A study was performed to investigate whether an exercise program supplemented with ice is more successful than the exercise program alone in treating patients with lateral elbow tendinopathy (tennis elbow)The exercise program consisted of slow progressive eccentric (lengthening) exercises of wristextensors and static stretching of the extensor carpi radialis brevis tendon five times a week for four weeks.
In the exercise program plus ice group, the ice was applied after the exercise program for 10 minutes in the form of an ice bag to the facet of the lateral epicondyle. Patients were evaluated at baseline, at the end of treatment, and three months after the end of treatment. Outcome measures used were the pain visual analogue scale and the dropout rate.
It was found that an exercise program consisting of eccentric and static stretching exercises had reduced the pain in patients with tennis elbow at the end of the treatment and at the follow up whether or not ice was included. Manias P, Stasinopoulos D: A controlled clinical pilot trial to study the effectiveness of ice as a supplement to the exercise programme for the management of lateral elbow tendinopathy. British Journal of Sports Medicine. 40(1):81-5, 2006.
According to a study in cadaver arms, muscle stretching of the wristextensors for lateral epicondylitis should be performed with elbow extension, forearm pronation, and wrist flexion-ulnar deviation. Takasaki H, Aoki M, Muraki T, Uchiyama E, Murakami G, Yamashita T: Muscle strain on the radial wrist extensors during motion-simulating stretching exercises for lateral epicondylitis: a cadaveric study. Journal of Shoulder & Elbow Surgery. 16(6):854-8, 2007
A forearm support band is often used with the intent to decrease stresses around the origin of the wristextensors. However, the influence of the location of the band has not been studied. The study on cadaver arms found that the best position to place the forearm support band was when the band was mounted 80% of the forearm length above the wrist. Takasaki H, Aoki M, Oshiro S, Izumi T, Hidaka E, Fujii M, Tatsumi HStrain reduction of the extensor carpi radialis brevis tendon proximal origin following the application of a forearm support band. Journal of Orthopaedic & Sports Physical Therapy. 38(5):257-61, 2008.