British Journal of Sports Medicine 2009;43:252-258
Original articles
A new integrative model of lateral epicondylalgia
1 Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia
2 School of Physiotherapy and Exercise Science, Griffith University, Gold Coast Campus, Queensland, Australia
3 Physiotherapy Department, Royal Brisbane & Women’s Hospital, Herston Queensland, Australia
Bill Vicenzino, Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Building 84A, St Lucia QLD 4072; b.vicenzino{at}uq.edu.au
Tennis elbow or lateral epicondylalgia is a diagnosis familiar to many within the general community and presents with an uncomplicated clinical picture in most cases. However, the underlying pathophysiology presents a more complex state and its management has not been conclusively determined. Research on this topic extends across anatomical, biomechanical and clinical literature; however, integration of findings is lacking. We propose that the current understanding of the underlying pathophysiology of lateral epicondylalgia can be conceptualised as encompassing three interrelated components: (i) the local tendon pathology, (ii) changes in the pain system, and (iii) motor system impairments. This paper presents a model that integrates these components on the basis of a literature review with the express aim of assisting in the targeting of specific treatments or combinations thereof to individual patients.
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