Activation of middle and lower trapezius and strengthening of serratus anterior muscle for the rehabilitation of a patient with chronic lateral epicondylalgia: A case report

Abstract

Introduction: The most quintessential elbow condition among athletes, especially tennis players, is lateral epicondylalgia, familiar as lateral epicondylitis. Individuals employed in professions that involve frequent physical exertion or repetitive movements are also susceptible to potential risk. This case report intents to present a brief overview of the patient’s treatment and rehabilitation for lateral epicondylalgia by using specific problem-oriented treatments. Case Report: In this case report, we report a case of a 35-year-old female patient who had chronic lateral epicondylitis on right elbow for three months. On physical examination, Numeric Pain Rating Scale (NPRS), Quick DASH, and Patient-rated Tennis Elbow Evaluation score and activities were evaluated on the initial visit to physical therapy and after discharge. By the time she attended three times a week for four weeks, she received conventional therapy lateral epicondylitis. Additionally, she also received a wide range of physiotherapy to stabilize the scapula, more specifically the middle and lower trapezius and strengthening of serratus anterior muscle. This helped to correct deformities, reduce pain, and restore elbow function. The patient reported NPRS = 8/10, Quick DASH = 72.7, and PR-TEE = 89 on the initial visit. At discharge the patient reported a 3 on NPRS, Quick DASH = 15.9, and PR-TEE = 34 with ability to return to full work and no associated symptoms or complaints. Conclusion: The combination of conventional physiotherapy intervention with scapular muscle activation and strengthening was comparatively effective in relieving the patient’s lateral epicondylalgia and push the patient to a higher level of functional activity within only four weeks.