The Foundry Orthopedics & Sports Medicine Blog

     So, your doctor says that you have tennis elbow but you’ve never played tennis?  Tennis elbow or lateral epicondylitis is a painful condition of the elbow usually caused by overuse.  Infrequently it is caused by trauma to the elbow.  Tennis and racquet sports can cause this condition as can various other activities which require repetitive and/or strenuous use of the forearm muscle.  Occupations which require repetition and weight lifting (chefs, plumbers, auto workers, carpenters) are often prone to developing tennis elbow.
     Your elbow joint is made up of three bones: your upper arm bone (humerus) and two forearm bones (radius and ulna).  At the bottom of the humerus are two bony bumps called epicondyles.  The one on the outside is the lateral epicondyle and the one on the inside is the medial epicondyle.  The muscles of your forearm work to extend your wrist and fingers.  The forearm extensor tendons (which attach the muscle to the bone) attach on the lateral epicondyle.  The Extensor Carpi Radialis Brevis (ECRB) tendon is commonly involved in tennis elbow.

     If I were to ask you what you thought of Olympic lifting, what’s the first thing that comes to mind?  Massive individuals grunting in tights while lifting an absurd amount of weight? Is it watching a gruesome YouTube video of people dislocating shoulders and elbows? 

Walking and running come naturally to us but pedaling isn’t a normal state of affairs.  One of the biggest challenges to a cyclist’s performance is achieving the correct alignment and positioning of the foot on the pedals, in relation to the position of the knees and hips, while eliminating unwanted movement and lost energy.

     So your orthopedic surgeon or primary care physician gave you a prescription for hand therapy - what is hand therapy? What types of treatment can you expect to receive? Is there a difference between seeing a hand therapist and going to see a physical or occupational therapist?
     Hand therapy is a very specialized practice area within the field of rehabilitative services.  The name is a little deceptive because most hand therapy clinics provide treatment for the entire upper extremity, not solely the hand. Hand therapy is the merging of occupational therapy and physical therapy theory and practice that combines comprehensive knowledge of the upper extremity, function, and activity. Using specialized skills in evaluation, assessment and treatment, hand therapists assist patients to regain maximum use of their arm and/or hand after injury, surgery or the onset of disease.
     Your first visit to hand therapy consists of a thorough evaluation of your affected arm and/or hand usually comparing those results to the same results taken on the unaffected side. The therapist will evaluate not only your motion, strength, dexterity, sensation and pain but ask how difficult it is for you to perform your normal everyday activities. Your hand therapist may prescribe an initial home exercise program and provide education on your diagnosis and expected treatment outcomes.  A plan of care individualized for your specific needs will be formulated and initial treatment performed.