Medial and Lateral Epicondylitis Rehabilitation

Q: I am a physician (chief of rheumatology in a large hospital) who read your recent article on T-Muscle with great interest. I agree that more effective treatment with shorter recovery time is necesssary for soft tissue injuries. I would appreciate your approach to chronic medial/lateral epicondylitis where the patient has had cortisone injections along with stretching and forearm bands. Thank you for your time and help.

A: Always look above and below the joint. Stretch the short, tight muscles (often the wrist flexors and shoulder internal rotators with most elbow issues) and strengthen the long, weak muscles (e.g., wrist extensors and shoulder external rotators.) Soft-tissue work will aid in freeing up the forearm and upper arm sleeve. Many modalities are used to accomplish this, such as ART, myofascial release, frequency-specific microcurrent, laser, acupuncture, deep tissue massage, etc. - emphasize the treatment which resonates well with the patient. And finally, we have had an extreme amount of success with epicondylitis cases through the use of platelet-rich plasma (PRP) injections. I typically refer patients to Dr. Anthony Galea for this procedure, and within 3 treatments most experience significant relief with return of full function. There is support to back this up (see this link).