TENNIS ELBOW

Dear AskLeuko

I enjoy the Leuko Strapping Tips in our magazine.

Could you perhaps help me with the correct way of strapping a tennis elbow. I read in an article that a physio in East London is doing it with good results.

Thank you
Judy

Dear Judy

It is very difficult to answer your question without going into the mechanism of a tennis elbow.

“Tennis Elbow” is a term used for pain on the outside of the elbow. It may not be caused by tennis but often is. In order to be able to grip an object, we use the muscles at the elbow. They are attached to bone by a broad tendon. If the grip is incorrect, this tendon can be injured because of the abnormal pull on it.

The injury may be acute or chronic. It may be injured over time e.g. an incorrect tennis racquet handle size or an incorrect backhand technique. It may be injured suddenly e.g. lifting a suitcase off a conveyor belt at the airport or laying bricks for an unaccustomed number of hours. Either way, because there is injury to the cells in the tendon, this injury is called a “tendinopathy”.

No single treatment has been found to be the absolute answer to healing but a combination of treatments usually helps to cure the condition.

• The most important factor is to change the cause if possible e.g. a faulty technique or a racquet grip must be corrected
• Research has shown that strapping to take pressure off the tendon is definitely effective
• Soft tissue therapy and other physiotherapy modalities to the injured area promote healing and reduce scarring
• Correct stretching exercises
• Correct strengthening exercises
• A corticosteroid injection is a controversial treatment. It should only be performed under an ultrasonic scan so that the radiologist is able to see where the injury is. It should only be used when all else fails
• Finally, surgery is the final option but is only needed very occasionally

The aim of ‘Tennis Elbow” strapping is to take pressure off the injured tendon. Two anchor strips around the limb are put in place; one above the elbow and one below.

Strips of strapping are used in a “V” shape, starting below the elbow. Each strip is first placed on the lower anchor and then pulled upwards to the top anchor in order to take pressure off the tendon. In physiotherapy terms, the aim is to unload tendon. This strapping technique appears to reduce the forces on the tendon during grip and thus allow healing to take place.


MEDIAL ELBOW PAIN

Medial elbow pain occurs in throwing sports where the elbow moves from flexion to extension, repetitively, over time, at a very fast rate. This condition can be seen in adults and children, usually between the ages of  9 and 14 years. Cricket bowlers, baseball pitchers and javelin throwers are the most at risk for injury of the medial collateral ligament of the elbow.

This repeated valgus stress injury is often caused by poor biomechanics, overload or  an incorrect throwing technique. Weakness of the stabilizers of the shoulder may aggravate this condition.

In order to protect this strain, Leuko Sportstape Premium is used as a strapping material. Patient education, technique analysis and correction of muscle imbalances must always be included as part of the treatment regime.

Leuko Sportstape Premium is a strong rigid adhesive tape, ideal for this type of strapping because it prevents excessive joint movement.

The application of the taping technique is as follows:

1. The elbow is placed in a few degrees of flexion.
2. Because strapping adheres better to strapping, two circumferential anchor straps are placed: one above the elbow and one below.
3. Depending on the size of the forearm, a number of taping strips are placed over the medial collateral ligament, starting on the top anchor and ending on the lower anchor.
4. This tape is most effective in a criss-cross pattern ( see picture )
5. Finally tapes are placed over the original anchors in order to secure all the strapping ends.
6. Ensure that the tape is not too tight and that it does not restrict the throwing motion.

 

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Please forward any queries or comments with respect to injuries, techniques or Leuko products to askleuko@bsnmedical.com for advice from the Leuko Strapping Panel, who are members of the South African Society of Physiotherapy. Selected questions will be loaded onto the BSN Medical website www.bsnmedical.co.za for reference purposes.

Refer to the Leuko Strapping Guide for basic guidelines.

"BSN Medical makes no warranties as to the accuracy or completeness of any information contained on this website and the user agrees, by accessing this website, that it may not hold BSN liable for any inaccuracies or incompleteness in the information. The material contained on this website is for information only and does not constitute medical advice.