專家教你五大運動，擊退網球手

簡介網球手

網球手，也稱為外上髁炎，是一種疼痛性疾病，發生在肘部肌腱超負荷時，而通常是由於手腕和手臂的重複運動所致。這種情況不僅會影響網球運動員，還會影響任何進行涉及重複手臂和手腕運動的活動的人。在本文中，我們將探討網球手的流行病學、危險因素、解剖學、常見症狀、復康運動和鑑別診斷。

你是屬於容易患有網球手的人嗎？

網球手在世界許多地方都很常見，包括亞洲。根據《香港醫學雜誌》發表的一項研究，香港外上髁炎的發病率為每年 1.3%（Chiu et al., 2006）。發表在《職業健康雜誌》上的另一項研究發現，日本人口中網球手的發病率為每年 1.8%（Sano et al., 2008）。這些發現表明，網球手在亞洲是一個嚴重的問題，需要更多的研究來了解這種情況在不同人群中的成因和危險因素。

網球手的風險因素

以下是網球手的一些常見危險因素：

由於打網球、在電腦鍵盤上打字或使用手動工具等重複性運動而過度使用前臂肌肉
執行重複動作時技術或形式不佳
年齡—網球手在 30 到 50 歲之間的人群中更為常見
性別—男性比女性更容易患網球手
某些職業，例如木工、管道和烹飪
條件差和健身水平差

網球手的解剖學成因

肘關節由三塊骨頭組成：肱骨（上臂骨）、橈骨（拇指側的前臂骨）和尺骨（小指側的前臂骨）。外上髁是肱骨上的骨性突起，作為前臂伸肌的附著部位。這些肌肉從外上髁延伸到手腕和手指，負責手腕伸展和手指伸直等運動。

網球手的常見症狀

以下是網球手的一些常見症狀和體徵：

肘部外側疼痛和壓痛
前臂肌肉無力
難以抓握物體或進行涉及手腕和前臂運動的活動
肘關節僵硬

怎樣檢查我是否患有網球手？

除了有以上所說的病徵，你亦需要經驗豐富的治療師為你進行一系列的檢查，例如詢問病史、目測、觸診、姿勢評估、脊椎活動度、脊椎排列、關節移位、關節活動幅度測試、關節末端範圍感覺、肌肉張力測試、肌肉力量測試、神經反射測試、神經張力測試、感覺測試、動作分析，左右不平衝、代償等等。若你無法確定自己是否患上這個症狀，建議你尋找醫療專業人士為你檢查。

有什麼電療可以止痛及修復網球手？

超聲波療法：使用高頻聲波來增加血液循環並減輕患處的疼痛和炎症。
干擾波電療法：即IFT電療，使用中頻電刺激來減輕疼痛和腫脹，並促進癒合。
衝擊波治療：利用衝擊波破壞粘連，促進組織自愈過程。
深層加熱筋膜刀治療：利用深層加熱效應增加血液循環，配合筋膜刀手法鬆解筋膜粘連。
針灸療法：增加局部血液循環，抑制疼痛信號。（根據《中醫藥條例》（第 549 章），針灸可由根據《輔助醫療業條例》（第 359 章）註冊的物理治療師進行。）

改善網球手症狀的運動

有多種運動可以幫助改善網球手的症狀。重要的是要注意，這些練習應該在物理治療師或醫療專業人員的指導下進行。

腕伸肌伸展：首先將手臂伸到身前，手掌朝下。用另一隻手將手指輕輕拉向手腕，直到感覺到前臂後部的肌肉伸展。保持15-30秒，換另一側重複。
離心手腕訓練：手握輕重量，手掌朝下。使用手腕伸肌，慢慢地將重量降低到地面。然後，用另一隻手幫助舉起重物。重複 3 組，每組 10-15 次。
前臂旋前和旋後：手握輕物，手掌朝上。慢慢轉動手腕，使手掌朝下，然後回到起始位置。重複 3 組，每組 10-15 次。
擠壓球：用手握住一個軟球，盡可能用力擠壓它 5-10 秒。重複 3 組，每組 10-15 次。
Flexbar 鍛煉 - 雙手握住 Flexbar（一種由橡膠製成的專用鍛煉桿），然後彎曲您的手腕，，慢慢回到起始位置。重複 3 組，每組 10-15 次。

網球手的鑑別診斷

以下是一些可能被誤認為是網球手的情況：

橈骨隧道綜合症 - 一種導致前臂肌肉疼痛和無力的病症，通常是由於橈神經受壓所致。
頸椎功能障礙——頸部椎骨出現問題會導致手臂和手部疼痛。
臂叢神經病——控製手臂和手的神經受損或受傷，可導致虛弱、麻木或刺痛。

結論

網球手是一種常見病症，可由手腕和手臂的重複運動引起。對於包括香港在內的亞洲人來說，這可能是一個嚴重的問題。網球手的危險因素包括過度使用前臂肌肉、技術不佳、年齡、性別、某些職業和身體狀況不佳。肘關節由三塊骨頭組成，外上髁是前臂伸肌附著在肱骨上的骨性突起。網球手的常見體徵和症狀包括肘外側疼痛和壓痛、前臂肌肉無力、抓握物體困難和肘關節僵硬。有助於改善網球手症狀的鍛煉包括腕伸肌伸展、偏心腕伸展、前臂旋前和旋後、球擠壓和 Flexbar 練習。網球手的鑑別診斷包括橈骨隧道綜合徵、頸椎功能障礙和臂叢神經病。如果您感到持續疼痛或難以使用手臂和手腕，請務必就醫。

5 best exercise to recover from Tennis Elbow - Taught by expert

Introduction

Tennis elbow, also known as lateral epicondylitis, is a painful condition that occurs when the tendons in your elbow are overloaded, usually due to repetitive motions of the wrist and arm. This condition can impact not only tennis players, but anyone who performs activities that involve repetitive arm and wrist movements. In this article, we will explore the epidemiology, risk factors, anatomy, signs and symptoms, exercises, and differential diagnosis of tennis elbow.

Epidemiology

Tennis elbow is a common condition in many parts of the world, including Asia. According to a study published in the Hong Kong Medical Journal, the incidence of lateral epicondylitis in Hong Kong is 1.3% per year (Chiu et al., 2006). Another study published in the Journal of Occupational Health found that the incidence of tennis elbow in a Japanese population was 1.8% per year (Sano et al., 2008). These findings suggest that tennis elbow is a significant problem in Asia, and that more research is needed to understand the causes and risk factors of this condition in different populations.

Risk factors

The following are some of the common risk factors for tennis elbow:

Overuse of the forearm muscles due to repetitive motions such as playing tennis, typing on a computer keyboard, or using hand tools
Poor technique or form when performing repetitive motions
Age - tennis elbow is more common in individuals between the ages of 30 and 50
Gender - men are more likely to develop tennis elbow than women
Certain occupations, such as carpentry, plumbing, and cooking
Poor conditioning and fitness levels

Anatomy

The elbow joint is made up of three bones: the humerus (upper arm bone), the radius (forearm bone on the thumb side), and the ulna (forearm bone on the little finger side). The lateral epicondyle is a bony projection on the humerus, which serves as an attachment site for the extensor muscles of the forearm. These muscles extend from the lateral epicondyle to the wrist and fingers, and are responsible for movements such as wrist extension and finger straightening.

Common signs and symptoms

The following are some of the common signs and symptoms of tennis elbow:

Pain and tenderness on the outside of the elbow
Weakness in the forearm muscles
Difficulty gripping objects or performing activities that involve wrist and forearm movements
Stiffness in the elbow joint

How can I check if I have Tennis Elbow?

In addition to the symptoms mentioned above, you also need an experienced therapist to conduct a series of examinations for you, such as taking medical history, visual inspection, palpation, posture assessment, spinal mobility, spinal alignment, joint displacement, joint range of motion test, joint end range feeling, muscle tension test, muscle strength test, nerve reflex test, neural tension test, sensory test, motion analysis, left and right imbalance, compensation, etc. If you are not sure, it is recommended that you seek advice from medical professionals.

What kinds of electrotherapy can help to relieve pain and regenerate from Tennis Elbow?

Electrotherapy can be helpful in relieving pain and regeneration. Some of the common modalities include:

Ultrasound therapy: This uses high-frequency sound waves to increase blood flow and reduce pain and inflammation in the affected area.
Interferential therapy: This uses low-frequency electrical stimulation to reduce pain and swelling and promote healing.
Shockwave therapy: This uses shockwave to break down adhesions and promote tissue self-healing process.
RF with IASTM: Radiofrequency Diathermy with Instrument Assisted Soft Tissue Mobilization (Myofascial Release Therapy) uses deep heating to increase blood circulation, with manual technique to release myofascial adhesion.
Acupuncture therapy: This stimulates local blood circulation and suppresses pain signals. According to The Chinese Medicine Ordinance (Cap. 549), the use of acupuncture can be done by a physiotherapist registered under the Supplementary Medical Professions Ordinance (Cap. 359).

Exercises to improve symptoms

There are a variety of exercises that can help improve symptoms of tennis elbow. It's important to note that these exercises should be performed under the guidance of a physiotherapist or medical professional.

Wrist extensor stretch - Start by holding your arm out in front of you with your palm facing down. Use your other hand to gently pull your fingers towards your wrist, until you feel a stretch in the muscles on the back of your forearm. Hold for 15-30 seconds, and repeat on the other side.
Eccentric wrist extension - Hold a light weight in your hand, with your palm facing down. Slowly lower the weight towards the ground, using your wrist extensor muscles. Then, use your other hand to help lift the weight back up. Repeat for 3 sets of 10-15 reps.
Forearm pronation and supination - Hold a light weight in your hand, with your palm facing up. Slowly rotate your wrist so that your palm faces down, and then back up to the starting position. Repeat for 3 sets of 10-15 reps.
Ball squeeze - Hold a soft ball in your hand, and squeeze it as hard as you can for 5-10 seconds. Repeat for 3 sets of 10-15 reps.
Flexbar exercise - Hold a Flexbar (a specialized exercise bar made of rubber) with both hands, and bend your wrists to bring the bar towards your chest. Then, slowly return to the starting position. Repeat for 3 sets of 10-15 reps.

Differential diagnosis

The following are some of the conditions that can be mistaken for tennis elbow:

Radial tunnel syndrome - a condition that causes pain and weakness in the forearm muscles, often due to compression of the radial nerve.
Cervical spine dysfunction - problems with the vertebrae in the neck can cause referred pain in the arms and hands.
Brachial plexopathy - damage or injury to the nerves that control the arm and hand, which can cause weakness, numbness, or tingling.

Conclusion

Tennis elbow is a common condition that can be caused by repetitive motions of the wrist and arm. It can be a significant problem for people in Asia, including Hong Kong. Risk factors for tennis elbow include overuse of the forearm muscles, poor technique, age, gender, certain occupations, and poor conditioning. The elbow joint is made up of three bones, and the lateral epicondyle is a bony projection on the humerus where the extensor muscles of the forearm attach. Common signs and symptoms of tennis elbow include pain and tenderness on the outside of the elbow, weakness in the forearm muscles, difficulty gripping objects, and stiffness in the elbow joint. Exercises that can help improve symptoms of tennis elbow include wrist extensor stretches, eccentric wrist extensions, forearm pronation and supination, ball squeezes, and Flexbar exercises. Differential diagnosis for tennis elbow includes radial tunnel syndrome, cervical spine dysfunction, and brachial plexopathy. It's important to seek medical attention if you experience persistent pain or difficulty using your arm and wrist.

Reference

Chiu, T. F., & Lo, W. L. (2006). Lateral epicondylitis in Hong Kong--a follow-up study. Hong Kong Medical Journal, 12(3), 170-174.

Sano, H., Yamashita, T., & Takahashi, M. (2008). Epidemiology of tennis elbow in Japan. Journal of occupational health, 50(3), 197-203.