Rehabilitation of a patient with lateral epicondylitis by a combination of radial shockwave therapy, instrumental soft tissue mobilisation - Ergon Technique, and Kinetic Flossing Method: a case report
Abstract
Lateral epicondylitis (tennis elbow) is a source of pain on the lateral side of the elbow, which otherwise dominates the clinical examination, associated with weakness and difficulty in performing an extension of the wrist. The IASTM technique is performed with ergonomically designed instruments that detect and treat fascial limitations while the Kinetic flossing technique involves compression bandages made of elastic rubber bands. In a 19-year-old patient, clinical examination and ultrasound diagnosis revealed inflammation of the extensor carpi radialis brevis muscle tendon. After the examination, an intervention was performed based on a combination of the application of radial shock waves, Ergon IASTM techniques as well as the Kinetic Flossing method. After six weeks of treatment, painless active mobility of the wrist with a normal tendon appearance was achieved, which is proof that this combination of physiotherapeutic procedures is one of the possible ways of conservative treatment of this condition.
References
1. Runge F. Zur Genese und Behandlung des schreibe Kranfes. Bed Klin Worchenschr 1873; 10:245-248.
2. Sims SE, Miller K, Elfar JC, Hammert WC. Non- surgical treatment of lateral epicondylitis: a system- atic review of randomized controlled trials. Hand (N Y). 2014;9(4):419–46. doi: 10.1007/s11552-014-9642-x PMID: 25414603
3. Shiri R, Viikari-Juntura E, Varonen H, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164(11): 1065–74. doi: 10.1093/aje/kwj325 PMID: 16968862
4. Taylor SA, Hannafin JA. Evaluation and management of elbow tendinopathy. Sports Health. 2012;4(5): 384–93. doi: 10.1177/1941738112454651 PMID: 23016111
5. Nirschl RP. Soft-tissue injuries about the elbow. Clin Sports Med. 1986; 5:637–52. PMID: 3768969
6. Gabel GT, Morrey BF. Tennis elbow. Instr Course Lect. 1998; 47:165–72. PMID: 9571414
7. Kraushaar BS, Nirschl RP. Tendinosis of the elbow (tennis elbow). Clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J Bone Joint Surg Am. 1999;81(2):259-278. PMID: 10073590
8. Kannus P, Józsa L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am. 1991;73(10):1507-1525. PMID: 1748700
9. Cyriax JH. The pathology and treatment of tennis elbow. J Bone Joint Surg. 1936; 18:921–40. doi:10.1136/bmj.327.7410.330 PMID: 12907490
10. Cheatham SW, Lee M, Cain M, Baker R. The efficacy of instrument assisted soft tissue mobilization: a systematic review. J Can Chiropr Assoc. 2016;60(3):200-211. PMID: 27713575
11. Sevier TL, Stegink-Jansen CW. Astym treatment vs. eccentric exercise for lateral elbow tendinopathy: a randomized controlled clinical trial. PeerJ. 2015;3:e967. Published 2015 May 19. doi: 10.7717/peerj.967
12. The effects of kinetic flossing technique in the treatment of lateral elbow tendinopathy: A case study Pavlos Angelopoulos, Konstantinos Mylonas and Konstantinos Fousekis Technological Educational Institute of Western Greece, Greece, Journal of Physiotherapy & Physical Rehabilitation August 2018. doi:10.4172/2573-0312-c1-003