A small trial revealed that for those who from suffer tennis elbow, wrist-strengthening exercises with an inexpensive rubber bar may relieve pain and restore function.

Adding these exercises to home care dramatically increased the number of patients with reduced disability scores, compared with standard care alone.

Pain and tenderness likewise improved at least fourfold more with the addition of isolated eccentric wrist extensor strengthening.

This kind of exercise has been shown to be effective for tendon-related Achilles, shoulder, and knee pain in the past, but there was no easy way to provide resistance while the elbow made this motion, the researchers said.

An estimated one to three percent of the population develop tennis elbow, and only a fraction of them actually play the game.

For the investigational exercise, patients were given a Thera-Band FlexBar to twist with the wrist of their uninjured arm and then slowly untwist with eccentric wrist extension of the injured arm over a period of about four seconds. Three sets of 15 repetitions were scheduled each day.

After seven weeks of physical therapy in both groups, pain scores improved to an average of about 5 on the 10-point Visual Analog Scale in the standard treatment group—but dropped all the way to about 1 point in the isolated eccentric exercise group.

The researchers cautioned that their study was limited by the small sample size, but noted that the treatment for home use was practical, inexpensive, did not require direct medical supervision, and had no significant side effects.

Among the wide array of treatments for tennis elbow—ranging from strengthening and stretching to cortisone injections and extracorporeal shockwave therapy—all have been shown to be, at best, equivocal in efficacy and could lower healthcare costs.

SOURCE: MedPage Today, SAN FRANCISCO, July 13
http://www.medpagetoday.com/Orthopedics/Orthopedics/15048

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