Tennis Elbow-Lateral Epicondylitis

 

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. But several other sports and activities can also put you at risk. Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse - repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

 

Your elbow joint is a joint made up of three bones: your upper arm bone (Humerus) and the two bones in your forearm (Radius and Ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle, 

where muscles, ligaments, and tendons joint together. Lateral epicondylitis, or tennis elbow, involves these muscles and tendons of your forearm which extend your wrist and fingers. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB). A condition involving the muscles attached to the medial epicondyle and bend the wrist is called Golfer Elbow or Medial Epicondylitis.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Causes

 

• Overuse- Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The Extensor Carpi Radialis Brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain. The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.

 

• Activities- Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle. Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.

 

• Age- Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be
  risk factors.

 

Symptoms 

 

The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.

 

Common signs and symptoms of tennis elbow include:

 

•  Pain or burning on the outer part of your elbow

 

•  Weak grip strength

 

The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however both arms can be affected.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-surgical treatment

 

• Rest- The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.

 

• Equipment check- As we saw before the ECRB muscle is activated during grip. The stronger the grip the higher the stress on the muscle. One of the ways to address this issue is by thickening the handles of your equipment (not too much), decreasing the grip level and by that the stress on the muscle. 

 

• Physical therapy- Strengthening the muscles of the forearm, using ice massage and stretching are only few of the techniques that may be used to alleviate pain the solving the problem. 

 

• Brace- Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.

 

Surgical Intervention 

 

If your symptoms do not respond to nonsurgical treatments, your doctor may recommend surgery. Open surgery or orthoscopic surgery can be performed. Our orthopedic surgeons will be glad to meet with you for a thorough interview and examination before discussing the surgical options.