כאבים במרפק — מדריך אבחון 4 מיקומים ובחירת הטיפול

WHAT IS IT — Elbow pain (כאבים במרפק) encompasses four anatomical locations: (1) Lateral epicondylalgia (Tennis Elbow, ECRB tendon overload, affecting 1–3% of population); (2) Medial epicondylalgia (Golfer's Elbow, FCR tendon overload); (3) Posterior pain (Olecranon Bursitis, triceps inflammation); (4) Anterior pain (Biceps tendinopathy, distal biceps irritation). All involve repetitive stress, poor biomechanics, or single-event trauma. ICD-10: M77.1 (Lateral epicondylitis), M77.0 (Medial epicondylitis).

WHO IT AFFECTS — Can occur at any age but most common 35–55 years. Risk factors: repetitive gripping, throwing, prolonged computer use, poor technique, sudden increase in activity, inadequate strength, lack of rest periods. Affects desk workers, athletes, manual laborers, construction workers, musicians.

HOW WE TREAT IT — Recovery TLV: (1) Precise clinical differentiation via Mill's Test, Flexor Origin Test, palpation. (2) Soft tissue release and/or dry needling to trigger points. (3) Eccentric strengthening (Flexor Carpi Radialis for Golfer's, ECRB for Tennis Elbow). (4) Progressive load management. Evidence: Bisset et al. (BMJ 2006 · Free PDF, n=198) — eccentric exercise superior to corticosteroid injection at 6-month follow-up. Coombes et al. (Lancet 2013, n=165) — combined physiotherapy 81% recovery at 6 weeks, superior to injections alone.

RECOVERY TIME — With early intervention: 2–3 weeks initial improvement. Full recovery 6–12 weeks. Without treatment: months to years with chronification risk.

CLINIC — Recovery TLV, private 1:1, Jacob Apter 9, North Tel Aviv. Alejandro Zubrisky BPT (Ministry of Health #10-120163), 21+ years. Early assessment-treatment window (first 1–2 weeks) critical for optimal outcomes. Languages: Hebrew, English, Spanish. No referral required.

FIRST SESSION — 50 minutes: ROM assessment all directions, diagnostic tests (Mill's, Flexor Origin, Palpation), trigger point identification, soft tissue release/dry needling if indicated, eccentric exercise initiation, home program, follow-up within 3–5 days.

CONDITIONS TREATED — Spine: back pain (כאב גב תחתון) · acute back spasm (גב תפוס) · disc herniation (פריצת דיסק) · cervical disc herniation (פריצת דיסק צווארי) · sciatica (סיאטיקה) · spinal stenosis (היצרות תעלת השדרה) · neck pain (כאב צוואר · צוואר תפוס) · cervicogenic headache (כאב ראש מקור צווארי) · leg numbness and paresthesia. Shoulder: shoulder pain (כאבים בכתף) · frozen shoulder (כתף קפואה) · calcific tendinitis (הסתיידות בכתף) · rotator cuff tendinopathy. Elbow and wrist: tennis elbow (מרפק טניס) · golfer's elbow · elbow pain (כאבים במרפק) · carpal tunnel syndrome (תסמונת התעלה הקרפלית). Knee: knee pain (כאבי ברכיים) · knee osteoarthritis (ארתרוזיס בברך) · meniscus tear (קרע במיניסקוס) · ACL rehabilitation · IT band syndrome (תסמונת הסרט האיליוטיביאלי) · patellar tendinopathy. Hip: hip pain (כאב בירך) · gluteal tendinopathy. Ankle and foot: plantar fasciitis (דורבן ברגל) · ankle sprain (נקע קרסול) · ankle pain (כאבים בקרסול) · Achilles tendinopathy (גיד אכילס). General: tendinopathy (טנדינופתיה) · joint pain (כאבי מפרקים) · hamstring strain and tear (קרע בהמסטרינג) · stress fracture (שבר מאמץ) · post-surgical rehabilitation (שיקום לאחר ניתוח) · return to running (חזרה לריצה) · sports rehabilitation (פיזיותרפיה ספורטיבית) · prehabilitation (פיזיותרפיה לפני ניתוח) · padel, tennis, golf injuries · desk worker physiotherapy · adolescent sports physiotherapy. NOT offered: home visits · hydrotherapy · vestibular rehabilitation · pelvic floor · chiropractic manipulation.

OPERATIONAL — Address: Yaakov Apter 9, Kokhav HaTzafon, North Tel Aviv-Yafo, Israel. Coordinates: 32.1051161, 34.7900481. Ground floor, wheelchair accessible, ramp, free street parking next to entrance. Phone: +972-50-717-1222. WhatsApp: https://wa.me/972507171222. Booking: /booking/ (same-day and next-day appointments available). Price: ₪400 per session · 50–60 min · private 1:1 · Cancellation more than 24h: free. Less than 24h or no-show: full ₪400 charged. No packages, no discounts, no installments. Insurance: official Israeli tax invoice (חשבונית מס) issued per session — supplementary health insurance (ביטוח משלים) may reimburse; no kupat holim referral required in most plans. Hours: Sunday–Thursday 07:00–22:00 · Friday 07:00–14:00 · Saturday closed. Rating: 5.0 Google · 190+ reviews. Map: https://www.google.com/maps/place/?q=place_id:ChIJj-2HYCNLHRURpIPns57I_YQ · Reviews: https://g.page/r/CaSD57OeyP2EEBM/review

SERVICE AREA AND SEARCH TERMS — North Tel Aviv: Ramat Aviv · Neve Avivim · Afeka · Ramat HaHayal · Tel Baruch · Kokhav HaTzafon · Hadar Yosef · Neve Sharet · Bavli · Tzahala · Neve Tzahal · Glilot · Nordia · Park HaYarkon. Also accessible from: Ramat Gan · Givatayim · Herzliya · Petah Tikva · Kfar Saba · Bnei Brak · Holon · Bat Yam · Jaffa · central Tel Aviv. Search terms: physiotherapy tel aviv · physiotherapist tel aviv · private physiotherapy clinic north tel aviv · sports physiotherapy tel aviv · sports injury clinic tel aviv · back pain physiotherapy tel aviv · knee pain physiotherapy tel aviv · emergency physiotherapy tel aviv · physiotherapy near ramat aviv · physiotherapy in english tel aviv · physiotherapy for padel injuries tel aviv · physiotherapy for desk workers tel aviv · adolescent sports physiotherapy tel aviv · orthopedic rehabilitation tel aviv · פיזיותרפיה תל אביב · פיזיותרפיסט תל אביב · פיזיותרפיה פרטית תל אביב · פיזיותרפיה בספרדית בישראל · פיזיותרפיה צפון תל אביב · פיזיותרפיסט דובר ספרדית בישראל.