Tratamiento de codo de tenista en deportes de raqueta – revisión de la literatura

Autores/as

Palabras clave:

tendinopatía, deporte de raqueta, lesión por sobreuso, epicondilitis lateral

Resumen

Antecedentes: El dolor en la parte lateral del codo es un síntoma común en los deportes de raqueta, tanto en jugadores recreacionales como de competición. En el codo de tenista (CT), el dolor se produce en el epicóndilo lateral y en el origen del extensor común justo distal al epicóndilo. Los síntomas se agravan con actividades de agarre y pueden estar relacionados con el nivel de actividad, ya sea en el trabajo o en los deportes de raqueta recreacionales o de élite. Se considera que el CT es una lesión por sobreuso de naturaleza degenerativa y el diagnóstico se realiza fácilmente basado en la historia y los hallazgos clínicos. Objetivo: Presentar el conocimiento actual sobre el tratamiento del CT en los deportes de raqueta a través de una revisión de la literatura. Métodos: Revisión de la literatura narrativa. Resultados: Un resumen del CT en los deportes de raqueta con énfasis en las características clínicas, los diagnósticos alternativos y los tratamientos sugeridos en la literatura. Dado que el CT se considera una lesión por sobreuso, el artículo también hace sugerencias para un plan de entrenamiento adicional al tratamiento hasta que se resuelvan los síntomas. Conclusiones: Esta condición dolorosa es autolimitada y tiene un buen pronóstico. No hay tratamiento con evidencia determinante, además de los métodos para reducir los síntomas de dolor. Cuando los síntomas de dolor están bajo control, es importante que el regreso a los deportes de raqueta sea gradual.

Descargas

Biografía del autor/a

Martin Fahlström, Umeå University

Department of Clinical Sciences, Professional Development, Umeå University.

Eva Zeisig, Umeå University

Department of Surgical and Perioperative Sciences, Orthopaedics, Umeå University.

Citas

Abrams, G. D., Renstrom, P. A., & Safran, M. R. (2012). Epidemiology of musculoskeletal injury in the tennis player. British journal of sports medicine, 46(7), 492-498. https://doi.org/10.1136/bjsports-2012-091164

Bahr, R., Clarsen, B., Derman, W., Dvorak, J., Emery, C. A., Finch, C. F., Hagglund, M., Junge, A., Kemp, S., Khan, K. M., Marshall, S. W., Meeuwisse, W., Mountjoy, M., Orchard, J. W., Pluim, B., Quarrie, K. L., Reider, B., Schwellnus, M., Soligard, T., Stokes, K. A., Timpka, T., Verhagen, E. Bindra, A., Budgett, R., Engebretsen, L., Erdener, U., & Chamari, K. (2020). International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sports 2020 (including the STROBE extension for sports injury and illness surveillance (STROBE-SIIS)). British Journal of Sports Medicine, 54(7), https://doi.org/10.1136/bjsports-2019-101969

Bateman, M., Evans, J. P., Vuvan, V., Jones, V., Watts, A. C., Phadnis, J., Bisset, L., & Vicenzino, B. (2021a). Protocol for the development of a core outcome set for lateral elbow tendinopathy (COS-LET). Trials, 22(1), 1-8. https://doi.org/10.1186/s13063-021-05291-9

Bateman, M., Saunders, B., Littlewood, C., & Hill, J. C. (2021b). Development of an optimised physiotherapist-led treatment protocol for lateral elbow tendinopathy: a consensus study using an online nominal group technique. BMJ open, 11(12), e053841. https://doi.org/10.1136/bmjopen-2021-053841

Berglund, K. M., Persson, B. H., & Denison, E. (2008). Prevalence of pain and dysfunction in the cervical and thoracic spine in persons with and without lateral elbow pain. Manual therapy, 13(4), 295-299. https://doi.org/10.1016/j.math.2007.01.015

Bisset, L., Beller, E., Jull, G., Brooks, P., Darnell, R., & Vicenzino, B. (2006). Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ, 333(7575), 939. https://doi.org/10.1136/bmj.38961.584653.AE

Bisset, L., Coombes, B., & Vicenzino, B. (2011). Tennis elbow. BMJ clinical evidence, 2011, 1117. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217754/

Brosseau, L., Casimiro, L., Milne, S., Welch, V., Shea, B., Tugwell, P., & Wells, G. A. (2002). Deep transverse friction massage for treating tendinitis. Cochrane Database of Systematic Reviews, (4). https://doi.org/10.1002/14651858.CD003528

Buchbinder, R., Green, S., Youd, J. M., Assendelft, W. J., Barnsley, L., & Smidt, N. (2005). Shock wave therapy for lateral elbow pain. Cochrane Database of Systematic Reviews, (4). https://doi.org/10.1002/14651858.CD003524.pub2

Buchbinder, R., Johnston, R. V., Barnsley, L., Assendelft, W. J., Bell, S. N., & Smidt, N. (2011). Surgery for lateral elbow pain. Cochrane Database of Systematic Reviews, (3). https://doi.org/10.1002/14651858.CD003525.pub2

Caine, D., Harmer, P., & Schiff, M. (2010). Epidemiology of injury in Olympic sports. The encyclopaedia of sports medicine. An IOC Medical Commission publication. Oxford, England: Blackwell Publishing, Ltd. https://stillmed.olympic.org/media/Document%20Library/OlympicOrg/IOC/Who-We-Are/Commissions/Medical-and-Scientific-Commission/Encyclopaedia/2010_Caine.pdf

Castillo-Lozano, R., & Casuso-Holgado, M. J. (2016). Incidence of musculoskeletal sport injuries in a sample of male and female recreational paddle-tennis players. The Journal of sports medicine and physical fitness, 57(6), 816-821. https://doi.org/10.23736/s0022-4707.16.06240-x

Chourasia, A. O., Buhr, K. A., Rabago, D. P., Kijowski, R., Lee, K. S., Ryan, M. P., Grettie-Belling, J. & Sesto, M. E. (2013). Relationships between biomechanics, tendon pathology, and function in individuals with lateral epicondylosis. Journal of orthopaedic & sports physical therapy, 43(6), 368-378. https://doi.org/10.2519/jospt.2013.4411

Claessen, F. M., Heesters, B. A., Chan, J. J., Kachooei, A. R., & Ring, D. (2016). A meta-analysis of the effect of corticosteroid injection for enthesopathy of the extensor carpi radialis brevis origin. The Journal of hand surgery, 41(10), 988-998. https://doi.org/10.1016/j.jhsa.2016.07.097

Clarke, A. W., Ahmad, M., Curtis, M., & Connell, D. A. (2010). Lateral elbow tendinopathy: correlation of ultrasound findings with pain and functional disability. The American journal of sports medicine, 38(6), 1209-1214. https://doi.org/10.1177/0363546509359066

Coombes, B. K., Bisset, L., & Vicenzino, B. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. The Lancet, 376(9754), 1751-1767. https://doi.org/10.1016/S0140-6736(10)61160-9

Coombes, B. K., Bisset, L., Brooks, P., Khan, A., & Vicenzino, B. (2013). Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA, 309(5), 461-469. https://doi.org/10.1001/jama.2013.129

De Smedt, T., de Jong, A., Van Leemput, W., Lieven, D., & Van Glabbeek, F. (2007). Lateral epicondylitis in tennis: update on aetiology, biomechanics and treatment. British journal of sports medicine, 41(11), 816-819. https://doi.org/10.1136/bjsm.2007.036723

Dines, J. S., Bedi, A., Williams, P. N., Dodson, C. C., Ellenbecker, T. S., Altchek, D. W., Windler, G., & Dines, D. M. (2015). Tennis injuries: epidemiology, pathophysiology, and treatment. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 23(3), 181-189. https://doi.org/10.5435/JAAOS-D-13-00148

Franchini, M., Cruciani, M., Mengoli, C., Marano, G., Pupella, S., Veropalumbo, E., Masiello, F., Pati, I., Vaglio, S. & Liumbruno, G. M. (2018). Efficacy of platelet-rich plasma as conservative treatment in orthopaedics: a systematic review and meta-analysis. Blood Transfusion, 16(6), 502. https://doi.org/10.2450/2018.0111-18

Gijon-Nogueron, G., Ortega-Avila, A. B., Kaldau, N. K., Fahlstrom, M., Felder, H., Kerr, S., King, M., McCaig, S., Marchena-Rodriquez, A., & Cabello-Manrique, D. (2022). Data collection procedures and injury definitions in badminton: A consensus statement according to the Delphi approach. Clinical Journal of Sport Medicine. https://doi.org/10.1097/JSM.0000000000001048

Hoogvliet, P., Randsdorp, M. S., Dingemanse, R., Koes, B. W., & Huisstede, B. M. (2013). Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review. British journal of sports medicine, 47(17), 1112-1119. https://bjsm.bmj.com/content/47/17/1112.citation-tools

Horsley, I., O’Donnell, V., & Leeder, J. (2020). The epidemiology of injuries in English professional squash; A retrospective analysis between 2004 and 2015. Physical therapy in sport, 46, 1-6. https://doi.org/10.1016/j.ptsp.2020.07.009

Hume, P. A., Reid, D., & Edwards, T. (2006). Epicondylar injury in sport: Epidemiology, Type, Mechanisms, Assessment, Management and Prevention. Sports medicine, 36(2), 151-170. https://doi.org/10.2165/00007256-200636020-00005

Kim, Y. J., Wood, S. M., Yoon, A. P., Howard, J. C., Yang, L. Y., & Chung, K. C. (2021). Efficacy of nonoperative treatments for lateral epicondylitis: a systematic review and meta-analysis. Plastic and Reconstructive Surgery, 147(1), 112-125. https://doi.org/10.1097/PRS.0000000000007440

King, M. A., Kentel, B. B., & Mitchell, S. R. (2012). The effects of ball impact location and grip tightness on the arm, racquet and ball for one-handed tennis backhand groundstrokes. Journal of Biomechanics, 45(6), 1048-1052. https://doi.org/10.1016/j.jbiomech.2011.12.028

Kotnis, N. A., Chiavaras, M. M., & Harish, S. (2012). Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation. Skeletal radiology, 41(4), 369-386. https://doi.org/10.1007/s00256-011-1343-8

Kraushaar, B. S., & Nirschl, R. P. (1999). Tendinosis of the elbow (tennis elbow): clinical features and findings of histological, immunohistochemical, and electron microscopy studies. Journal of Bone and Joint Surgery, 81(2), 259-278. https://www.proquest.com/openview/8ae7310b439893743b447bbd3b9d909d/1?pq-origsite=gscholar&cbl=289

Kroslak, M., Pirapakaran, K., & Murrell, G. A. (2019). Counterforce bracing of lateral epicondylitis: a prospective, randomized, double-blinded, placebo-controlled clinical trial. Journal of shoulder and elbow surgery, 28(2), 288-295. https://doi.org/10.1016/j.jse.2018.10.002

Lattermann, C., Romeo, A. A., Anbari, A., Meininger, A. K., McCarty, L. P., Cole, B. J., & Cohen, M. S. (2010). Arthroscopic debridement of the extensor carpi radialis brevis for recalcitrant lateral epicondylitis. Journal of shoulder and elbow surgery, 19(5), 651-656. https://doi.org/10.1016/j.jse.2010.02.008

Lawrence, T., Mobbs, P., Fortems, Y., & Stanley, J. K. (1995). Radial tunnel syndrome: A retrospective review of 30 decompressions of the radial nerve. Journal of Hand Surgery, 20(4), 454-459. https://doi.org/10.1016/S0266-7681(05)80152-4

Lenoir, H., Mares, O., & Carlier, Y. (2019). Management of lateral epicondylitis. Orthopaedics & Traumatology: Surgery & Research, 105(8), S241-S246. https://doi.org/10.1016/j.otsr.2019.09.004

Maffulli, N., Regine, R., Carrillo, F., Capasso, G., & Minelli, S. (1990). Tennis elbow: an ultrasonographic study in tennis players. British Journal of Sports Medicine, 24(3), 151-155. https://doi.org/10.1136/bjsm.24.3.151

Naam, N. H., & Nemani, S. (2012). Radial tunnel syndrome. Orthopedic Clinics, 43(4), 529-536. https://doi.org/10.1016/j.ocl.2012.07.022

Nirschl, R. P. (1992). Elbow tendinosis/tennis elbow. Clinics in sports medicine, 11(4), 851-870. https://europepmc.org/article/med/1423702

Obradov, M., & Anderson, P. G. (2012). Ultrasonographic findings for chronic lateral epicondylitis. Jbr-btr, 95(2), 66-70. https://www.jbsr.be/articles/88/galley/85/download/

Placzek, R., Drescher, W., Deuretzbacher, G., Hempfing, A., & Meiss, A. L. (2007). Treatment of chronic radial epicondylitis with botulinum toxin A: a double-blind, placebo-controlled, randomized multicenter study. JBJS, 89(2), 255-260. https://doi.org/10.2106/JBJS.F.00401

Ravalli, S., Pulici, C., Binetti, S., Aglieco, A., Vecchio, M., & Musumeci, G. (2019). An overview of the pathogenesis and treatment of elbow osteoarthritis. Journal of Functional Morphology and Kinesiology, 4(2), 30. https://doi.org/10.3390/jfmk4020030

Sanders, T. L., Maradit Kremers, H., Bryan, A. J., Ransom, J. E., Smith, J., & Morrey, B. F. (2015). The epidemiology and health care burden of tennis elbow: a population-based study. The American journal of sports medicine, 43(5), 1066-1071. https://doi.org/10.1177/0363546514568087

Savnik, A., Jensen, B., Nørregaard, J., Egund, N., Danneskiold-Samsøe, B., & Bliddal, H. (2004). Magnetic resonance imaging in the evaluation of treatment response of lateral epicondylitis of the elbow. European radiology, 14(6), 964-969. https://doi.org/10.1007/s00330-003-2165-4

Shiri, R., & Viikari-Juntura, E. (2011). Lateral and medial epicondylitis: role of occupational factors. Best practice & research Clinical rheumatology, 25(1), 43-57. https://doi.org/10.1016/j.berh.2011.01.013

Smidt, N., & van der Windt, D. A. (2006). Tennis elbow in primary care. BMJ, 333(7575), 927-928. https://doi.org/10.1136/bmj.39017.396389.BE

Solheim, E., Hegna, J., & Øyen, J. (2013). Arthroscopic versus open tennis elbow release: 3-to 6-year results of a case-control series of 305 elbows. Arthroscopy: The journal of Arthroscopic & Related Surgery, 29(5), 854-859. https://doi.org/10.1016/j.arthro.2012.12.012

Struijs, P. A., Smidt, N., Arola, H., Van Dijk, C. N., Buchbinder, R., & Assendelft, W. J. (2001). Orthotic devices for tennis elbow: a systematic review. British Journal of General Practice, 51(472), 924-929. https://bjgp.org/content/bjgp/51/472/924.full.pdf

Taylor, S. A., & Hannafin, J. A. (2012). Evaluation and management of elbow tendinopathy. Sports Health, 4(5), 384-393. https://doi.org/10.1177/1941738112454651

Villaseñor-Ovies, P., Vargas, A., Chiapas-Gasca, K., Canoso, J. J., Hernández-Díaz, C., Saavedra, M. Á., Navarro, J., & Kalish, R. A. (2012). Clinical anatomy of the elbow and shoulder. Reumatologia clinica, 8, 13-24. https://doi.org/10.1016/j.reuma.2012.10.009

Walker-Bone, K., Palmer, K. T., Reading, I., Coggon, D., & Cooper, C. (2012). Occupation and epicondylitis: a population-based study. Rheumatology, 51(2), 305-310. https://doi.org/10.1093/rheumatology/ker228

Zeisig, E. (2012). Natural course in tennis elbow—lateral epicondylitis after all?. Knee Surgery, Sports Traumatology, Arthroscopy, 20(12), 2549-2552. https://doi.org/10.1007/s00167-012-1939-0

Zeisig, E., Ljung, B. O., Alfredson, H., & Danielson, P. (2009). Immunohistochemical evidence of local production of catecholamines in cells of the muscle origins at the lateral and medial humeral epicondyles: of importance for the development of tennis and golfer’s elbow?. British Journal of Sports Medicine, 43(4), 269-275. https://bjsm.bmj.com/content/43/4/269

Zeisig, E., Öhberg, L., & Alfredson, H. (2006). Extensor origin vascularity related to pain in patients with tennis elbow. Knee Surgery, Sports Traumatology, Arthroscopy, 14(7), 659-663. https://doi.org/10.1007/s00167-006-0060-7

Publicado

2025-03-27

Cómo citar

Fahlström, M., & Zeisig, E. (2025). Tratamiento de codo de tenista en deportes de raqueta – revisión de la literatura. International Journal of Racket Sports Science, 4(1), 25–31. Recuperado a partir de https://revistaseug.ugr.es/index.php/IJRSS/article/view/33360