The Role of Manual Therapy in the Management of Tennis Elbow: A Narrative Review

Abstract

Tennis elbow, or lateral epicondylitis, is a common overuse injury characterized by pain and tenderness on the lateral aspect of the elbow, primarily affecting the extensor tendons, particularly the extensor carpi radialis brevis (ECRB).
risk factors associated with the development of tennis elbow:
Age: The peak incidence of tennis elbow occurs between 40 to 50 years of age. In women aged 42 to 46, the incidence can rise to about 10% 2. This age-related risk could be due to degenerative changes in the tendons and muscles as people age, leading to a higher vulnerability to injuries.
Occupation: Certain occupations that require repetitive wrist and arm movements can increase the risk of developing tennis elbow. Jobs involving gripping, lifting, or repetitive hand movements, such as painting, plumbing, or assembly work, are often associated with this condition 6.
Sports Activities: Although tennis is one of the most recognized causes, it is responsible for only about 5% of cases. Other racquet sports such as squash, badminton, and activities that involve repetitive gripping or wrist extension can also lead to tennis elbow, particularly if proper techniques are not used 6.
Mechanics of Movement: Poor technique in sports or activities that involve the upper limb can contribute significantly to the development of tennis elbow. For example, improper form during racquet sports or lifting can place undue stress on the elbow 6.
Repetitive Motions: Engaging in activities that require repetitive motions of the wrist and arm can lead to cumulative trauma to the elbow. This includes hobbies or activities like gardening, using hand tools, or even typing for extended periods 6.
Previous Injuries: A history of elbow or arm injuries can predispose individuals to tennis elbow. Previous trauma may weaken the tendons or muscles, making them more susceptible to further injury 6.
Grip Strength: Individuals with decreased grip strength may also be at risk. Weakness in the muscles of the forearm can alter the mechanics of the elbow joint, leading to increased stress on the tendons Prevalence and impact of tennis elbow incidence occurs at 40 to 50 years of age, with prevalence in women aged 42 to 46 years increasing to 10%.
The condition can arise from repetitive wrist and arm movements and is prevalent among individuals engaged in manual labor and sports like tennis. While most cases are self-limiting, persistent symptoms can lead to an impact on daily activities and quality of life.
The Rationale for manual therapy to alleviate pain, improve range of motion, and enhance functional recovery.
Manual Therapy Techniques for tennis elbow various techniques, including joint mobilization, soft tissue manipulation, and specific therapeutic exercises.
Literature review
A review of literature was conducted from July to August 2024, searching the PEDRO and PubMed databases for relevant randomized control trail and systematic review studies .