Investigating the relationship between pain level and grip and wrist muscles strength in individuals with lateral epicondylitis: is pain a barrier to strength assessment?

PURPOSE: This study was carried out to examine the relationship between rest, activity, and nighttime pain and grip and isokinetic muscle strength of the wrist muscles in individuals with lateral epicondylitis. METHODS: Fifty-six sedentary individuals aged between 18 and 65 years diagnosed with unilateral lateral epicondylitis volunteered to participate in the study. The level of rest, activity, and nighttime pain was evaluated with visual analog scale (VAS). The grip strengths of both arms were evaluated by averaging a maximum of three grip strength measurements using a hand dynamometer. The strength of both wrist flexor and extensor muscles were evaluated with isokinetic dynamometer at angular velocities of 60 and 180°/s with five and 15 concentric repetitions respectively. RESULTS: There was no significant relationship found between the affected side's grip strength and isokinetic muscle strength with rest, activity and nighttime pain (all P > 0.05). However, there was a difference observed between the affected and unaffected side in grip strength and isokinetic strength measurements of all wrist muscles (all P < 0.05); the unaffected side values were found to be higher. CONCLUSION: The result of this study found no correlation between the stated level of pain and the true muscle strength in the affected hand. In line with these findings, we think that assessments involving strength can be made in other musculoskeletal problems where pain is present. However, the findings may not reflect the true muscle strength which will tend to be underrated.

Effect of contraction type at varying angular velocities on isokinetic muscle strength training.

The aim of this study is to determine whether concentric and eccentric isokinetic training performed at certain angular velocities in sedentary individuals is effective only in the angular velocities and contraction type where the training is performed, or at other angular velocities and contraction types that are not being trained. Twenty-eight sedentary individuals (matched according to weight, age and gender) volunteered to participate in this case study. The study was conducted on a total of 56 extremities belonging to 28 individuals (14 women, 14 men) aged between 24 and 60 years. Concentric and eccentric strength tests were performed at 30-60-90-120-150-180°/sec. The participants were randomly divided into two groups as concentric training group and eccentric training group, through stratified randomization matching. The training was done 3 days a week for a total of 6 weeks. At the end of the study, no difference was found between the pre- and posttraining measurements in the concentric training group (P>0.05). In the eccentric training group, the eccentric muscle strength of the knee flexors and extensors at angular velocity of 90°/sec, the eccentric strength of the knee extensors at angular velocity of 120°/sec, and the eccentric muscle strength of the knee flexors at angular velocity of 180°/sec were found to be different and an increase was seen after the training (P=0.032, P=0.049, P=0.041, P=0.032). These results demonstrate that eccentric training may be preferred in cases where muscle strength increase is needed in short time.