What’s Tennis Elbow?
Tennis Elbow, also known medically as Lateral Epicondylitis, is an injury from overuse that affects the tendons of muscles that attach to lateral epicondyle of the elbow. The lateral epicondyle is a small protrusion of bone that is located at the bottom outside edge of the humerus, or upper arm bone. Tennis Elbow is an inflammation of these tendons, which attach muscle to bone, that attach at this site. The muscles that attach to the lateral epicondyle are several muscles that run through the forearm. Tennis elbow, lateral epicondylitis, is a very common complaint involving elbow pain.
What Causes Tennis Elbow?
The causes of Tennis Elbow include many other activities besides tennis. It is referred to as Tennis Elbow because it is a common disorder seen in individuals that play tennis because of the frequent, forceful extending of the wrist involved. Extension of the wrist involves straightening the hand and wrist from a bent position. The muscles that are located in the forearm that attach to the lateral epicondyle are responsible for, among other things, straightening the wrist/hand and supinating the hand, or turning it outward, palm facing up. Other racket sports cause this condition just as frequently. Causes and risk factors of Tennis Elbow may be:
- Overuse of the forearm muscles that extend the wrist and fingers as in tennis, racquetball, squash fencing, and weight lifting
- Overuse from other activities such as gardening, raking, knitting, typing, painting, woodworking and other manual work, cooking
- Increased age
- Improperly warming-up before engaging in strenuous activity
- Improper athletic technique
- Certain medications such as steroids
- Smoking and excessive alcohol use
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Symptoms of Tennis Elbow
Generally, the symptoms of Tennis Elbow will develop gradually and worsen over time. Symptoms of Tennis elbow may be any one or all of the following:
- Elbow pain located on the outer part of the elbow
- Pain that worsens with gripping activities, making a fist, opening doors, holding a glass of water, and many other activities that in part require extension of the wrist
- Weakness noticed with any of the above activities
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Tennis Elbow Treatment
The treatment for Tennis Elbow is almost always conservative. The treatment involves:
- Discontinuation of the aggravating activity, allowing the tendons to rest
- NSAIDs (nonsteroidal anti-inflammatory drugs
- Strapping and/or taping of the firearm in order to support the elbow and take pressure off of it
- Cortisone injections
- Extracorporeal shock wave therapy: this intervention consists of sending sound waves to the area of injury in order to facilitate healing
- Physical therapy: there are many exercises that a patient will be instructed to perform in physical therapy with the focus on eccentric exercises. Eccentric exercises are a form of strengthening the muscle as it lengthens, as opposed to a concentric contraction as in a biceps curl, when the muscle is shortening as it contracts. Eccentric exercises have been proven to be quite effective in managing the pain of tendon injuries. Deep tissue and transverse friction massage are also modalities that physical therapists frequently use when treating tendon injuries
There are surgical options that may be considered when the progression of this condition is very advanced and conservative treatment fails to reduce pain and improve function. Surgery for Lateral Epicondylitis involves removal of the damaged/diseased part of the tendon.