manuelletherapie 2011; 15(2): 80-92
DOI: 10.1055/s-0031-1273370

© Georg Thieme Verlag KG Stuttgart · New York

Entwicklung eines Algorhythmus zur Behandlung der Epicondylopathia lateralis (Tennisellenbogen) anhand evidenzbasierter physiotherapeutischer Studien[1]

Development of an Algorithm for Treatment of Lateral Epicondylopathia (Tennis Elbow) by Means of Evidence-Based Physiotherapeutic StudiesP. Glatthaar1, 2 , F. Morrison2, 3 , R. Wiesner4
  • 1Arzt- und Physiotherapiepraxis Peter Glatthaar, Hamburg
  • 2Deutscher Verband für Manuelle Therapie (DVMT) e. V., Fürstenfeldbruck
  • 3Physio- u. Sporttherapie Zentrum (PSZ), Großkrotzenburg
  • 4Praxis für Physio- und physikalische Therapie Balzer/Rahmann (FOBIZE Bremen)
Further Information

Publication History

Manuskript eingetroffen: 6.7.2010

Manuskript akzeptiert: 22.9.2010

Publication Date:
20 May 2011 (online)


Im Physiotherapiebereich könnten Algorhythmen zum Patientenmanagement dienen, wenn sie evidenzbasiert und mit klinischer Erfahrung und Wissen gepaart sind. Da sich in der Literatur kein physiotherapeutischer Algorhythmus der Epicondylopathia lateralis fand, bestand das Ziel dieser Literaturstudie darin, einen solchen zu entwickeln.


In physiotherapy algorithms could serve to help patient management when evidence-based and coupled with clinical experience and knowledge. As no physiotherapeutic algorithms for lateral epicondylopathia could be found in the current this literature study aimed at developing such an algorithm.

1 Die Arbeit wurde im Rahmen der DVMT-OMT-Ausbildung erstellt.


  • 1 Abbott J H. Mobilization with movement applied on the elbow effects shoulder range of movement in subject with lateral epicondylalgia.  Manual Therapy. 2001;  6 170-177
  • 2 Alizadehkhaiyat O, Fisher A C, Kemp G J et al. Pain, Functional Disability, and Psychologic Status in Tennis Elbow.  Clin J Pain. 2007;  23 482-489
  • 3 Assendelft W JJ, Rikken S AJJ, Mel M et al. NHG standard Epicondylitis.  Huisarts Wet. 1997;  40 21-26
  • 4 Berglund K M, Persson B H, Denison E. Prevalence of pain and dysfunction in the cervical and thoracic spine in persons with and without lateral elbow pain.  Manual Therapy. 2008;  13 295-299
  • 5 Bisset L, Paungmali A, Vincenzino B et al. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia.  Br J Sports Med. 2005;  39 411-422
  • 6 Bisset L, Beller E, Jull G et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial.  BMJ. 2006;  333 939-945
  • 7 Bisset L M, Russell T, Bradley S et al. Bilateral sensorimotor abnormalities in unilateral lateral epicondylalgia.  Arch Phys Med Rehabil. 2006;  87 490-495
  • 8 Bisset L, Smidt N, Van der Windt D A et al. Conservative treatment of tennis elbow - do subgroups of patients respond differently?.  Rheumatology. 2007;  46 1601-1605
  • 9 Bjordal J M, Lopes-Martins R A, Joensen J et al. A systematic review with procedural assessments and meta-analysis of Low Level Laser Therapy in lateral elbow tendinopathy (tennis elbow).  BMC Musculoskelet Disord. 2008;  9 1-15
  • 10 Buchbinder R, Green S, Struis P. Clinical Evidence Tennis Ellbow.  BMJ Clinical Evidence. 2008;  5 1-20
  • 11 Butler D S. Mobilisation des Nervensystems. Berlin: Springer; 1998
  • 12 Cleland J A, Flynn T W, Palmer J A. Incorporation of Manual Theapy Directed at the Cervicothoracic Spine in Patients with LE: A Pilot Clinical Trial.  JM & MT. 2005;  13 143-151
  • 13 Cook D, Guyatt G, Laupacis A et al. Rules of Evidence and Clinical Recommendations on the Use of Antithrombotic Agents.  Chest. 1992;  102 305-311
  • 14 Coombes K B, Bisset L, Vicenzino B. An integrative model of lateral epicondylalgia.  Br J Sports Med. 2008;  DOI: 10.1136 /bjsm.2008.052738
  • 15 Croisier J L, Foidart-Dessalle M, Tinant F et al. An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy.  Br J Sports Med. 2007;  41 269-275
  • 16 De Smedt T, Jong de A, Leemput van W et al. Lateral epicondylitis in tennis: update on aetiology, biomechanics and treatment.  BJSM. 2007;  41 816-819
  • 17 Delisle A, Larviere C, Plamondon A et al. Comparison of three computer office workstations offering forearm support: impact on upper limb posture and muscle activation.  Ergonomics. 2006;  49 139-160
  • 18 Dixon D, Johnston M, McQueen M et al. The Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) can measure the impairment, activity limitations and participation restriction constructs from the International Classification of Functioning, Disability and Health (ICF).  BMC Musculoskeletal Disorders. 2008;  9 114 DOI: 10.1186 / 1471-2474-9-114
  • 19 Ellis R F, Hing W A. Neural Mobilisation: A Systematic Review of Randomized Controlled Trials with an Analysis of Therapeutic Efficacy.  The Journal of Manual & Manipulative Therapy. 2008;  16 8-22
  • 20 Fink M, Wolkenstein E, Karst M et al. Acupuncture in chronic epicondylitis: a randomized controlled trial.  Rheumatology. 2002;  41 205-209
  • 21 Gifford L. Schmerzphysiologie. In: Berg van den F, (Hrsg). Angewandte Physiologie. 2: Organsysteme verstehen und beeinflussen.. Stuttgart: Thieme; 2005
  • 22 Gunn C C, Milbrandt W E. Tennis elbow and the cervical spine.  Can Med Assoc J. 1976;  114 803-809
  • 23 Johnson G W, Cadwallader K, Scheffel S B et al. Treatment of Lateral Epicondylitis.  American Family Physician. 2007;  76 843-853
  • 24 Jull G, Moore A. Evidence based practices: the need for new research directions.  Manual Therapy. 2000;  5 131
  • 25 Juul-Kristensen B, Lund H, Hansen K et al. Poorer elbow proprioception in patients with lateral epicondylitis than in healthy controls: a cross-sectional study.  J Shoulder Elbow Surg. 2008;  17 72-81
  • 26 Khan M K, Cook J L, Kannus P et al. Time to abandon the „tendinitis” myth.  BMJ. 2002;  324 626
  • 27 Kraushaar B S, Nirschl R. Current Concepts Review – Tendinosis of the Elbow.  Journal of Bone & Joint Surgery. 1999;  81A 259-278
  • 28 Magra M, Maffulli N. Nonsteroidal Antiinflammatory Drugs in Tendinopathy Friend or Foe.  Clin J Sport Med. 2006;  16 1-3
  • 29 Maher C G, Sherrington C, Herbert R D et al. Reliability of the PEDro Scale for Rating Quality of Randomized Controlled Trials.  Physical Therapy. 2003;  83 713-721
  • 30 Main C, Spanswick C. Pain management. An interdisciplinary approach. Edinburgh: Churchill Livingstone; 2000
  • 31 Maitland G D, Hengeveld E, Banks K. et al .Maitland’s vertebral manipulation. Oxford: Butterworth-Heinemann; 2001
  • 32 Manchanda G, Grover D. Effectiveness of movement with mobilization compared with manipulation of wrist in case of lateral epicondylitis.  Indian Journal of Physiotherapy and Occupational Therapy. 2008;  2 16-25
  • 33 Mellor S. Treatment of Tennis Elbow: The evidence.  BMJ. 2003;  327 330
  • 34 Müller W, Lorenz W, Kopp I et al. Leitlinie für Leitlinien. AWMF online; 2004
  • 35 Mulligan B R. Manual Therapy – NAGS, SNAGS, MWMS. Minneapolis: OPTP; 2004
  • 36 Ollivierre C O, Nirschl R P. Tennis elbow. Current concepts of treatment and rehabilitation.  Sports Med. 1996;  22 133-139
  • 37 Pascarelli E M, Hsu J P. Understanding Work-Related Upper Extremity Disorders: Clinical Findings in 485 Computer Users, Musicians and Others.  Journal of Occupational Rehabilitation. 2001;  11 1-21
  • 38 Paungmali A, O’Leary S, Souvlis T et al. Hypoalgesic and Sympathoexcitatory Effects of Mobilization with Movement for Lateral Epiconylalgia.  Physical Therapy. 2003;  83 374-383
  • 39 Placzek R, Lang M, Perka C et al. Insertionstendopathien des Ellenbogens.  Z Orthop. 2006;  144 1-18
  • 40 Rompe J, Overend T, MacDermid J. Validation of the Patient-rated Tennis Elbow Evaluation Questionnaire.  Journal of Hand Therapy. 2007;  20 3-11
  • 41 Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis: Mosby; 2002
  • 42 Shiri R. Prevalence and Determinants of Lateral and Medial Epicondylitis: A Population Study.  American Journal of Epidemiology. 2006;  164 1065-1074
  • 43 Smidt N, Van der Windt D A, Assendelft W JJ et al. Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis.  Arch Phys Med Rehabil. 2002;  83 1145-1150
  • 44 Smidt N, Van der Windt D A, Devillé W LJM et al. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial.  Lancet. 2002;  359 657-662
  • 45 Sorgatz H. „Repetitive Strain Injuries”.  Orthopädie. 2002;  31 1006-1014
  • 46 Struijs P AA, Damen P J, Bakker E WP et al. Manipulation of the Wrist for Management of Lateral Epicondylitis: A Randomized Pilot Study.  Physical Therapy. 2003;  83 608-616
  • 47 Struijs P AA, Kerkhoffs G MMJ, Assendelft W JJ et al. Conservative Treatment of Lateral Epicondylitis: Brace versus Physical Therapy or a Combination of Both – A Randomized Clinical Trial.  American Journal of Sports Medcine. 2004;  32 462-469
  • 48 Theis C, Herber S, Meurer A et al. Evidenz-basierte Überprüfung der Therapieempfehlungen bei Epicondylopathia humeri lateralis (Tennisellenbogen) – eine Übersicht.  Zentalbl Chir. 2004;  129 252-260
  • 49 Van Tulder M, Furlan A, Bombardier C et al. Updated method guidelines for systematic reviews in the cochrane collaboration back review group.  Spine. 2003;  28 1290-1299
  • 50 Van Tulder M, Malmivaara A, Koes B W. Repetitive Strain Injuries.  The Lancet. 2007;  369 1815-1822
  • 51 Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia.  Pain. 1996;  68 69-74
  • 52 Vicenzino B, Paungmali A, Buratowski S et al. Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia.  Man Ther. 2001;  6 205-212
  • 53 Vicenzino B. Lateral Epicondylalgia: A Musculoskeletal Physiotherapy Perspective.  Manual Therapy. 2003;  8 66-79
  • 54 Vicenzino B, Bisset L. Joint Manipulation in the Management of Lateral Epicondylalgia: A Clinical Commentary.  The Journal of Manual & Manipulative Therapy. 2007;  15 50-56
  • 55 Walker-Bone K, Palmer K T, Reading I et al. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.  Arthritis Rheum. 2004;  51 642-651
  • 56 Waugh E J, Jaglal S B, Davis A M. Computer use associated with poor long-term prognosis of conservatively managed lateral epicondylalgia.  J Orthop Sports Phys Ther. 2004;  34 770-780
  • 57 Wiesner R. Übungen in der Physiotherapie. Stuttgart: Thieme; 2009
  • 58 Yaxley G, Jull G. Adverse neural tension.  Australian Physiotherapy. 1993;  39 15-22

1 Die Arbeit wurde im Rahmen der DVMT-OMT-Ausbildung erstellt.

Peter Glatthaar

PT Arzt, OMT-DVMT, Arzt- und PT-Praxis

Borsteler Bogen 27

22453 Hamburg