Tennis Elbow or lateral epicondylitis is a condition in which the outer part of the elbow becomes extremely painful and tender to touch. People often complain of pain gripping an object, di!cul-ty shaking hands, turning a door knob or using a screw driver.

Extensor Muscles

Overuse of the Extensor Musclesleads to pain here

Lateral Epicondyle Tendon

WHO Contrary to popular belief, Tennis Elbow does not always or only occur as a result of playing tennis! It has been shown to equally a!ect both males and females and tends to be more common over the age of about 40, although it can occur at any age.

HOW Trauma such as a direct blow to the lateral elbow or epicondyle or a drag type force to the elbow (i.e. heavy load or over forceful extension or bending of the wrist) can cause Tennis Elbow. Incorrect tennis technique, such as miss hitting a ball, changing grip or altering string tension may all also lead to a strain on the wrist extension muscles and eventually to a Tennis Elbow.

WHYMedical explanations of why Tennis Elbow may occur includes evidence that there are microscopic and small tears between the common extensor tendons (muscles that bend the wrist backwards) and the periosteum (lining of the bone) of the lateral epicondyle. It involves speci"cally the Extensor Carpi Radialis Longus and Extensor Carpi Radialis Brevis muscles which attach to the outside part of the arm, just above the elbow. Sometimes there can be some involvement of one of the nerves on the outside of the elbow, the radial nerve. It is not uncom-mon for su!erers of Tennis Elbow to also develop of other conditions such as shoulder rotator cu! problems, or even wrist tendonitis.

DIAGNOSIS The diagnosis of Tennis Elbow can involve a number of tests where a physician will press the a!ected area while requesting the patient to move the elbow, wrist, and "ngers. Tennis elbow su!erers will also complain of pain with stretching and resisted wrist extension. X-rays can be used to exclude fractures or arthritis as a cause of the pain. Ultrasound and magnetic resonance imaging (MRI) can identify #uid and swelling where the Extensor Carpi Radialis Brevis muscle attaches to the bone.

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Tennis Elbow Twister™- the answer to Tennis Elbow -

HOW DOES IT WORKMuscles acting around a joint will generally work in a balanced way, such that when the

muscles on one side of a joint are active (the agonist muscles), the muscles on the opposite side of the joint (the antagonist muscles) will relax.

The TETwister™ exercises the muscles of both forearms in an alternating way to simulate normal muscle

activity. Agonist muscles contraction, and hence antagonist muscle relaxation, happens when twisted in one direction, and this is followed by the reverse muscle loading in a controlled fashion when twisted in the other

direction.

The unique feature of the TETwister™ is the elastic recoil element that engages the agonist/antagonist muscle interaction, and thereby allows better contraction performance in the agonist muscles, and encourages relaxation of the antagonist muscles.

The TETwister™ relies on repetitive low loads in an alternating fashion, reproducing controlled normal muscle contraction (both concentric and eccentric) and relaxation, to encourage healing and rehabilitation of the damaged muscle attachments.

TREATMENT Almost all Tennis Elbow su!erers complain that it can be a frustrating and painful condition that negatively a!ects their ability to participate in sport, work and recreational activities.

Physicians may choose to trial a variety of injections to treat symptoms and underlying cause, all with varying aims including Cortisone (CSI), Platelet Rich Plasma (PRP) and prolotherapy, often with a mixed response.

On many occasions the severity of Tennis Elbow symptoms settle without any treatment, although it may take between six months and two years. Such as prolonged period of activity modi"cation is unacceptable to most su!erers of Tennis Elbow and they will seek a more timely return to normal activity.

While many treatments have been proposed, exercises to stretch and strengthen the damaged muscles are a frequent management strategy. This is most e!ectively done when it simulates the normal loading pattern of muscles, using an alternating contraction and relaxation exercise technique. These loading and #exibility routines need to be undertaken within a carefully monitored progression plan, and most successfully involve use of eccentric exercises. Eccentric exercises are those where a muscle is gently lengthening under some load, as (for example) happens to the quadriceps muscles (muscles on the front of the thigh) when slowly squatting. This is as distinct from concentric contraction as happens to the quadriceps muscles as you stand up from a squat.

Recently published scienti"c studies have con"rmed and highlighted the bene"t of eccentric exercises in the treatment regimen for Tennis Elbow. Details of references are listed on the web site.

The TETwister™ (Tennis Elbow Twister) has been developed by medical professionals for exactly this purpose.

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WHERE GRIPPING IS VERY PAINFUL AND THE LATERAL ELBOW IS STILL EXTREMELY PAINFUL IN THE MORNING.

This level is extremely important as it is where you lay the groundwork for future progress. Do too much and your pain will worsen. TIP : Monitoring how painful your elbow is in the morning gives a great idea of progress. Do too much the prior day and it is most likely you will pay theprice with increased elbow pain the next morning. An ideal circumstance would be that you perform your TETwister program as directed one day andyou wake with elbow pain no worse than the prior day. As your elbow pain settles your capacity to exercise will increase, allowing more reps with the TETwister. No further increase in morning pain allows for more progression…but slowly!

Start by gripping the TETwister™ with both hands. One hand twists the device in the forward direction while the other hand twists it in the opposing direction. The aim is to perform the exercises with the elbows straight, however, in the initial stages, bending the elbows will reduce the stain on the painful muscle insertion. Adjustment of the angle between the wrists facilitates a comfortable exercise position, and avoids strain to uninvolved structures. Moving your hands further apart on the TETwister™ can reduce the twisting tension and may be a good idea initially. While the twisting tension may not feel very strong, overloading the damaged muscle can be counterproductive. Start gently!

PROGRESSION PROGRAMSLEVEL 1

REPETITIONS : START WITH 5$10 REPETITIONS, AND JUST AT THE PAINFUL LIMIT OF EACH TWIST, HOLD THE %ISOMETRIC& POSITION FOR FIVE SECONDS.

SETS : DO THIS 4 TIMES A DAY AND INCREASE THE NUMBERS OF TWISTS AND THE LENGTH OF TIME YOU HOLD THE POSITION AS YOUR ENDURANCE INCREASES.

BEWARE : IF YOU GET PAIN, REDUCE THE REPETITIONS OR THE LOAD TENSION AT THE START OF EACH EXERCISE.

WARNING :If your elbow pain worsens in the mornings after a day of exercise, you may need to slow down even further and perform a few gentle twists, but do this every hour until your pain starts to settle. Vary the speed, hold times and repetitions to see what works the muscles most e!ectively.

The device is held with both hands, and twisted in an alternating fashion to cause a contraction / relaxation cycle of the forearm muscles.

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LEVEL 2

WHERE MORNING PAIN IS CONSIDERABLY IMPROVED AND GRIP STRENGTH IS IMPROVING

Start by gripping the TETwister™ with both hands. This time the opposite hand to the painful elbow twists the device in the forward direction or away while the other hand with the sore elbow holds a neutral position ie does not move. Slowly the stationary hand allows the devices tension to bend the wrist forward. This creates an Isometric (stationary) then eccentric contraction on the wrist extensors. Again this twisting tension may not feel very strong, however considerable tension is being developed in the muscles and again overloading the damaged muscle can be counterproductive.

REPETITIONS : START WITH 10 REPETITIONS SETS : BUILD TO DOING THIS 3 THREE TIMES IN A SESSION

SESSIONS : BUILD TO 3 TIMES PER DAY I.E. 3 X 10 SETS / 3 TIMES PER DAY

BEWARE : IF YOU GET PAIN, REDUCE THE REPETITIONS OR THE LOAD TENSION AT THE START OF EACH EXERCISE.

LEVEL 3

VERY LITTLE MORNING SORENESS … PREFERABLY NONE. GRIP STRENGTH APPROACHING NORMAL.

It’s time to add a little strength and endurance to your forearm muscles.

Start by gripping the TETwister™ with both hands. One hand twists the device in the forward direction while the other hand twists it in the opposing direction. This time we are looking to create some fatigue…maybe even a little muscle burn!

TETwister™ really works. Although it will not "x ALL Tennis Elbows (or golfers elbows), TETwister™ allows you to easily and conveniently carry out a targeted and e!ective exercise program without the need for expensive equipment, and hopefully avoid

more invasive treatments such as injections and surgery. TETwister™ is an ideal way to keep the forearm muscles tuned up to avoid injury recurrence, once your symptoms have settled.

IMPORTANT – TETwister™ is not a substitute for advice and treatment by a doctor or other health professional, who you should consult if symptoms persist.

REPETITIONS : START WITH 20$30 REPETITIONS, NO HOLD JUST ALTERNATING MOVEMENT TO THE EXTREME OF YOUR RANGE.

SETS : PERFORM 3$5 SETS.

SESSIONS : PERFORM THIS PROGRAM 2$3 TIMES PER WEEK

BEWARE : IF YOU GET PAIN, REDUCE THE REPETITIONS OR THE LOAD TENSION AT THE START OF EACH

DISCLAIMER :This product should be used only as described in the product brochure information. We always recommend you should seek professional medical advicein conjunction with the use of this product and the information contained with it. Lockeroom sports will not accept responsibility for injuries while using the product. COPYRIGHT RESERVED 2014 LOCKEROOM SPORTS