Effective Conservative Treatment of Medial Epicondylitis with Physical Therapy–A Case Study

Abstract

Background and Purpose: Like other common tendinopathies, there is debate as to whether medial epicondylitis and tendinitis treatment should focus on inflammation or degeneration management. This case study demonstrates the effectiveness of physical therapy when both are addressed. Case Description: A patient with bilateral medial epicondylitis and tendinitis recovered with physical therapy directed at both inflammatory and degenerative elements. Soft tissue manipulation, phonophoresis, and electrical stimulation were utilized at areas detected by microcurrent injury detection. Therapeutic exercise in the clinic and home were also utilized. Outcomes: In 11 treatments, strength increased from 4/5 to 5/5 or 5-/5.  Pain decreased from 8/10 to 0/10 on Verbal Numerical Rating Scale (VNRS). Patient experienced full return to ADLs, no pain or restrictions. Discussion: Three aspects were unique to this case. First, soft tissue manipulation was used to palpate and remodel degenerative tissues. Second, microcurrent injury detection mapped out specific areas of injured tissues. Finally, modalities were applied to these specific areas, which changed from the flexor tendon and muscle to the proximal cubital tunnel. Used together, the patient experienced full recovery in a timely manner. This case suggests that tendinitis may be a combination of degenerative and inflammatory elements which should both be addressed in a treatment plan.