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Elbow flexor and extensor muscle weakness in lateral epicondylalgia
  1. Brooke K Coombes1,
  2. Leanne Bisset2,3,
  3. Bill Vicenzino1
  1. 1Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
  2. 2School of Physiotherapy and Exercise Science, Griffith University, Gold Coast, Australia
  3. 3Gold Coast Health Services District, Gold Coast, Australia
  1. Correspondence to Bill Vicenzino, Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Building 84A, St Lucia QLD 4072, Australia; b.vicenzino{at}


Objective To evaluate whether deficits of elbow flexor and extensor muscle strength exist in lateral epicondylalgia (LE) in comparison with a healthy control population.

Design Cross-sectional study.

Participants 150 participants with unilateral LE were compared with 54 healthy control participants.

Main outcome measures Maximal isometric elbow flexion and extension strength were measured bilaterally using a purpose-built standing frame such that gripping was avoided.

Results The authors found significant side differences in elbow extensor (−6.54 N, 95% CI −11.43 to −1.65, p=0.008, standardised mean difference (SMD) −0.45) and flexor muscle strength (−11.26 N, 95% CI −19.59 to −2.94, p=0.009, SMD −0.46) between LE and control groups. Within the LE group, only elbow extensor muscle strength deficits between sides was significant (affected–unaffected: −2.94 N, 95% CI −5.44 to −0.44).

Conclusion Small significant deficits of elbow extensor and flexor muscle strength exist in the affected arm of unilateral LE in comparison with healthy controls. Notably, comparing elbow strength between the affected and unaffected sides in unilateral epicondylalgia is likely to underestimate these deficits.

Trial Registration Australian New Zealand Clinical Trials Register ACTRN12609000051246.

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

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the NHMRC, University of Queensland.

  • Provenance and peer review Not commissioned; externally peer reviewed.