Patient case (clinical description): A 17-year-old male comes to the office due to several months of right elbow pain.  The pain is worse with activity and limits his workouts and activities.  He has tried over-the-counter medications with limited relief.  Medical history is notable for eczema, and current medications include a topical hydrocortisone ointment.  He is sexually active with his girlfriend and uses condoms. He does not smoke or drink alcohol. He plays tennis most of the days of the week. The comprehensive evaluation shows pain on the lateral side of the elbow, made worse by pressure applied on the lateral epicondyle of the humerus and when making a fist with the elbow joint straightened. The patient has this pain since last year and had several courses of physical therapy.

Patient's own account: I'm 17, and I had to go to the doctor because I've been suffering from my right elbow for several months. The pain is even worse when I do sports and it kind of limits me for my workouts and activities. I tried over-the-counter medications but it didn't work much. I had eczema before and my medication is ointments that contain cortisone. I am sexually active as a 17-year-old guy, and I have a girlfriend, and we use condoms. I don't smoke or drink. I play tennis most days of the week. I did an exam that showed pain on the side of my elbow and it was worse when they applied some pressure on it and when I was putting my hand as a fist. I have had this pain since last year, and I had several sessions of physical therapy already.

Clinical trial: Trial of Blood Flow Restriction Plus Physical Therapy vs. Physical Therapy Alone for Lateral Epicondylitis

Eligibility criteria:
Inclusion Criteria:

          -  The diagnoses included are lateral elbow pain, lateral epicondylitis, or lateral
             epicondylalgia, more general diagnoses elbow tendinitis or elbow pain will be included
             if their clinical picture at physical therapy meets criteria for lateral
             epicondylitis.

          -  If the inclusion diagnosis is other than lateral epicondylitis or tennis elbow (such
             as elbow pain), we will confirm the diagnosis at the first therapy visit with
             tenderness at the lateral epicondyle and/or pain with resisted wrist/long finger
             extension at the lateral epicondyle.

          -  Pain for 4 weeks or more.

          -  All participants must be between the age of 18 and 70 years old and have had pain for
             4 weeks or more.

        Exclusion Criteria:

          -  Ligamentous elbow sprain, osteoarthritis of elbow and cervical radiculopathy in the
             affected limb will be excluded from the study.

          -  Any history of ligamentous, bony or other soft tissue reconstruction surgery at the
             affected elbow,

          -  Vascular disorders to include: history of DVT, history of endothelial dysfunction,
             peripheral vascular disease

          -  Injection therapy (corticosteroid, platelet rich plasma, or other injection therapy)
             in the prior 3 months to the affected site

          -  Current fracture in affected arm

          -  History of crush injury to affected arm

          -  Any surgery on affected arm in last 1 year

          -  Surgical procedure on their contralateral extremity (Changed 9/2019 to surgery within
             last year on contralateral upper extremity).

          -  History of lymphectomy (such as axillary exploration with breast surgery, lymph node
             biopsy in the affected axilla/arm)

          -  Pregnancy

          -  Active infection

          -  Current cancer diagnosis/treatment

          -  Sickle cell anemia or trait

          -  Kidney dialysis

          -  History of syncope/passing out with pressure to body (such as massage, or blood
             pressure cuff).

          -  inability to consent
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 18 Years old.
Subject must be at most 70 Years

Eligibility (NLI label): Contradiction