Setting: Sports Clinic Gender: Female Age: 28 years Presenting Problem/Current Condition: Pain in the right elbow after increasing the frequency of her tennis games. Medical History: No significant medical issues Other Information: Recreational tennis player, recently started competing Physical Therapy Examination(s): Tenderness over the lateral epicondyle. Pain on resisted wrist extension Physical Therapy Plan of Care: None, this is the first visit 1. What is the MOST likely diagnosis for the patient's presentation? A) Golfer’s elbow B) Tennis elbow C) Olecranon bursitis D) Cubital tunnel syndrome Answer: B) Tennis elbow Rationale: Tennis elbow, or lateral epicondylitis, is characterized by pain over the lateral epicondyle and is often exacerbated by resisted wrist extension. The patient's symptoms, along with her recent increase in tennis games, align with this condition. Tennis elbow is caused by repetitive stress on the tendons of the forearm, especially those that straighten the wrist. Given the physical examination findings and the patient's history, tennis elbow is the most appropriate diagnosis. 2. What is the INITIAL recommended management for this condition? A) Complete rest and avoidance of all physical activity B) Activity modification and pain management C) Immediate surgical intervention D) High-intensity resistance training Answer: B) Activity modification and pain management Rationale: For tennis elbow (lateral epicondylitis), the initial treatment approach typically involves conservative measures. Activity modification means adjusting or reducing activities that aggravate the condition, like certain tennis strokes. Pain management can include methods like ice, non-steroidal anti-inflammatory drugs (NSAIDs), and sometimes physical therapy techniques. Surgery is usually considered only after conservative treatments have been exhausted, and high-intensity resistance training would not be appropriate during the acute phase of the condition. 3. Which of the following therapeutic modalities might be beneficial in the early stages of the condition? A) Continuous Ultrasound B) Hot pack C) Cryotherapy D) Neuromuscular Electrical Stimulation Answer: C) Cryotherapy Rationale: Cryotherapy, which involves the application of cold, can help reduce inflammation and alleviate pain in the acute stages of an injury. Continuous ultrasound and hot packs which heat the tissue may aggravate this acute condition and prolong inflammation. Neuromuscular electrical stimulation (NMES), has the purpose of increasing strength and endurance in muscular tissue. Strength and endurance are not the primary impairments at this time.
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