Essay Example on Abundant debate for the exact pathology of lateral Epicondylosis

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There is abundant debate for the exact pathology of lateral epicondylosis and there still exists no agreement Existing evidence following surgical intervention shows that it is a chronic disorder and instead of inflammatory cells there is presence of degenerative changes like increased fibroblasts and disorganized collagen These findings contradict the extensively used term epicondylitis which designates an inflammatory disorder There has been recent recommendation that the term epicondylitis be replaced with epicondylitis which is a more precise descriptor of the underlying degenerative process 9 13 The degenerative process in this condition is said to originate due to repetitive microtrauma A few examinations looking at the surgical examples and cadaveric examples demonstrate that this condition develops through a gradually developing phases starting with degenerative angiogenesis and closures with fibrosis and calcification 14 This condition is encountered by approximately 2 5th of the common population sooner or later during their lifetime The incidence is found both in men as well as in women aged 35 54 years The documented prevalence is found to be 4 7 for each 1000 patients going to therapeutic setup Up to half of every one of the tennis players additionally encounter some sort of elbow torment with 75 to 80 of these grievances inferable from lateral epicondylosis 15 25 It is for the most part trusted that tennis players utilizing a double hand strike seldom suffer from tennis elbow as the nondominant arm seems to assimilate more of the stroke energy resulting in alteration of the biomechanics of the swing

Evaluations involving electrodiagnostic procedure EMG demonstrated decreased amplitudes in the wrist extensors during a double handed stroke which is used by experienced tennis players It can also be taken into account that the single handed stroke used by recreational players is associated with faulty mechanics which adds up to increased extensor activity leading to lateral epicondylosis 26 Lateral epicondylosis is primarily encountered by recreational tennis players The technique used by experienced players is increase of their wrist extension just prior to ball impact whereas recreational players use a more flexed wrist position 27 When the pattern of muscle activation and joint mechanics were observed in both recreational and experienced players using kinematic data in combination with a computer model substantial eccentric contractions of the extensor carpi were discovered which are the probable reason for repetitive microtrauma leading to lateral epicondylosis 28 Among all the manual therapies used around the globe MWM i e mobilization with movement is presently acquiring tremendous recognition

This technique of Mulligan is prescribed if during its application it allows the painful joint to be moved freely without any pain or disablement The technique involves application of a glide or translation in perpendicular direction to the plane of the affected movement which is being performed during the glide In the recent observations mobilization with movement have been gaining a good reputation for treating various musculoskeletal disorders many of which were difficult to be treated by other treatment approaches and manipulation techniques e g lateral epicondylosis De Quervain s disorder 29 31

 Eccentric contraction of an active muscle is the lengthening of the muscle under any load or weight When eccentric contractions are performed multiple times for muscle training then it is termed as eccentric exercise training The primary objective of this exercise focuses on braking or slowing down the elongation process of a muscle which provides a challenge for the muscle leading to increase in muscle strength quicker healing and improved metabolic rate It delivers a braking mechanism for the muscle tendon groups undergoing concentric movements to protect the joint s from possible injury as the contraction is released 32 Sportspersons elderly people and patients desiring to retrain their muscles and tendons have found to obtain great benefit from eccentric exercises


33 NEED OF THE STUDY Regardless of various treatment alternatives being proposed for the recovery of patients with lateral epicondylosis the practicability of those therapy procedures are generally doubtful and there is a necessity for further research Recovery from lateral epicondylosis may incorporate exercise massage manipulation taping acupuncture orthotics ultrasound therapy modification of ADL activities and enough rest or a break from work Distinguishing an effective treatment program for patients with lateral epicondylosis would have noteworthy advantages for quiet recuperation and will likewise include as an enhanced treatment benefit 34 37 There is existence of exceptional number of studies which suggest the deployment of mobilization with movement as a curative approach for clients visiting with lateral epicondylitis Furthermore for the same condition a good number of studies have been performed on eccentric exercises as well But the evidence regarding the effectiveness of these physiotherapy treatment techniques on recreational tennis players with lateral epicondylosis is lacking to support any current treatment Finally further research is warranted to examine the effects of eccentric exercise along with mobilization with movement in recreational tennis players with lateral epicondylitis

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