Effectiveness of ultrasound and exercises therapy program on lateral epicondylitis
Corresponding Author(s) : M Shukla
maitris741@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 9 No. 2 (2021): 2021 Volume - 9 Issue - 2
Abstract
LE- lateral epicondylitis
ECRB-extensor carpi radialisbrevis
VAS-visual analogue scale
RM-repetition maximum
GS-grip strength
Aim: To study the effect of ultrasound combined with exercises Versus cryo-therapy combined with exercises on tennis elbow(lateral epicondylitis).
Material and Method: It is an experimental study conducted on tennis players with lateral epicondylitis. 1week pulsed ultrasound and exercise was given to one group of 15 players and another group of 15 players were given cryotherapy and exercise. Verbal numeric pain scale and grip strength were used as outcome measures and scores were recorded before and after intervention.
Results: There was significant difference (p<0.001) in grip strength post intervention (210.66) from pre intervention value of (197.33) in group 1 and also significant improvement seen (p<0.001) in group 2 after intervention (220) from pre intervention value(200).There was significant improvement seen in group 1 in VAS after exercise(2.73±0.08) from pre intervention value (4.0±0.65) and also significant changes seen in group 2 after intervention (1.93±.457) from pre intervention value(4.53±.743). For inter group analysis of VAS between the group 1(11.10) and group 2(19.90) shows significant change (p=0.003).For inter group analysis of Grip strength between group 1 (18.90) and group 2(12.10) shows significant improvement (p=0.028).
Conclusion: Both ultrasound with exercise and cryotherapy with exercise are useful in reducing pain and improving grip strength in patients with tennis elbow. Pulsed ultrasound hasa significant improvement as compared to cryotherapy
Keywords
Tennis elbow
ultrasound
cryotherapy
tennis players
Mill’s test
Cozen’s test
visual analogue scale
grip strength
sphygmomanometer
1.
M Shukla, J Pandya. Effectiveness of ultrasound and exercises therapy program on lateral epicondylitis. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2021 Jul. 6 [cited 2025 Nov. 19];9(2):349-55. Available from: https://ijamscr.com/ijamscr/article/view/1025
Download Citation
Endnote/Zotero/Mendeley (RIS)BibTeX
References
-
[1]. Assendelft, W., Green, S., Buchbinder, R., Struijs, P. and Smidt, N., 2003. Tennis elbow. Bmj, 327(7410), p.329.
[2]. Shiri, R., Viikari-Juntura, E., Varonen, H. and Heliövaara, M., 2006. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology, 164(11), pp.1065-1074.
[3]. Hong, Q.N., Durand, M.J. and Loisel, P., 2004. Treatment of lateral epicondylitis: where is the evidence?.Joint Bone Spine, 71(5), pp.369-373.
[4]. LaFreniere, J.G., 1979. “Tennis Elbow”: Evaluation, Treatment, and Prevention. Physical therapy, 59(6), pp.742-746.
[5]. Kushner S, Reid DC. Manipulation in the treatment of tenniselbow. J Orthop Sports PhysTher 1986;7:264e72.
[6]. Wadsworth, C.T., Nielsen, D.H., Burns, L.T., Krull, J.D. and Thompson, C.G., 1989. Effect of the counterforce armband on wrist extension and grip strength and pain in subjects with tennis elbow. Journal of Orthopaedic& Sports Physical Therapy, 11(5), pp.192-197.
[7]. Vicenzino, B. and Wright, A., 1996. Lateral epicondylalgia I: epidemiology, pathophysiology, aetiology and natural history. Physical therapy reviews, 1(1), pp.23-34.
[8]. Shiri, R., Viikari-Juntura, E., Varonen, H. and Heliövaara, M., 2006. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology, 164(11), pp.1065-1074.
[9]. Hong QN, Durand MJ, Loisel P. Treatment of lateral epicondylitis : where is the evidence? Joint, Bone, Spine.2004; 71:369-73
[10]. Vicenzino, B. and Wright, A., 1996. Lateral epicondylalgia I: epidemiology, pathophysiology, aetiology and natural history. Physical therapy reviews, 1(1), pp.23-34.
[11]. Walker-Bone, K.E., Palmer, K.T., Reading, I. and Cooper, C., 2003, December. Soft-tissue rheumatic disorders of the neck and upper limb: prevalence and risk factors. In Seminars in arthritis and rheumatism (Vol. 33, No. 3, pp. 185-203). WB Saunders.
[12]. Walker?Bone, K., Palmer, K.T., Reading, I., Coggon, D. and Cooper, C., 2004. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Care & Research, 51(4), pp.642-651.
[13]. Walker-Bone KE, Palmer KT, Griffin MJ, et al. Prevalence and occupational associations of neck pain in the British population. ScandJ work Environ Health.2001; 27:49-56.
[14]. Stasinopoulos, D. and Johnson, M.I., 2004. Cyriax physiotherapy for tennis elbow/lateral epicondylitis. British journal of sports medicine, 38(6), pp.675-677.
[15]. Allander, E., 1974. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scandinavian journal of rheumatology, 3(3), pp.145-153.
[16]. Leclerc, A., Landre, M.F., Chastang, J.F., Niedhammer, I., Roquelaure, Y. and Study Group on Repetitive Work, 2001. Upper-limb disorders in repetitive work. Scandinavian journal of work, environment & health, pp.268-278.
[17]. Kryger, A.I., Lassen, C.F. and Andersen, J.H., 2007. The role of physical examinations in studies of musculoskeletal disorders of the elbow. Occupational and environmental medicine, 64(11), pp.776-781.
[18]. Luk, J.K., Tsang, R.C. and Leung, H.B., 2014. Lateral epicondylalgia: midlife crisis of a tendon. Hong Kong Med J, 20(2), pp.145-51.
[19]. COONRAD, R.W. and HOOPER, W.R., 1973. Tennis elbow: its course, natural history, conservative and surgical management. JBJS, 55(6), pp.1177-1182.
[20]. Nirschl, R.P., 1992. Elbow tendinosis/tennis elbow. Clinics in sports medicine, 11(4), pp.851-870.
[21]. Riek, S., Chapman, A.E. and Milner, T., 1999. A simulation of muscle force and internal kinematics of extensor carpi radialisbrevis during backhand tennis stroke: implications for injury. Clinical Biomechanics, 14(7), pp.477-483.
[22]. Schneeberger, A.G. and Masquelet, A.C., 2002. Arterial vascularization of the proximal extensor carpi radialisbrevis tendon. Clinical Orthopaedics and Related Research (1976-2007), 398, pp.239-244.
[23]. Le Huec, J.C., Schaeverbeke, T., Chauveaux, D., Rivel, J., Dehais, J. and Le Rebeller, A., 1995. Epicondylitis after treatment with fluoroquinolone antibiotics. The Journal of bone and joint surgery. British volume, 77(2), pp.293-295.
[24]. Chourasia AO, Buhr KA, Rabago DP, Kijowski R, Irwin CB, Sesto ME. Effect of lateral epicondylosis on grip force development. Journal of Hand Therapy. 2012 Jan 1;25(1):27-37.
[25]. Nagrale, A.V., Herd, C.R., Ganvir, S. and Ramteke, G., 2009. Cyriax physiotherapy versus phonophoresis with supervised exercise in subjects with lateral epicondylalgia: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 17(3), pp.171-178.
[26]. Green, S., Buchbinder, R., Barnsley, L., Hall, S., White, M., Smidt, N. and Assendelft, W.J., 2001. Non?steroidal anti?inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database of Systematic Reviews, (4).
[27]. Assendelft, W.J., Hay, E.M., Adshead, R. and Bouter, L.M., 1996. Corticosteroid injections for lateral epicondylitis: a systematic overview. British Journal of General Practice, 46(405), pp.209-216.
[28]. Teitz, C.C., Garrett Jr, W.E., Miniaci, A., Lee, M.H. and Mann, R.A., 1997. Instructional Course Lectures, The American Academy of Orthopaedic Surgeons-Tendon Problems in Athletic Individuals. JBJS, 79(1), pp.138-52.
[29]. Basford, J.R., Sheffield, C.G. and Harmsen, W.S., 1999. Laser therapy: a randomized, controlled trial of the effects of low-intensity Nd: YAG laser irradiation on musculoskeletal back pain. Archives of physical medicine and rehabilitation, 80(6), pp.647-652.
[30]. Maher, S., 2006. Is low-level laser therapy effective in the management of lateral epicondylitis?.Physical Therapy, 86(8), pp.1161-1167.
[31]. VasseljenJr, O., Høeg, N., Kjeldstad, B., Johnsson, A. and Larsen, S., 1992. Low level laser versus placebo in the treatment of tennis elbow. Scandinavian journal of rehabilitation medicine, 24(1), pp.37-42.
[32]. Lundeberg, T., Haker, E. and Thomas, M., 1987. Effect of laser versus placebo in tennis elbow. Scandinavian journal of rehabilitation medicine, 19(3), pp.135-138.
[33]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[34]. Pienimaki, T., 2000. Conservative treatment and rehabilitation of tennis elbow: a review article. Critical Reviews™ in Physical and Rehabilitation Medicine, 12(3).
[35]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[36]. Roetert, E.P., Brody, H., Dillman, C.J., Groppel, J.L. and Schultheis, J.M., 1995. The biomechanics of tennis elbow. An integrated approach. Clinics in Sports Medicine, 14(1), pp.47-57.
[37]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[38]. Brattberg, G., 1983. Acupuncture therapy for tennis elbow. Pain, 16(3), pp.285-288.
[39]. Molsberger, A. and Hille, E., 1994. The analgesic effect of acupuncture in chronic tennis elbow pain. Rheumatology, 33(12), pp.1162-1165.
[40]. Cyriax, J.H., 1936. The pathology and treatment of tennis elbow. JBJS, 18(4), pp.921-940.
[41]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25Kamien, M., 1990.
[42]. Viswas, R., Ramachandran, R. and KordeAnantkumar, P., 2012. Comparison of effectiveness of supervised exercise program and Cyriax physiotherapy in patients with tennis elbow (lateral epicondylitis): a randomized clinical trial. The scientific world journal, 2012.
[43]. E.Hakers and T.Lundeberge effect of laser versus placebo in tennis elbow scad j rehab med 19 pg 135-38
[44]. Hamilton, G.F., McDonald, C. and Chenier, T.C., 1992. Measurement of grip strength: validity and reliability of the sphygmomanometer and jamar grip dynamometer. Journal of Orthopaedic& Sports Physical Therapy, 16(5), pp.215-219.
[45]. Tuomo T Pienimäki, Tuula K Tarvainen, Pertti T Siira and HeikkiVanharanta,Received 20 October 1995; accepted 16 May 1996. Available online 19 October 2005
[46]. De Smet, L., Van Ransbeeck, H. and Fabry, G., 1998. GRIP STRENGTH IN TENNIS ELBOVV: LONG-TERM RESU ITS OF (OPERATIVE TREATMENT. Actaorthopaedicabelgica, 64, pp.2-1998.
[47]. Wuori, J.L., Overend, T.J., Kramer, J.F. and MacDermid, J., 1998. Strength and pain measures associated with lateral epicondylitis bracing. Archives of physical medicine and rehabilitation, 79(7), pp.832-837.
[48]. Bleakley CM, McDonough SM, Domhnall C MacAuley DC (2008) Some conservative strategies are effective when added to controlled mobilization with external support in acute ankle sprains: a systematic review. Australian Journal of Physiotherapy 54: 7–20.
[49]. Pienimäki, T., Tarvainen, T., Siira, P., Malmivaara, A. and Vanharanta, H., 2002. Associations between pain, grip strength, and manual tests in the treatment evaluation of chronic tennis elbow. The Clinical journal of pain, 18(3), pp.164-170.
[50]. Brosseau, L., Casimiro, L., Milne, S., Welch, V., Shea, B., Tugwell, P. and Wells, G.A., 2002. Deep transverse friction massage for treating tendinitis. Cochrane Database of Systematic Reviews, (4).
[51]. Fairbank SR, Corelett RJ. The role of ECB muscle in Lateral epicondylitis, physiotherapy. Am J Sports Med 2003;31(2):189–95.
References
[1]. Assendelft, W., Green, S., Buchbinder, R., Struijs, P. and Smidt, N., 2003. Tennis elbow. Bmj, 327(7410), p.329.
[2]. Shiri, R., Viikari-Juntura, E., Varonen, H. and Heliövaara, M., 2006. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology, 164(11), pp.1065-1074.
[3]. Hong, Q.N., Durand, M.J. and Loisel, P., 2004. Treatment of lateral epicondylitis: where is the evidence?.Joint Bone Spine, 71(5), pp.369-373.
[4]. LaFreniere, J.G., 1979. “Tennis Elbow”: Evaluation, Treatment, and Prevention. Physical therapy, 59(6), pp.742-746.
[5]. Kushner S, Reid DC. Manipulation in the treatment of tenniselbow. J Orthop Sports PhysTher 1986;7:264e72.
[6]. Wadsworth, C.T., Nielsen, D.H., Burns, L.T., Krull, J.D. and Thompson, C.G., 1989. Effect of the counterforce armband on wrist extension and grip strength and pain in subjects with tennis elbow. Journal of Orthopaedic& Sports Physical Therapy, 11(5), pp.192-197.
[7]. Vicenzino, B. and Wright, A., 1996. Lateral epicondylalgia I: epidemiology, pathophysiology, aetiology and natural history. Physical therapy reviews, 1(1), pp.23-34.
[8]. Shiri, R., Viikari-Juntura, E., Varonen, H. and Heliövaara, M., 2006. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology, 164(11), pp.1065-1074.
[9]. Hong QN, Durand MJ, Loisel P. Treatment of lateral epicondylitis : where is the evidence? Joint, Bone, Spine.2004; 71:369-73
[10]. Vicenzino, B. and Wright, A., 1996. Lateral epicondylalgia I: epidemiology, pathophysiology, aetiology and natural history. Physical therapy reviews, 1(1), pp.23-34.
[11]. Walker-Bone, K.E., Palmer, K.T., Reading, I. and Cooper, C., 2003, December. Soft-tissue rheumatic disorders of the neck and upper limb: prevalence and risk factors. In Seminars in arthritis and rheumatism (Vol. 33, No. 3, pp. 185-203). WB Saunders.
[12]. Walker?Bone, K., Palmer, K.T., Reading, I., Coggon, D. and Cooper, C., 2004. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Care & Research, 51(4), pp.642-651.
[13]. Walker-Bone KE, Palmer KT, Griffin MJ, et al. Prevalence and occupational associations of neck pain in the British population. ScandJ work Environ Health.2001; 27:49-56.
[14]. Stasinopoulos, D. and Johnson, M.I., 2004. Cyriax physiotherapy for tennis elbow/lateral epicondylitis. British journal of sports medicine, 38(6), pp.675-677.
[15]. Allander, E., 1974. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scandinavian journal of rheumatology, 3(3), pp.145-153.
[16]. Leclerc, A., Landre, M.F., Chastang, J.F., Niedhammer, I., Roquelaure, Y. and Study Group on Repetitive Work, 2001. Upper-limb disorders in repetitive work. Scandinavian journal of work, environment & health, pp.268-278.
[17]. Kryger, A.I., Lassen, C.F. and Andersen, J.H., 2007. The role of physical examinations in studies of musculoskeletal disorders of the elbow. Occupational and environmental medicine, 64(11), pp.776-781.
[18]. Luk, J.K., Tsang, R.C. and Leung, H.B., 2014. Lateral epicondylalgia: midlife crisis of a tendon. Hong Kong Med J, 20(2), pp.145-51.
[19]. COONRAD, R.W. and HOOPER, W.R., 1973. Tennis elbow: its course, natural history, conservative and surgical management. JBJS, 55(6), pp.1177-1182.
[20]. Nirschl, R.P., 1992. Elbow tendinosis/tennis elbow. Clinics in sports medicine, 11(4), pp.851-870.
[21]. Riek, S., Chapman, A.E. and Milner, T., 1999. A simulation of muscle force and internal kinematics of extensor carpi radialisbrevis during backhand tennis stroke: implications for injury. Clinical Biomechanics, 14(7), pp.477-483.
[22]. Schneeberger, A.G. and Masquelet, A.C., 2002. Arterial vascularization of the proximal extensor carpi radialisbrevis tendon. Clinical Orthopaedics and Related Research (1976-2007), 398, pp.239-244.
[23]. Le Huec, J.C., Schaeverbeke, T., Chauveaux, D., Rivel, J., Dehais, J. and Le Rebeller, A., 1995. Epicondylitis after treatment with fluoroquinolone antibiotics. The Journal of bone and joint surgery. British volume, 77(2), pp.293-295.
[24]. Chourasia AO, Buhr KA, Rabago DP, Kijowski R, Irwin CB, Sesto ME. Effect of lateral epicondylosis on grip force development. Journal of Hand Therapy. 2012 Jan 1;25(1):27-37.
[25]. Nagrale, A.V., Herd, C.R., Ganvir, S. and Ramteke, G., 2009. Cyriax physiotherapy versus phonophoresis with supervised exercise in subjects with lateral epicondylalgia: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 17(3), pp.171-178.
[26]. Green, S., Buchbinder, R., Barnsley, L., Hall, S., White, M., Smidt, N. and Assendelft, W.J., 2001. Non?steroidal anti?inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database of Systematic Reviews, (4).
[27]. Assendelft, W.J., Hay, E.M., Adshead, R. and Bouter, L.M., 1996. Corticosteroid injections for lateral epicondylitis: a systematic overview. British Journal of General Practice, 46(405), pp.209-216.
[28]. Teitz, C.C., Garrett Jr, W.E., Miniaci, A., Lee, M.H. and Mann, R.A., 1997. Instructional Course Lectures, The American Academy of Orthopaedic Surgeons-Tendon Problems in Athletic Individuals. JBJS, 79(1), pp.138-52.
[29]. Basford, J.R., Sheffield, C.G. and Harmsen, W.S., 1999. Laser therapy: a randomized, controlled trial of the effects of low-intensity Nd: YAG laser irradiation on musculoskeletal back pain. Archives of physical medicine and rehabilitation, 80(6), pp.647-652.
[30]. Maher, S., 2006. Is low-level laser therapy effective in the management of lateral epicondylitis?.Physical Therapy, 86(8), pp.1161-1167.
[31]. VasseljenJr, O., Høeg, N., Kjeldstad, B., Johnsson, A. and Larsen, S., 1992. Low level laser versus placebo in the treatment of tennis elbow. Scandinavian journal of rehabilitation medicine, 24(1), pp.37-42.
[32]. Lundeberg, T., Haker, E. and Thomas, M., 1987. Effect of laser versus placebo in tennis elbow. Scandinavian journal of rehabilitation medicine, 19(3), pp.135-138.
[33]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[34]. Pienimaki, T., 2000. Conservative treatment and rehabilitation of tennis elbow: a review article. Critical Reviews™ in Physical and Rehabilitation Medicine, 12(3).
[35]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[36]. Roetert, E.P., Brody, H., Dillman, C.J., Groppel, J.L. and Schultheis, J.M., 1995. The biomechanics of tennis elbow. An integrated approach. Clinics in Sports Medicine, 14(1), pp.47-57.
[37]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[38]. Brattberg, G., 1983. Acupuncture therapy for tennis elbow. Pain, 16(3), pp.285-288.
[39]. Molsberger, A. and Hille, E., 1994. The analgesic effect of acupuncture in chronic tennis elbow pain. Rheumatology, 33(12), pp.1162-1165.
[40]. Cyriax, J.H., 1936. The pathology and treatment of tennis elbow. JBJS, 18(4), pp.921-940.
[41]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25Kamien, M., 1990.
[42]. Viswas, R., Ramachandran, R. and KordeAnantkumar, P., 2012. Comparison of effectiveness of supervised exercise program and Cyriax physiotherapy in patients with tennis elbow (lateral epicondylitis): a randomized clinical trial. The scientific world journal, 2012.
[43]. E.Hakers and T.Lundeberge effect of laser versus placebo in tennis elbow scad j rehab med 19 pg 135-38
[44]. Hamilton, G.F., McDonald, C. and Chenier, T.C., 1992. Measurement of grip strength: validity and reliability of the sphygmomanometer and jamar grip dynamometer. Journal of Orthopaedic& Sports Physical Therapy, 16(5), pp.215-219.
[45]. Tuomo T Pienimäki, Tuula K Tarvainen, Pertti T Siira and HeikkiVanharanta,Received 20 October 1995; accepted 16 May 1996. Available online 19 October 2005
[46]. De Smet, L., Van Ransbeeck, H. and Fabry, G., 1998. GRIP STRENGTH IN TENNIS ELBOVV: LONG-TERM RESU ITS OF (OPERATIVE TREATMENT. Actaorthopaedicabelgica, 64, pp.2-1998.
[47]. Wuori, J.L., Overend, T.J., Kramer, J.F. and MacDermid, J., 1998. Strength and pain measures associated with lateral epicondylitis bracing. Archives of physical medicine and rehabilitation, 79(7), pp.832-837.
[48]. Bleakley CM, McDonough SM, Domhnall C MacAuley DC (2008) Some conservative strategies are effective when added to controlled mobilization with external support in acute ankle sprains: a systematic review. Australian Journal of Physiotherapy 54: 7–20.
[49]. Pienimäki, T., Tarvainen, T., Siira, P., Malmivaara, A. and Vanharanta, H., 2002. Associations between pain, grip strength, and manual tests in the treatment evaluation of chronic tennis elbow. The Clinical journal of pain, 18(3), pp.164-170.
[50]. Brosseau, L., Casimiro, L., Milne, S., Welch, V., Shea, B., Tugwell, P. and Wells, G.A., 2002. Deep transverse friction massage for treating tendinitis. Cochrane Database of Systematic Reviews, (4).
[51]. Fairbank SR, Corelett RJ. The role of ECB muscle in Lateral epicondylitis, physiotherapy. Am J Sports Med 2003;31(2):189–95.
[2]. Shiri, R., Viikari-Juntura, E., Varonen, H. and Heliövaara, M., 2006. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology, 164(11), pp.1065-1074.
[3]. Hong, Q.N., Durand, M.J. and Loisel, P., 2004. Treatment of lateral epicondylitis: where is the evidence?.Joint Bone Spine, 71(5), pp.369-373.
[4]. LaFreniere, J.G., 1979. “Tennis Elbow”: Evaluation, Treatment, and Prevention. Physical therapy, 59(6), pp.742-746.
[5]. Kushner S, Reid DC. Manipulation in the treatment of tenniselbow. J Orthop Sports PhysTher 1986;7:264e72.
[6]. Wadsworth, C.T., Nielsen, D.H., Burns, L.T., Krull, J.D. and Thompson, C.G., 1989. Effect of the counterforce armband on wrist extension and grip strength and pain in subjects with tennis elbow. Journal of Orthopaedic& Sports Physical Therapy, 11(5), pp.192-197.
[7]. Vicenzino, B. and Wright, A., 1996. Lateral epicondylalgia I: epidemiology, pathophysiology, aetiology and natural history. Physical therapy reviews, 1(1), pp.23-34.
[8]. Shiri, R., Viikari-Juntura, E., Varonen, H. and Heliövaara, M., 2006. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology, 164(11), pp.1065-1074.
[9]. Hong QN, Durand MJ, Loisel P. Treatment of lateral epicondylitis : where is the evidence? Joint, Bone, Spine.2004; 71:369-73
[10]. Vicenzino, B. and Wright, A., 1996. Lateral epicondylalgia I: epidemiology, pathophysiology, aetiology and natural history. Physical therapy reviews, 1(1), pp.23-34.
[11]. Walker-Bone, K.E., Palmer, K.T., Reading, I. and Cooper, C., 2003, December. Soft-tissue rheumatic disorders of the neck and upper limb: prevalence and risk factors. In Seminars in arthritis and rheumatism (Vol. 33, No. 3, pp. 185-203). WB Saunders.
[12]. Walker?Bone, K., Palmer, K.T., Reading, I., Coggon, D. and Cooper, C., 2004. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Care & Research, 51(4), pp.642-651.
[13]. Walker-Bone KE, Palmer KT, Griffin MJ, et al. Prevalence and occupational associations of neck pain in the British population. ScandJ work Environ Health.2001; 27:49-56.
[14]. Stasinopoulos, D. and Johnson, M.I., 2004. Cyriax physiotherapy for tennis elbow/lateral epicondylitis. British journal of sports medicine, 38(6), pp.675-677.
[15]. Allander, E., 1974. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scandinavian journal of rheumatology, 3(3), pp.145-153.
[16]. Leclerc, A., Landre, M.F., Chastang, J.F., Niedhammer, I., Roquelaure, Y. and Study Group on Repetitive Work, 2001. Upper-limb disorders in repetitive work. Scandinavian journal of work, environment & health, pp.268-278.
[17]. Kryger, A.I., Lassen, C.F. and Andersen, J.H., 2007. The role of physical examinations in studies of musculoskeletal disorders of the elbow. Occupational and environmental medicine, 64(11), pp.776-781.
[18]. Luk, J.K., Tsang, R.C. and Leung, H.B., 2014. Lateral epicondylalgia: midlife crisis of a tendon. Hong Kong Med J, 20(2), pp.145-51.
[19]. COONRAD, R.W. and HOOPER, W.R., 1973. Tennis elbow: its course, natural history, conservative and surgical management. JBJS, 55(6), pp.1177-1182.
[20]. Nirschl, R.P., 1992. Elbow tendinosis/tennis elbow. Clinics in sports medicine, 11(4), pp.851-870.
[21]. Riek, S., Chapman, A.E. and Milner, T., 1999. A simulation of muscle force and internal kinematics of extensor carpi radialisbrevis during backhand tennis stroke: implications for injury. Clinical Biomechanics, 14(7), pp.477-483.
[22]. Schneeberger, A.G. and Masquelet, A.C., 2002. Arterial vascularization of the proximal extensor carpi radialisbrevis tendon. Clinical Orthopaedics and Related Research (1976-2007), 398, pp.239-244.
[23]. Le Huec, J.C., Schaeverbeke, T., Chauveaux, D., Rivel, J., Dehais, J. and Le Rebeller, A., 1995. Epicondylitis after treatment with fluoroquinolone antibiotics. The Journal of bone and joint surgery. British volume, 77(2), pp.293-295.
[24]. Chourasia AO, Buhr KA, Rabago DP, Kijowski R, Irwin CB, Sesto ME. Effect of lateral epicondylosis on grip force development. Journal of Hand Therapy. 2012 Jan 1;25(1):27-37.
[25]. Nagrale, A.V., Herd, C.R., Ganvir, S. and Ramteke, G., 2009. Cyriax physiotherapy versus phonophoresis with supervised exercise in subjects with lateral epicondylalgia: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 17(3), pp.171-178.
[26]. Green, S., Buchbinder, R., Barnsley, L., Hall, S., White, M., Smidt, N. and Assendelft, W.J., 2001. Non?steroidal anti?inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database of Systematic Reviews, (4).
[27]. Assendelft, W.J., Hay, E.M., Adshead, R. and Bouter, L.M., 1996. Corticosteroid injections for lateral epicondylitis: a systematic overview. British Journal of General Practice, 46(405), pp.209-216.
[28]. Teitz, C.C., Garrett Jr, W.E., Miniaci, A., Lee, M.H. and Mann, R.A., 1997. Instructional Course Lectures, The American Academy of Orthopaedic Surgeons-Tendon Problems in Athletic Individuals. JBJS, 79(1), pp.138-52.
[29]. Basford, J.R., Sheffield, C.G. and Harmsen, W.S., 1999. Laser therapy: a randomized, controlled trial of the effects of low-intensity Nd: YAG laser irradiation on musculoskeletal back pain. Archives of physical medicine and rehabilitation, 80(6), pp.647-652.
[30]. Maher, S., 2006. Is low-level laser therapy effective in the management of lateral epicondylitis?.Physical Therapy, 86(8), pp.1161-1167.
[31]. VasseljenJr, O., Høeg, N., Kjeldstad, B., Johnsson, A. and Larsen, S., 1992. Low level laser versus placebo in the treatment of tennis elbow. Scandinavian journal of rehabilitation medicine, 24(1), pp.37-42.
[32]. Lundeberg, T., Haker, E. and Thomas, M., 1987. Effect of laser versus placebo in tennis elbow. Scandinavian journal of rehabilitation medicine, 19(3), pp.135-138.
[33]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[34]. Pienimaki, T., 2000. Conservative treatment and rehabilitation of tennis elbow: a review article. Critical Reviews™ in Physical and Rehabilitation Medicine, 12(3).
[35]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[36]. Roetert, E.P., Brody, H., Dillman, C.J., Groppel, J.L. and Schultheis, J.M., 1995. The biomechanics of tennis elbow. An integrated approach. Clinics in Sports Medicine, 14(1), pp.47-57.
[37]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25.
[38]. Brattberg, G., 1983. Acupuncture therapy for tennis elbow. Pain, 16(3), pp.285-288.
[39]. Molsberger, A. and Hille, E., 1994. The analgesic effect of acupuncture in chronic tennis elbow pain. Rheumatology, 33(12), pp.1162-1165.
[40]. Cyriax, J.H., 1936. The pathology and treatment of tennis elbow. JBJS, 18(4), pp.921-940.
[41]. Manchanda, G. and Grover, D., 2008. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis. Indian J PhysiotherOccupTher, 2(1), pp.16-25Kamien, M., 1990.
[42]. Viswas, R., Ramachandran, R. and KordeAnantkumar, P., 2012. Comparison of effectiveness of supervised exercise program and Cyriax physiotherapy in patients with tennis elbow (lateral epicondylitis): a randomized clinical trial. The scientific world journal, 2012.
[43]. E.Hakers and T.Lundeberge effect of laser versus placebo in tennis elbow scad j rehab med 19 pg 135-38
[44]. Hamilton, G.F., McDonald, C. and Chenier, T.C., 1992. Measurement of grip strength: validity and reliability of the sphygmomanometer and jamar grip dynamometer. Journal of Orthopaedic& Sports Physical Therapy, 16(5), pp.215-219.
[45]. Tuomo T Pienimäki, Tuula K Tarvainen, Pertti T Siira and HeikkiVanharanta,Received 20 October 1995; accepted 16 May 1996. Available online 19 October 2005
[46]. De Smet, L., Van Ransbeeck, H. and Fabry, G., 1998. GRIP STRENGTH IN TENNIS ELBOVV: LONG-TERM RESU ITS OF (OPERATIVE TREATMENT. Actaorthopaedicabelgica, 64, pp.2-1998.
[47]. Wuori, J.L., Overend, T.J., Kramer, J.F. and MacDermid, J., 1998. Strength and pain measures associated with lateral epicondylitis bracing. Archives of physical medicine and rehabilitation, 79(7), pp.832-837.
[48]. Bleakley CM, McDonough SM, Domhnall C MacAuley DC (2008) Some conservative strategies are effective when added to controlled mobilization with external support in acute ankle sprains: a systematic review. Australian Journal of Physiotherapy 54: 7–20.
[49]. Pienimäki, T., Tarvainen, T., Siira, P., Malmivaara, A. and Vanharanta, H., 2002. Associations between pain, grip strength, and manual tests in the treatment evaluation of chronic tennis elbow. The Clinical journal of pain, 18(3), pp.164-170.
[50]. Brosseau, L., Casimiro, L., Milne, S., Welch, V., Shea, B., Tugwell, P. and Wells, G.A., 2002. Deep transverse friction massage for treating tendinitis. Cochrane Database of Systematic Reviews, (4).
[51]. Fairbank SR, Corelett RJ. The role of ECB muscle in Lateral epicondylitis, physiotherapy. Am J Sports Med 2003;31(2):189–95.