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Br J Sports Med 2009;43:252-258 doi:10.1136/bjsm.2008.052738
  • Original article

A new integrative model of lateral epicondylalgia

  1. B K Coombes1,
  2. L Bisset2,3,
  3. B Vicenzino1
  1. 1
    Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia
  2. 2
    School of Physiotherapy and Exercise Science, Griffith University, Gold Coast Campus, Queensland, Australia
  3. 3
    Physiotherapy Department, Royal Brisbane & Women’s Hospital, Herston Queensland, Australia
  1. 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
  • Accepted 12 November 2008
  • Published Online First 2 December 2008

Abstract

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.

Footnotes

  • Funding: National Health & Medical Research Council Grant #511238.

  • Competing interests: None.

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