Rehabilitation Science

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Rapid and Successful Rehabilitation and Return to Play for a D1 Gymnast After Treatment for Lateral Epicondylosis with Ultrasound Guided Percutaneous Tenotomy (Tenex)

Received: Mar. 26, 2020    Accepted: Apr. 15, 2020    Published: May 14, 2020
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Abstract

Lateral elbow pain is a commonly seen in sports medicine. There are multiple interventions for this chronic condition which may lead to difficulty with successful treatment. There are also multiple rehabilitation strategies employed for treatment. Variations in treatments and rehabilitation protocols can lead to different and sometimes unsuccessful long term outcomes. We present a novel case of a Division 1 college gymnast with recalcitrant lateral elbow pain who underwent percutaneous tenotomy (Tenex) of the common wrist extensor tendon. The athlete was able to return to full Division 1 athletics two months after the procedure. This case is unique secondary to the patient being a high level athlete and his rapid return to the intensity and requirements of competing in Division 1 sports. We also developed a specific rehabilitation protocol that we postulated would be appropriate after this procedure. We illustrate the athlete’s rehabilitation in detail. We feel that this specific protocol may have also influenced his rapid and complete return. We anticipate that this specific rehabilitation protocol may potentially guide future rehabilitation protocols after the Tenex procedure for recalcitrant lateral epicondylosis. In addition, this rehabilitation protocol may be considered after the Tenex procedure for additional conditions like medial epicondylosis, achilles tendinosis, patella tendinosis and gluteal tendinosis.

DOI 10.11648/j.rs.20200501.11
Published in Rehabilitation Science ( Volume 5, Issue 1, March 2020 )
Page(s) 1-4
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Percutaneous Tenotomy, Tenex, Lateral Epicondylosis

References
[1] Cutts, S. Gangoo, S. Modi, N. Tennis elbow: A clinical review article: J. Orthop. 2019, 17: 203-207.
[2] Dimberg, L. The prevalence and causation of tennis elbow in a population of workers in an engineering industry. Egonomic. 1987 20 537-539.
[3] J. P. Haahr, J. H. Andersen. Physical and psychosocial risk factors for lateral epicondylitis: a population based case-referent study. Occup Environ Med, 60 (2003), pp. 322-329.
[4] Bateman, M. Tichener, AG. Clark, D., Tambe, AA. Managemnt of Tennis Elbow: a survey of UK clinical practice.
[5] Nirschl, RP, Ashman, SH. Elbow tendinopathy: Tennis elbow. Clin Sports Med. 2003; 22: 813–836.
[6] Koh, Joyce; Mohan, P; Morrery, B et al. Fasciotoomy and Surgical Tenotomy for Recalcitrant Lateral Elbow Tendinopathy. AJSM. Vol. 41, 636-644, 2013.
[7] Morrey, B. Ultrasound Percutaneous Tenotomy for Epicondylitis. Techniques in Shoulder and Elbow Surgery. Vol. 14 Number 2, June 2013.
[8] Barnes, D. Beckley, J. Smith, J. Ultrasonic Percutaneous Tenotomy for Chronic Lateral elbow Tendinosis: A Prospective Study. Journal of Shoulder and Elbow Surgery 2014. 1-7.
[9] Battista, CT. Dorweiler, MA, Fisher, ML, Morrey, BF, Noyes, MP. Ultrasonic Percutaneous Tenotomy of Common Extensor Tendons for Recalcitrant Lateral Epicondylitis. Tech Hand Up Extrem Surg. 2018, 22 (1) 15-18.
[10] Seng, C. Mohan, PC, Koh, SB. Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Sustainability and Sonographic Progression at 3 years. Am J Sports Med. 216 44 (2) 504-510.
[11] Boden AL, Scott MT, Dalwadi PP, Mautner K, Mason RA, Gottschalk MB. Platelet Rich Plasma versus Tenex in the treatment of medial and lateral epicondylitis. Journal of shoulder and elbow surgery. 2019; 28 (1) 112-119.
[12] Mattie, R. Wong, J. McCormick, Z. Yu, S. Percutaneous needle Tenotomy for the Treatment of Lateral Epicondylitis: A Systemic Review of the Literature. PM R 2017, 9 (6) 603-611.
[13] Lenoir, H, Mares, O, Carlier, Y. Management of Lateral Epicondylitis. Orthop Traumatol Surg Res. 2019 15 (8S) S 241-S246.
[14] Bateman, M., Whitby, E, Kacha, S., Salt, E. Current physiotherapy practice in the management of tennis elbow: A service evaluation. Musculoskeletal Care. 2018. 16 (2) 322 – 326.
[15] Sussman, W. Mautner, K. Malanga, G. The role of rehabilitation after regenerative and orthobiologic procedures for the treatment of tendinopathy: a systematic review. Regen Med. 2018 13 (2) 249-263.
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  • APA Style

    Bryant Walrod, Wilbert Turner, Kelly Pauls. (2020). Rapid and Successful Rehabilitation and Return to Play for a D1 Gymnast After Treatment for Lateral Epicondylosis with Ultrasound Guided Percutaneous Tenotomy (Tenex). Rehabilitation Science, 5(1), 1-4. https://doi.org/10.11648/j.rs.20200501.11

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    ACS Style

    Bryant Walrod; Wilbert Turner; Kelly Pauls. Rapid and Successful Rehabilitation and Return to Play for a D1 Gymnast After Treatment for Lateral Epicondylosis with Ultrasound Guided Percutaneous Tenotomy (Tenex). Rehabil. Sci. 2020, 5(1), 1-4. doi: 10.11648/j.rs.20200501.11

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    AMA Style

    Bryant Walrod, Wilbert Turner, Kelly Pauls. Rapid and Successful Rehabilitation and Return to Play for a D1 Gymnast After Treatment for Lateral Epicondylosis with Ultrasound Guided Percutaneous Tenotomy (Tenex). Rehabil Sci. 2020;5(1):1-4. doi: 10.11648/j.rs.20200501.11

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  • @article{10.11648/j.rs.20200501.11,
      author = {Bryant Walrod and Wilbert Turner and Kelly Pauls},
      title = {Rapid and Successful Rehabilitation and Return to Play for a D1 Gymnast After Treatment for Lateral Epicondylosis with Ultrasound Guided Percutaneous Tenotomy (Tenex)},
      journal = {Rehabilitation Science},
      volume = {5},
      number = {1},
      pages = {1-4},
      doi = {10.11648/j.rs.20200501.11},
      url = {https://doi.org/10.11648/j.rs.20200501.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.rs.20200501.11},
      abstract = {Lateral elbow pain is a commonly seen in sports medicine. There are multiple interventions for this chronic condition which may lead to difficulty with successful treatment. There are also multiple rehabilitation strategies employed for treatment. Variations in treatments and rehabilitation protocols can lead to different and sometimes unsuccessful long term outcomes. We present a novel case of a Division 1 college gymnast with recalcitrant lateral elbow pain who underwent percutaneous tenotomy (Tenex) of the common wrist extensor tendon. The athlete was able to return to full Division 1 athletics two months after the procedure. This case is unique secondary to the patient being a high level athlete and his rapid return to the intensity and requirements of competing in Division 1 sports. We also developed a specific rehabilitation protocol that we postulated would be appropriate after this procedure. We illustrate the athlete’s rehabilitation in detail. We feel that this specific protocol may have also influenced his rapid and complete return. We anticipate that this specific rehabilitation protocol may potentially guide future rehabilitation protocols after the Tenex procedure for recalcitrant lateral epicondylosis. In addition, this rehabilitation protocol may be considered after the Tenex procedure for additional conditions like medial epicondylosis, achilles tendinosis, patella tendinosis and gluteal tendinosis.},
     year = {2020}
    }
    

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    AU  - Bryant Walrod
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    AB  - Lateral elbow pain is a commonly seen in sports medicine. There are multiple interventions for this chronic condition which may lead to difficulty with successful treatment. There are also multiple rehabilitation strategies employed for treatment. Variations in treatments and rehabilitation protocols can lead to different and sometimes unsuccessful long term outcomes. We present a novel case of a Division 1 college gymnast with recalcitrant lateral elbow pain who underwent percutaneous tenotomy (Tenex) of the common wrist extensor tendon. The athlete was able to return to full Division 1 athletics two months after the procedure. This case is unique secondary to the patient being a high level athlete and his rapid return to the intensity and requirements of competing in Division 1 sports. We also developed a specific rehabilitation protocol that we postulated would be appropriate after this procedure. We illustrate the athlete’s rehabilitation in detail. We feel that this specific protocol may have also influenced his rapid and complete return. We anticipate that this specific rehabilitation protocol may potentially guide future rehabilitation protocols after the Tenex procedure for recalcitrant lateral epicondylosis. In addition, this rehabilitation protocol may be considered after the Tenex procedure for additional conditions like medial epicondylosis, achilles tendinosis, patella tendinosis and gluteal tendinosis.
    VL  - 5
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Author Information
  • Department of Family Medicine, The Ohio State University, Columbus, Ohio, U.S.A

  • Department of Athletics, The Ohio State University, Columbus, Ohio, U.S.A

  • Department of Family Medicine, The Ohio State University, Columbus, Ohio, U.S.A; Department of Athletics, The Ohio State University, Columbus, Ohio, U.S.A

  • Section