Relationships between biomechanics, tendon pathology, and function in individuals with lateral epicondylosis.
The pathophysiology of elbow lateral epicondylosis (LE) is poorly understood, as it has a multifactorial aetiology. It can be a very challenging condition to treat.
This study investigated the relationship between pain, motor impairment and tendon pathology in LE. 26 participants with unilateral or bilateral LE recorded the biomechanical measures of grip strength, rate of force development and electromechanical delay. Rate of force development was measured by the multiaxis profile (MAP) dynamometer. It measures how quickly a strong, non-painful grip can be produced. Electromechanical delay was measured by the MAP dynamometer and surface EMG of extensor carpi radialis. Magnetic resonance imaging (MRI) and ultrasonography (US) were used to measure tendon pathology, while self-rated pain and function was assessed by the Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE).
There was significant correlation between the biomechanical measures and PRTEE, but not MRI or US with PRTEE. Higher PRTEE scores were associated with lower grip strength, lower rate of force development and higher electromechanical delay. The rate of force development correlated higher with PRTEE than did grip strength.
An implication for treatment, from this study, might be that physiotherapy interventions that include velocity-dependent training might lead to improvements in rate of force development and function. > From: Chourasia et al., J Orthop Sports Phys Ther 43 (2013) 368-378. All rights reserved to Journal of Orthopaedic & Sports Physical Therapy.
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Ultrasound of the common extensor origin at the lateral epicondyl
EMG extensor carpi radialis muscle (Image by: etemg.com)