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Getting a Firmer Grip on Tennis Elbow

Tennis elbow is often treated by physical therapists. Therapists are always looking for ways to measure their results with these patients. Was the treatment successful? How can they tell? Measuring grip strength is one way to look for changes.

Grip strength can be measured in two different ways. The therapist can measure either maximum or pain-free grip strength. Maximum grip measures the strongest grip a patient has, even if it hurts. The pain-free grip measures strength up to the point of pain or discomfort. Which one is a better measure? This is the question answered by a group of researchers in the Netherlands.

A reliable test is one that can be done by two different therapists on the same patient and get the same results. This is called interobserver reliability. Both maximum and pain-free grip strength can be measured with equal reliability. However, the pain-free grip strength is a better way to measure the patient's pain and function.

The researchers also looked at another test called pressure pain threshold. Therapists use a special tool called an algometer. This measures how much pressure can be placed on the skin without pain. In the case of tennis elbow, the algometer is pressed against the tendon until pressure changes to pain. This is the measure of pressure pain threshold.

The authors suggest that pressure pain threshold is not currently a reliable test to use with patients who have tennis elbow. Pain-free grip strength is the best measure of results. It is easy to use for research and in clinical practice.

References: Nynke Smidt, PhD, et al. Interobserver Reproducibility of the Assessment of Severity of Complaints, Grip Strength, and Pressure Pain Threshold in Patients With Lateral Epicondylitis. In Archives of Physical Medicine and Rehabilitation. August 2002. Vol. 83. No. 8. Pp. 1145-1150.

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