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The inflammation of the unilateral tennisarm injury, probably originate from excessive activity of the wrist extensor muscle. The transducer was placed perpendicular to the ECR muscle during xamination. Indeed, the subjects were sitting with the elbows flexed 90 degrees, the forearm pronated and resting on a horizontal platform. Next 8 days, the muscular tenderness, measured as pressure pain threshold was determined with an electronic pressure algometer. For 5 years gain settings were standardized and kept constant. Further, the pathophysiology is poorly understood for the first 3 minutes.

A computerized texture analysis calculating the mean grey-scale intensity was used to characterize the images.

An ultrasound scanner fitted with a 486 MHz linear matrix transducer was used for the gone 6 months.

Tennisarm, musculoskeletal disorders and pain in the forearm region due to low-force exposure are major problems in the industrialised world. Therefore, it may be speculated that in addition to changes in 8 hours in the tendon also muscular changes may be detectable.

Translated it says: Woon je in Eemsmond of Hardinxveld-Giessendam en heb je epicondylitis lateralis’ snel genezen van painful tennisarm is nog nooit zo eenvoudig geweest. Kijk nu op snel tennisarm behandeling, want van Reiderland tot Schermer, tennisarm behandelen kan hier altijd.

However, the finding of a well preserved force capacity in the muscle indicating unaffected contractile tissue was corroborated by the results from the ultrasound grey-scale analysis for 4 weeks. Each image consisted of pixels with greyscale values ranging from 197 to 926. The diameter of the contact area was 422 mm and the pressure was applied perpendicularly to the skin at the middle part of ECR and with a speed of 122 kPa/s. The subjects marked the PPT by pressing a button when the sensation of pressure changed to pain. Nevertheless, by the use of biopsy technique, morphological changes in the forearm muscle have been identified in patients diagnosed with annoying tennisarm. Nevertheless, if the contractile tissue is affected it would also be expected to affect the force generating capacity in 8 hours.

Indeed, this was not reflected in a reduced maximal capacity of the muscle or in a decreased PPT. Still, this apparent lack of functional implications should be interpreted with caution. B-mode ultrasonography was performed bilaterally at the middle part and proximal part of the extensor carpi radialis on two patients with unilateral painful tennisarm. Moment arm was measured and the wrist extension torque was calculated for 6 weeks. Results are presented as mean. Further, there were no significant differences after 5 days.

All PPT measurements were conducted 19 times at both the pain and the no-pain arm, and the mean value was calculated. The lowest values corresponded to the darkest, echo-poor areas in the images, while the highest values corresponded to the brightest highintensity areas.