• Baseball
• Epicondylitis
• Overhead athlete
• Physical examination
• Posterolateral rotatory instability
• Throwing elbow
• Ulnar collateral ligament
• Valgus extension overload

• Humans
• Physical Examination/methods
• Elbow Joint/physiopathology
• Elbow Joint/anatomy & histology
• Elbow Joint/physiology
• Elbow Injuries
• Athletic Injuries/diagnosis
• Athletic Injuries/physiopathology
• Biomechanical Phenomena
• Tennis Elbow/diagnosis
• Tennis Elbow/physiopathology
• Collateral Ligament, Ulnar/injuries
• Joint Instability/diagnosis
• Joint Instability/physiopathology
• Elbow/anatomy & histology

Recognizing the mechanical origin of enthesitis/enthesopathy and the avulsion-nature of what had previously been considered erosions, it seems inappropriate to attribute it to stresses related to a person’s normal activities. Conversely, sudden or unconditioned repetitive stresses appears the more likely culprit. Studies of enthesial reaction have lacked standardization as to findings present among individuals who appear to be healthy. Clinical evaluation by palpation and manipulation may be as effective as application of radiologic techniques. Recognition of the mechanical nature of the disease, including individuals with inflammatory arthritis suggests prescription of mechanical solutions that reduce stresses across the involved enthesis.

• Enthesitis
• Epicondylitis
• Erosion
• Avulsion
• Clinical examination

• Humans
• Tennis Elbow/surgery
• Chronic Disease
• Male
• Middle Aged
• Female
• Treatment Outcome
• Adult

• CFT
• ME treatment
• common flexor tendon
• golfer’s elbow
• medial epicondylitis

• assistive device
• benchmarking and evaluation
• elbow exoskeleton
• electromyography
• motion capture
• wearable robots

• National Research Foundation of Korea
• Istituto Nazionale per l'Assicurazione Contro Gli Infortuni sul Lavoro

• dog
• gait analysis
• insertional biceps tendinopathy
• intra-articular injection
• triamcinolone acetonide

• 2018R1D1A1B07047451 National Research Foundation of Korea

• Elbow
• Rehabilitation
• Return to sport
• Sports injuries
• Upper limb

• Lateral epicondylitis
• elbow
• functional outcome
• grip strength
• suture anchor
• tennis elbow
• wrist extension strength

• Medial epicondylitis
• arthroscopic techniques
• golfer’s elbow
• open techniques
• sports injury
• tendinopathy

• Arthroscopy
• ECRB
• Lateral epicondylitis
• Tennis elbow
• Treatment

• Humans
• Adolescent
• Elbow
• Tendons
• Athletes
• Elbow Joint
• Tendon Injuries/prevention & control
• Risk Factors
• Athletic Injuries/prevention & control
• Athletic Injuries/etiology

It is a well-known fact that physical activity benefits people of all age groups. However, highly intensive training, maladaptation, improper equipment, and lack of sufficient rest lead to contusions and sports-related injuries. From the perspectives of sports professionals and those performing regular–amateur sports activities, it is important to maintain proper levels of training, without encountering frequent injuries. The bodily responses to physical stress and intensive physical activity are detected on many levels. Epigenetic modifications, including DNA methylation, histone protein methylation, acetylation, and miRNA expression occur in response to environmental changes and play fundamental roles in the regulation of cellular activities. In the current review, we summarise the available knowledge on epigenetic alterations present in tissues and organs (e.g., muscles, the brain, tendons, and bones) as a consequence of sports-related injuries. Epigenetic mechanism observations have the potential to become useful tools in sports medicine, as predictors of approaching pathophysiological alterations and injury biomarkers that have already taken place.

Medial epicondylalgia (ME), commonly known as “the golfer’s elbow”, typically develops in individuals who perform repetitive forearm movements and weight-bearing activities. It accounts for up to 20% of all epicondylitis cases and is most prevalent in particular sports and occupations. Though the diagnosis can be made based on sole clinical examination, additional imaging might be essential for confirmation of medial epicondylitis and excluding other pathologies of the medial epicondyle region. US imaging, with a sensitivity and specificity of 95% and 92%, respectively, remains a practical and accessible alternative to MRI. However, its diagnostic efficacy highly depends on the operator’s experience and requires proper technique. This article describes the ultrasound examination and technique for adequate visualization of elbow joint structures. It also discusses the differential diagnosis of other common and less-known pathologies of the medial compartment of the elbow, including snapping triceps, medial collateral ligament injury, and cubital tunnel neuropathy.

• differential diagnosis
• elbow
• epicondylitis
• golfer’s elbow
• ultrasound

• Lateral epicondylitis
• complication
• leukocyte-poor
• leukocyte-rich
• platelet-rich plasma
• systematic review
• tennis elbow

• Humans
• Injections
• Pain
• Platelet-Rich Plasma
• Tendinopathy/therapy
• Tennis Elbow/therapy
• Treatment Outcome

Elbow injuries are frequently seen in throwing and overhead athletes. This review provides a framework for diagnosis, treatment, and particularly rehabilitation of common elbow pathologies, including ulnar collateral ligament injury, valgus extension overload, and medial and lateral epicondylitis. Advanced rehabilitation facilitates complete return to functional sport-specific activity and is based on objective criteria. As diagnostic and therapeutic modalities improve our understanding of elbow pathologies in the athletic patient, continued research will further elucidate objective evidence-based rehabilitation techniques.

• Elbow
• Rotator cuff
• Shoulder
• Sports medicine
• Weekend warrior

Although the Nirschl technique was introduced approximately 40 years ago, only limited information is available about the long-term results, especially concerning extensor power changes after surgery.

The purpose of this study was to investigate long-term clinical results of surgical treatment of lateral epicondylitis using the modified Nirschl technique. The main outcome variable was muscle strength for wrist extension because the extensor origin was not reattached after removal of the degenerative extensor tendon.

Data from 99 patients who underwent surgical lateral epicondylitis treatment between 2007 to 2012 were included in the study. The mean follow-up period was 8.5 years (5 to 10, ± 1.1 years) and the mean age at surgery was 44.8 years (32 to 70, ± 9.8 years). The surgeries were performed using the modified Nirschl method and did not include extensor origin reattachment. Outcome measurements included the Visual Analogue Scale (VAS) score, Disabilities of the Arm, Shoulder and Hand (DASH) score, the MAYO elbow performance score, and Nirschl and Pettrone’s grades. Wrist extension and grip strength were analyzed using a digital handgrip dynamometer (microFET2TM system) and JAMA hand dynamometer.

Mean time required to return to work was 2.4 months after surgery. At the last follow-up after surgery, the mean VAS score had significantly improved, from 4.9 to 1.1. Mean MAYO elbow performance scores significantly improved, from 64 to 90, and mean DASH scores improved from 50 to 13. The Nirschl and Pettrone’s grades were 80% rated as ‘excellent’ and 16% rated as ‘good’. After adjusting for power differences between the dominant and non-dominant arms, the difference between wrist extensor power of the operated elbow and the non-operated opposite elbow at the final follow-up was not statistically significant. No patients complained about wrist extension weakness.

Although reattachment of the extensor origin was not performed during the modified Nirschl surgical technique, there was no significant weakness in wrist extension power and the long-term follow-up revealed favorable clinical results.

Level IV (case series). Retrospective study.

The online version contains supplementary material available at 10.1186/s12891-021-04079-x.

• Clinical outcome
• Lateral epicondylitis
• Strength
• Surgery
• Wrist extension

• Iron Age
• celts
• entheses
• long bone indices
• physical activity

• Extracorporeal Shock Wave Therapy
• Lateral Epicondilosis
• Prolotherapy
• Tennis Elbow

• epidemiology
• health care costs
• medial epicondylitis
• surgical treatment

Introduction: Lateral epicondylitis is a common musculoskeletal disorder of the upper limb. Corticosteroid injection has been widely used as a major mode of treatment. However, better understanding of the pathophysiology of the disease led to a major change in treating the disease, with new options including platelet-rich plasma (PRP) are currently used.

Objectives/research aim: To systematically evaluate the effect of corticosteroid versus PRP injections for the treatment of LE.

Hypothesis: PRP injections provide longer-term therapeutic effect and less rate of complications compared to corticosteroid injection.

Level of evidence: Level 2 evidence (4 included studies are of level 1 evidence, 1 study of level 2 evidence).

Design: Systematic Review (according to PRISMA guidelines).

Methods: Eleven databases used to search for relevant primary studies comparing the effects of corticosteroid and PRP injections for the treatment of LE. Quality appraisal of studies performed using Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0, CASP Randomised Controlled Trial Checklist, and SIGN Methodology Checklist 2.

Results: 732 papers were identified. Five randomised controlled trials (250 Patients) met the inclusion criteria. Clinical findings: Corticosteroid injections provided rapid symptomatic improvement with maximum effect at 6/8/8 weeks before symptoms recurrence, whereas PRP showed slower ongoing improvements up to 24/52/104 weeks(3 studies). Corticosteroid showed more rapid symptomatic improvement of symptoms compared to PRP up to the study end-point of 3 months(1 study). Comparable therapeutic effects of corticosteroid and PRP were observed at 6 weeks(1 study). Ultrasonographic Findings: (1) Doppler activity decreased more significantly in patients who received corticosteroid compared to PRP. (2) Reduced tendon thickness and more patients with cortical erosion noted in corticosteroid group whereas increased tendon thickness and less number of patients with common extensor tendon tears noted in PRP group. (3) Fewer patients reported Probe-induced tenderness and oedema in the common extensor tendon in both corticosteroid and PRP groups (2 studies).

Conclusion: Corticosteroid injections provide rapid therapeutic effect in the short-term with recurrence of symptoms afterwards, compared to the relatively slower but longer-term effect of platelet-rich plasma.

• Medial epicondylitis
• common flexor origin release
• decortications
• elbow
• multiple drilling
• surgical treatment

• Adult
• Age Factors
• Aged
• Arthralgia/surgery
• Cumulative Trauma Disorders/surgery
• Disability Evaluation
• Elbow Joint/surgery
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Patient Satisfaction
• Retrospective Studies
• Return to Sport
• Suture Anchors

• Epicondylitis
• Epicondylosis
• Sonography
• Tendinopathy
• Ultrasound
• Ultrasound-guided injection

• Chronic elbow tendinosis
• Nirschl surgical technique
• Platelet rich plasma (PRP)

To develop the logistic and the probit models to analyse electromyographic (EMG) equivalent uniform voltage- (EUV-) response for the tenderness of tennis elbow. In total, 78 hands from 39 subjects were enrolled. In this study, surface EMG (sEMG) signal is obtained by an innovative device with electrodes over forearm region. The analytical endpoint was defined as Visual Analog Score (VAS) 3+ tenderness of tennis elbow. The logistic and the probit diseased probability (DP) models were established for the VAS score and EMG absolute voltage-time histograms (AVTH). TV₅₀ is the threshold equivalent uniform voltage predicting a 50% risk of disease. Twenty-one out of 78 samples (27%) developed VAS 3+ tenderness of tennis elbow reported by the subject and confirmed by the physician. The fitted DP parameters were TV₅₀ = 153.0 mV (CI: 136.3–169.7 mV), γ₅₀ = 0.84 (CI: 0.78–0.90) and TV₅₀ = 155.6 mV (CI: 138.9–172.4 mV), m = 0.54 (CI: 0.49–0.59) for logistic and probit models, respectively. When the EUV ≥ 153 mV, the DP of the patient is greater than 50% and vice versa. The logistic and the probit models are valuable tools to predict the DP of VAS 3+ tenderness of tennis elbow.

• biomechanics
• corticosteroid
• platelet-derived growth factor-BB
• platelet-rich plasma
• tendinopathy

• Achilles Tendon/drug effects
• Achilles Tendon/pathology
• Achilles Tendon/physiology
• Adrenal Cortex Hormones/pharmacology
• Animals
• Becaplermin
• Biomechanical Phenomena/drug effects
• Biomechanical Phenomena/physiology
• Disease Models, Animal
• Humans
• Injections, Intralesional
• Male
• Platelet-Rich Plasma
• Proto-Oncogene Proteins c-sis/pharmacology
• Rats
• Rats, Sprague-Dawley
• Recombinant Proteins/pharmacology
• Tendinopathy/drug therapy
• Tendinopathy/pathology
• Tendinopathy/physiopathology
• Treatment Outcome

• Bursitis/drug therapy
• Glucocorticoids/administration & dosage
• Humans
• Injections/methods
• Nerve Compression Syndromes/drug therapy
• Rheumatic Diseases/drug therapy
• Tendinopathy/drug therapy
• Tenosynovitis/drug therapy

• tennis elbow
• brace
• electromyography

• Adult
• Braces
• Electromyography
• Equipment Design
• Female
• Forearm/physiology
• Humans
• Male
• Middle Aged
• Tennis Elbow/physiopathology
• Tennis Elbow/therapy
• Wrist/physiology
• Wrist Joint
• Young Adult