| Tennis Elbow/ lateral epicondylitis or extensor | | | | exercises. During eight weeks of treatment, the |
| tendonitis at the elbow is a condition that can case | | | | patients of the two groups received 12 sessions of |
| pain about the outside of the elbow (pain about the | | | | laser or placebo, two sessions per week (weeks 1-4) |
| inside of the elbow may be flexor tendonitis or | | | | and one session per week (weeks 5-8). Pain at rest, |
| Golfer’s elbow). It is seen more typically on the | | | | at palpation on the lateral epicondyle, during resisted |
| dominant arm and aggravated by things such as | | | | wrist extension, middle finger test, and strength testing |
| gripping and squeezing. It is not only seen in tennis | | | | was evaluated using Visual Analogue Scales. Also it |
| players but is common in tennis players. People | | | | was evaluated the grip strength, the range of motion |
| such as electricians, carpenters and gardeners also | | | | and weight test. Parameters were determined before |
| get tennis elbow. It is more common in men although | | | | the treatment, at the end of the eighth week course of |
| many times I hear woman who suffer with tennis | | | | treatment (week 8), and eighth (week 8) after the end |
| elbow complain of pain with activities such as lifting a | | | | of treatment. RESULTS: Relative to the group B, the |
| jug of milk or opening a jar. A tendon is a structure | | | | group A had (1) a significant decrease of pain at rest |
| that connects muscle to bone. Tendonitis refers to | | | | at the end of 8 weeks of the treatment (p < 0.005) |
| inflammation of the tendon. Standard treatments for | | | | and at the end of following up period (p < 0.05), (2) a |
| elbow tendonitis or lateral epicondylitis, extensor | | | | significant decrease in pain at palpation and pain on |
| tendonitis include rest (which may include using a tennis | | | | isometric testing at 8 weeks of treatment (p < 0.05), |
| elbow splint, ice and non –steroidal anti-inflammatory | | | | and at 8 weeks follow-up (p < 0.001), (3) a significant |
| drugs such as Ibuprofen). More difficult cases are | | | | decrease in pain during middle finger test at the end of |
| offered a cortisone injection into the tendon to bring | | | | 8 weeks of treatment (p < 0.01), and at the end of |
| down the inflammation. | | | | the follow-up period (p < 0.05), (4) a significant |
| High Power Laser Therapy has been shown to | | | | decrease of pain during grip strength testing at 8 |
| increase bone, ligament, tendon and cartilage repair as | | | | weeks of treatment (p < 0.05), and at 8 weeks |
| well as reduce inflammation, decrease pain and | | | | follow-up (p < 0.001), (5) a significant increase in the |
| increase circulation. I have found this treatment to be | | | | wrist range of motion at 8 weeks follow-up (p < 0.01), |
| very successful although it is not well know. | | | | (6) an increase in grip strength at 8 weeks of |
| Here are a couple of recent articles from the scientific | | | | treatment (p < 0.05) and at 8 weeks follow-up (p < |
| literature regarding Laser Therapy and Tennis Elbow/ | | | | 0.01), and (7) a significant increase in weight-test at 8 |
| lateral epicondylitis/extensor tendonitis. | | | | weeks of treatment (p < 0.05) and at 8 weeks |
| Physiotherapy Department, Queen Elizabeth Hospital, | | | | follow-up (p < 0.005). CONCLUSION: The results |
| Hong Kong. | | | | suggested that the combination of laser with |
| OBJECTIVE: The aim of this study was to evaluate | | | | plyometric exercises was more effective treatment |
| the effectiveness of 904-nm low-level laser therapy | | | | than placebo laser with the same plyometric exercises |
| (LLLT) in the management of lateral epicondylitis. | | | | at the end of the treatment as well as at the follow-up. |
| BACKGROUND DATA: Lateral epicondylitis is | | | | Future studies are needed to establish the relative and |
| characterized by pain and tenderness over the lateral | | | | absolute effectiveness of the above protocol. |
| elbow, which may also result in reduction in grip | | | | PMID: 17603862 [PubMed - indexed for MEDLINE] |
| strength and impairment in physical function. LLLT has | | | | Ankara Education and Research Hospital, Department |
| been shown effective in its therapeutic effects in | | | | of Physical Medicine and Rehabilitation, Division of Hand |
| tissue healing and pain control. METHODS: Thirty-nine | | | | Rehabilitation, Ankara, Turkey. The aims of this study |
| patients with lateral epicondylitis were randomly | | | | were to evaluate the effects of low-level laser |
| assigned to receive either active laser with an energy | | | | therapy (LLLT) and to compare these with the effects |
| dose of 0.275 J per tender point (laser group) or sham | | | | of brace or ultrasound (US) treatment in tennis elbow. |
| irradiation (placebo group) for a total of nine sessions. | | | | The study design used was a prospective and |
| The outcome measures were mechanical pain | | | | randomized, controlled, single-blind trial. Fifty-eight |
| threshold, maximum grip strength, level of pain at | | | | outpatients with lateral epicondylitis (9 men, 49 women) |
| maximum grip strength as measured by the Visual | | | | were included in the trial. The patients were divided into |
| Analogue Scale (VAS) and the subjective rating of | | | | three groups: 1) brace group-brace plus exercise, 2) |
| physical function with Disabilities of the Arm, Shoulder | | | | ultrasound group-US plus exercise, and 3) laser |
| and Hand (DASH) questionnaire. RESULTS: | | | | group-LLLT plus exercise. Patients in the brace group |
| Significantly greater improvements were shown in all | | | | used a lateral counterforce brace for three weeks, US |
| outcome measures with the laser group than with the | | | | plus hot pack in the ultrasound group, and laser plus hot |
| placebo group (p < 0.0125), except in the two | | | | pack in the LLLT group. In addition, all patients were |
| subsections of DASH. CONCLUSION: This study | | | | given progressive stretching and strengthening |
| revealed that LLLT in addition to exercise is effective | | | | exercise programs. Grip strength and pain severity |
| in relieving pain, and in improving the grip strength and | | | | were evaluated with visual analog scale (VAS) at |
| subjective rating of physical function of patients with | | | | baseline, at the second week of treatment, and at the |
| lateral epicondylitis. | | | | sixth week of treatment. VAS improved significantly in |
| Faculty of Human Movement & Quality of Life, | | | | all groups after the treatment and in the ultrasound and |
| Peloponnese University, Sparta, Greece. | | | | laser groups at the sixth week (p<0.05). Grip strength |
| OBJECTIVE: This study was undertaken to compare | | | | of the affected hand increased only in the laser group |
| the effectiveness of a protocol of combination of laser | | | | after treatment, but was not changed at the sixth |
| with plyometric exercises and a protocol of placebo | | | | week. There were no significant differences between |
| laser with the same program, in the treatment of tennis | | | | the groups on VAS and grip strength at baseline and |
| elbow. BACKGROUND DATA: The use of low-level | | | | at follow-up assessments. The results show that, in |
| laser has been recommended for the management of | | | | patients with lateral epicondylitis, a brace has a shorter |
| tennis elbow with contradictory results. Also, plyometric | | | | beneficial effect than US and laser therapy in reducing |
| exercises were recommended for the treatment of | | | | pain and that laser therapy is more effective than the |
| the tendinopathy. METHODS: Fifty patients who had | | | | brace and US treatment in improving grip strength. |
| tennis elbow participated in the study and were | | | | The advantage of High Power Laser Therapy over |
| randomized into two groups. Group A (n = 25) was | | | | cold or low level laser is that High Power Laser |
| treated with a 904 Ga-As laser CW, frequency 50 Hz, | | | | Therapy provides more power which allows the |
| intensity 40 mW and energy density 2.4 J/cm(2), plus | | | | physician to reach deeper (target) tissues. This |
| plyometric exercises and group B (n = 25) that | | | | permits saturation of the injured tissue with the light |
| received placebo laser plus the same plyometric | | | | energy which creates the healing effect. |