Efficacy of a Stretching Protocol for Lateral Epicondylitis

Epicondylitis is one of the most common soft tissue disorders of the locomotor system of the upper limb. Despite the existence of a large number of therapeutic alternatives for this type of injury, no agreed treatment protocol has been found. Some authors even suggest treating the patient from a more global biomechanical perspective. OBJECTIVES. To evaluate the efficacy of applying a stretching protocol to the entire muscle chain involved in this injury and circumscribed to the entire affected upper limb. METHODOLOGY. The study will be made up of 40 patients of both genders, randomly distributed in two groups: a control group made up of twenty patients to whom the usual Physiotherapy treatment will be applied, and an experimental group made up of the rest of the subjects, in which a stretching protocol will be applied to the whole upper limb affected and defined for this study. The evaluation process will consist of measuring pain perception using a visual analogue scale (VAS) and grip strength with a dynamometer. These measurements will be performed on all study subjects before starting treatment, at week 4 and week 6.

Static stretching of the extensor carpi radialis brevis and eccentric strengthening of the wrist extensor musculature

Passive and active analytical stretching exercises described by Neiger and Simons , applying them to the muscle chain involved in lateral epicondylitis described by Busquet

For each stretching technique described, 3 repetitions of 15 seconds duration will be performed of 15 seconds duration each, within the patient's tolerance threshold. In any case, the impossibility of performing any technique due to exacerbation of pain shall be recorded in a patient record created for this study, noting the technique in question and the reason for its technique in question and the reason for its non-application. Passive stretches shall be applied in the same order for all subjects. The physiotherapists in charge of applying the treatments will be trained in advance in the different techniques to be applied and will not in the different techniques to be applied and shall not intervene at any time in the two previous phases. Both the control group and the study group will receive their respective treatments two days a week for four weeks. In no case will any other type of treatment be associated treatment during the whole process.

Static stretching of the extensor carpi radialis brevis and eccentric strengthening of the wrist extensor musculature

Static stretching of the extensor carpi radialis brevis and eccentric strengthening of the wrist extensor musculature

Measurement of pain perception: by means of a visual analogue scale (VAS), consisting of drawing a 100 mm long line in a centred position on a DINA A4 paper, cut with a segment perpendicular to it at each end. After informing the subject that the left and right segments represent the absence of pain and the maximum pain imaginable respectively, the subject is asked to point with a pencil on the line to the point where their pain is located.

A dynamometer shall be used for the test. Special care was taken to ensure that all subjects had the same position in order to be able to compare results. After informing the patient how to perform this test, the evaluation process consists of performing a maximum grip force for three seconds, executing it three times and with a minimum time interval of 60 seconds between them to avoid muscle fatigue. After completion of the test, the arithmetic mean of the results will be considered as the result.

Inclusion Criteria: Adult subjects over 18 years of age. Clinical diagnosis of lateral epicondylitis made by the Rehabilitation Physicians collaborating in this study. Patient's prior informed consent for inclusion in the study. Exclusion Criteria: Patients with significant psychological, neurological and physical impairments that would prevent the recruitment of the information necessary for the research. Patients with significant psychological, neurological and physical alterations that would prevent the application of the treatments necessary for the research. Patients in a situation of legal litigation that could be affected by their participation in this study. Refusal to participate in the study.

Publication in journals indexed in the Journal Citation Report (JCR),in the field of Rehabilitation and Physical Medicine and Physiotherapy. 2. Dissemination of results in national and international Congresses of Rehabilitation and Physical Medicine and Physiotherapy. 3. Dissemination to the public, press releases and explanatory brochures of the project.

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