Tendon neuroplastic training for lateral elbow tendinopathy: 2 case reports.

OBJECTIVE: To report 2 cases of lateral elbow tendinopathy treated with a novel adaptation of tendon neuroplastic training (TNT).

CLINICAL FEATURES: Patient 1: A 61-year-old male machine operator presented with one year of bilateral lateral elbow pain related to his occupation of using torque wrenches. Patient 2: A 37-year-old male electrician presented with two months of recurrent left lateral elbow pain related to repetitive motions of gripping and pulling at work.

INTERVENTION AND OUTCOME: Both patients underwent 8 weeks of a novel rehabilitation program, including TNT, which involved pacing their resistance exercises to a metronome. Both patients experienced clinically meaningful improvements in pain and functional outcome scores that were sustained at the 3-month follow-up.

SUMMARY: Recent evidence suggests that the central nervous system may play a role in chronic tendinopathies. It is possible that TNT may address the central nervous system component of chronic/recurrent tendinopathy that is not addressed by traditional passive therapies. However, further research is needed.