2011 (UTC)

I appreciate your consideration of my concern, and I agree with your solutions. I might suggest we make the heading "Physical interventions" or "Physical treatments", which still disambiguate from the profession of physical therapy, but stand alone better than just "physical". Either way, I am satisfied with the result. Regards. Puhlaa (talk) 23:51, 25 September 2011 (UTC)

The main heading is "treatments" thus we already know that this is physical treatments and a second treatment is not needed.Doc James (talk · contribs · email) 00:00, 26 September 2011 (UTC)

Tennis elbow and hairdressing

Hi, can I firstly say that this email may be something that you do not do, but as i am not to literate when using the computer, my apologies if this email is not what your site wants. I would like to have put a comment against the article i was looking up which was Tennis Elbow, while you have outlined it is in some cases repetitive use, i would like to add that one of the common industries for tennis elbow is hairdressing, i say this because my daughter is a hairdresser and has been complaining a lot about the pain she feels in her arm above the elbow, which travels down to her wrist and fingers. There email done. Thank you if you have read it, and please let me know if this is not what your site requires. Jackie Child— Preceding unsigned comment added by Jackie Child (talk • contribs)

Review

doi:10.1016/j.amjmed.2012.09.018 JFW | T@lk 21:27, 12 February 2013 (UTC)

Starting a new rounds of edits

There are many opportunities for improvement on this page. I edited the opening section and I promise to return to edit the some more of the article to provide citations, balance, and readability. — Preceding unsigned comment added by Dr311 (talk • contribs) 19:27, 2 September 2013 (UTC)

nonsensical sentence.

"the trial was stopped after 8 weeks because the improvement using the bar for therapy was so significant."

If it was "so significant" why was the trial stopped?

Perhaps the Op meant to say, "not significant." Still an awkward sentence but at least it makes sense. — Preceding unsigned comment added by 68.38.197.76 (talk) 03:07, 20 September 2013 (UTC)

Lateral epicondylitis (tennis elbow) is tendinosis – noninflammatory tendinosis isn’t mentioned once in this lateral epicondylitis Wikipedia article

Lateral epicondylitis (tennis elbow) is tendinosis – noninflammatory tendinosis isn’t mentioned once in this lateral epicondylitis Wikipedia article

The very first entry of this Wikipedia article says this:

Tennis elbow is an acute or chronic inflammation of the tendons

This leads to inflammation

The reference used is: American Academy of Orthopedic Surgery Information http://orthoinfo.aaos.org/topic.cfm?topic=a00068

I don’t think that this is correct.

I believe that lateral epicondylitis (tennis elbow) is tendinosis, or becomes tendinosis, which is a noninflammatory condition.

Tendinosis isn’t mentioned once in this lateral epicondylitis Wikipedia article.

I did a Google scholar search a while back with the terms “tendinosis tennis elbow”.

I gathered a few sentences of a few citations from the first 10 pages of Google scholar.

https://docs.google.com/document/d/1l_u4p2Hf7douxpMBbvFTOYLcmPjO2S4B-NayvfFn4b8/edit

I put them in an unlisted Google Docs because I’m not sure if copyrighted material can be on the talk page, even if it’s just for discussion.

(I think that I added the references to my list as the page increased, so the references at the top could be the more reputable ones.

However, I’m not entirely sure.

It would be very convenient if I could post citations somewhere, and then some sort of impact factor or ranking could be displayed beside each citation).

Please see that lateral epicondylitis (tennis elbow) is associated with tendinosis.

Here are a few top samples:

(The information is not paraphrased yet)

(I used the Reddit editor to additionally skew the text)

> ^The ^general ^opinion ^is ^that ^the ^condition ^is ^due ^to ^overuse, ^and ^that ^the ^extensor ^carpi ^radialis ^brevis ^muscle ^(ECRB) ^plays ^a ^central ^role.1–3

> ^Furthermore, ^there ^is ^no ^traditional ^inflammation.2 ^4

> ^The ^histological ^findings ^vary, ^and ^include ^microrupture, ^granulation ^tissue ^and ^degenerative ^changes.2 ^3 ^5 ^6

> ^Consequently, ^the ^term ^“lateral ^elbow ^tendinopathy ^or ^tendinosis” ^is ^used ^instead ^of ^“lateral ^epicondylitis”.

du Toit, C; Stieler, M; Saunders, R; Bisset, L; Vicenzino, B (2008). "Diagnostic accuracy of power Doppler ultrasound in patients with chronic tennis elbow". British Journal of Sports Medicine. 42 (11): 572–576. doi:10.1136/bjsm.2007.043901. ISSN 0306-3674.

> ^“The ^histology ^of ^pathologic ^tennis ^elbow ^tissue ^reveals ^noninflammatory ^tissue, ^thus ^the ^term ^angio-fibroblastic ^tendinosis.”

Nirschl RP (1992). "Elbow tendinosis/tennis elbow". Clin Sports Med. 11 (4): 851–70. PMID 1423702. {{cite journal}}: Unknown parameter |month= ignored (help)

> ^Tennis ^elbow ^tendinosis ^is ^most ^commonly ^caused ^by ^tendon ^overuse ^and ^failed ^tendon ^healing.

Nirschl RP, Ashman ES (2004). "Tennis elbow tendinosis (epicondylitis)". Instr Course Lect. 53: 587–98. PMID 15116648.

> ^Longitudinal ^sonogram ^of ^the ^lateral ^elbow ^shows ^thickening ^and ^heterogeneity ^of ^the ^CET ^consistent ^with ^tendinosis, ^with ^intrasubstance ^tears, ^calcifications, ^and ^marked ^irregularity ^of ^the ^lateral ^epicondyle

> ^Although ^epicondylitis ^is ^a ^term ^often ^used ^to ^describe ^this ^condition, ^most ^studies ^reporting ^on ^the ^histopathologic ^findings ^have ^shown ^no ^evidence ^of ^either ^an ^acute ^or ^a ^chronic ^inflammatory ^process.16

> ^Histologic ^studies ^have ^shown ^that ^this ^disorder ^is ^actually ^the ^result ^of ^tendon ^degeneration ^that ^leads ^to ^replacement ^of ^normal ^tissue ^by ^a ^disorganized ^arrangement ^of ^collagen.20–23

> ^This ^condition ^is ^therefore ^more ^appropriately ^referred ^to ^as ^“tendinosis” ^or ^“tendinopathy” ^rather ^than ^“tendinitis.”20,21,24

McShane JM, Nazarian LN, Harwood MI (2006). "Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow". J Ultrasound Med. 25 (10): 1281–9. PMID 16998100. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

> ^Ultrasonography ^(US) ^+ ^colour ^Doppler ^(CD) ^examination ^shows ^structural ^tendon ^changes ^with ^hypo-echoic ^areas, ^and ^a ^vascularity, ^corresponding ^to ^the ^painful ^area ^in ^the ^extensor ^origin.

Zeisig, Eva; Öhberg, Lars; Alfredson, Håkan (2006). "Sclerosing polidocanol injections in chronic painful tennis elbow-promising results in a pilot study". Knee Surgery, Sports Traumatology, Arthroscopy. 14 (11): 1218–1224. doi:10.1007/s00167-006-0156-0. ISSN 0942-2056.

Merger proposal

I propose merging Cozen's test into Tennis elbow. The former is a very brief description of a test for the latter. — Moriwen (talk) 20:34, 18 June 2023 (UTC)

  Y Merger complete. Klbrain (talk) 10:09, 22 July 2023 (UTC)

Wiki Education assignment: WikiProject Medicine Fall 2024 UCF COM - Block 6

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 October 2024 and 17 November 2024. Further details are available on the course page. Student editor(s): Jcassinat (article contribs).

— Assignment last updated by Jcassinat (talk) 13:25, 23 October 2024 (UTC)

Great work, Jcassinat! Dolphinstar15 (talk) 00:15, 2 November 2024 (UTC)

Student Workplan:

Update the Introduction

• Simplify medical terminology to make it more accessible to a broader audience
• Add a brief overview of the condition’s impact and significance in daily life.

• Break longer paragraphs into shorter ones, making it easier to read and understand.
• Use bullet points or subheadings for lists of symptoms, causes, and treatments.
• Add a table or infographic summarizing key information, such as risk factors, symptoms, and treatment options.

Expand the Causes Section

• Include more information about biomechanical theories, repetitive motions, and potential risk factors
• Discuss new research or findings about the condition’s pathogenesis to provide updated information

Add a Prevention Section

• Introduce a new section that discusses strategies to prevent tennis elbow, such as postural adjustments, proper technique, and conditioning exercises.
• Add information about stretching and strengthening routines that may reduce the risk.

Expand the Diagnosis Section

• Provide more details about physical examination maneuvers, like Cozen’s test, and additional tests that may help confirm the diagnosis.
• Include other clinical tests like Mill's Test, Maudsley's Test, or Chair Test.
• Include a note about differential diagnosis (e.g., radial tunnel syndrome, posterior interosseous nerve syndrome)

Expand the Surgery Section

• Include details about rehabilitation protocols after surgery and outcomes based on recent meta-analysis
• Discuss minimally invasive techniques

Include a Prognosis Section

• Add a section detailing the typical prognosis, including average recovery times for different treatments and factors affecting recovery (e.g., age, severity)

References and Sources

• Update references to make sure they are citing reviews and meta-analysis
• Remove citations labeled as "[citation needed]" with appropriate citations

Jcassinat (talk) 16:04, 24 October 2024 (UTC)

Here is my peer review for the WikiProject Medicine work plan. Overall, excellent job with your updates to the article! Your contributions have definitely improved the quality and content.

• Lead section: The intro sentence does a good job clearly stating the purpose of the article. There is a good overview of each section and your additional sentences help provide more information about the symptoms.
  • One improvement that could be made would be to condense some redundant wording. Although you added some of the signs and symptoms, there is a separate sentence a couple of paragraphs later that includes "Signs consistent with the diagnosis include pain when a subject tries to bend back the wrist against resistance." Combining these two might help save some space and reduce redundancy.
  • The Hemmingway app also rates the intro section as "post graduate" reading level. The reading level could be improved by condensing some of the longer sentences, such as "It is often stated that the condition is caused by excessive use of the muscles of the back of the forearm, but this is not supported by experimental evidence and is a common misinterpretation or unhelpful thought about symptoms." A good target would be a grade 9 reading level, but this might be hard to achieve with such a complex anatomical topic.
• Content: Your content added is very thorough! The edits in the signs and symptoms section really adds quality descriptions. You also really expanded the depth of the article by adding the sections on non-operative treatments, alternative treatments, and types of surgery. The content appears up to date with no unnecessary content added. Nice work!
• Tone: The tone and balance is professional and unbiased. The wording maintains neutrality throughout the entire article.
• Sources: You did a great job adding a diverse range of recent sources from peer reviewed journals. All of the tested links work and the citations appear to not have any issues. There are a couple of changes that could be made to help improve the source quality for the article:
  • One change would be the source for citation 41 (Otoshi et al.). This is technically a primary source since it is a research study instead of a secondary sources like a systemic review or metanalysis. The content is really helpful for your prevention section, but finding another secondary source would help strengthen the evidence.
  • Some of the sources for other sections added by other users include links to general websites (MedlinePlus, Mayo Clinic, Vive Health, etc.). Replacing these with peer reviewed secondary sources would help further strengthen the quality of evidence in the article.
• Organization: The content added is clear and concise, which can be challenging for complex topics such as describing surgeries or alternative therapies. Excellent organization!
• Images: Great job adding the table. It is easy to read, and organizes the information very well. This is a very helpful addition to the article.
• Overall: You did an excellent job adding to this article. The content that you added has helped improve the depth of the article, especially with regards to the most modern treatments and surgeries. Your evidence is also very diverse. With a few small changes to some of the sources, as well as improvements in the lead section readability, your article will be very solid and will do a great job at making a complex medical topic very accessible to a lot of people.

An872654 (talk) 12:28, 15 November 2024 (UTC)

Response to peer review

- As suggested by peer review I have changed the lead section to make it easier to read and reduced redundancy

- I have also gone through the sources and made the necessary changes including getting rid of non-peer reviewed articles as described by the peer reviewer

- As per the hemingway app I have improved the readability of the intro sections, with some of the more technical treatments like percutaneous surgery, and PRP are still above 9th grade reading level due to technical nature of treatment and anatomical terms Jcassinat (talk) 13:06, 15 November 2024 (UTC)