Middle and Lower Trapezius Strengthening for the Management of Lateral Epicondylalgia: A Case Report

被引:10
作者
Bhatt, Jiten B. [1 ]
Glaser, Randal [2 ]
Chavez, Andre [3 ]
Yung, Emmanuel [3 ,4 ,5 ]
机构
[1] Kaiser Permanente Panorama City Orthopaed Phys Th, Panorama City, CA USA
[2] Kaiser Permanente Panorama City, Santa Clarita, CA USA
[3] Kaiser Permanente West Los Angeles Orthopaed Phys, Los Angeles, CA USA
[4] Sacred Heart Univ, Doctor Phys Therapy Program, Fairfield, CT USA
[5] Sacred Heart Univ, Orthopaed Phys Therapy Residency Program, Fairfield, CT USA
关键词
scapula; shoulder; tendinopathy; tennis elbow; MUSCLE CRAMPS; UPPER-LIMB; CORTICOSTEROID INJECTION; MEDIAL EPICONDYLITIS; TENNIS PLAYERS; ELBOW; PAIN; PHYSIOTHERAPY; EXERCISE; RESPONSIVENESS;
D O I
10.2519/jospt.2013.4659
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
STUDY DESIGN: Case report. BACKGROUND: Addressing weakness of the shoulder region, especially the rotator cuff and scapular musculature, is often suggested clinically for the treatment of individuals with lateral epicondylalgia. However, to our knowledge, the clinical effectiveness of this approach has not been established. CASE DESCRIPTION: The patient was a 54-year-old woman with a 5-month history of right lateral elbow pain, whose symptoms were reproduced with clinical tests typically used to diagnose lateral elbow tendinopathy. The patient also demonstrated weakness in her middle and lower trapezius muscles, and the medial border of her scapula, measured with a tape measure, was 11cm lateral from the spinous processes of the thoracic spine with the patient standing in relaxed stance. Based on improved grip strength and reduced associated elbow pain when tested with the scapula manually corrected in a more adducted position, treatment focused solely on strengthening of the middle and lower trapezius muscles over a 10-week period. OUTCOMES: Following the intervention, the patient presented with improved scapular position, with the medial border of the scapula being 9 cm lateral to the midthoracic spine. The patient's middle and lower trapezius strength improved from 3+/5 and 4 /5, respectively, to 5/5, and her grip strength from 26.1 to 42.2 kg. The patient's scores on the Disabilities of the Arm, Shoulder and Hand questionnaire also improved from 44.2 at the initial evaluation to 0 at the completion of therapy, with the patient being able to perform all of her daily activities in a pain-free manner. DISCUSSION: The results of this case report suggest that assessment and treatment of scapular musculature warrant consideration in the management of individuals with lateral epicondylalgia.
引用
收藏
页码:841 / 847
页数:7
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