You don’t have to be a tennis enthusiast to develop tennis elbow. Tennis elbow (aka lateral epicondylitis) is a painful and stubborn injury and can affect a number of people. A brief review of the anatomy can explain how tennis elbow develops.
We have a group of muscles in our forearm called wrist extensor muscles that are responsible for bending our wrist up and controlling finger movements. The attachment point for the wrist extensor muscles is on the lateral epicondyle (outer portion of the elbow) to the fingers. They are used very frequently throughout the day to control motions like picking up keys, turning doorknobs, and lifting heavy objects.
When these muscles get injured from repetitive motions or a trauma, you can develop lesions. The lesions typically develop in the muscle belly or the tendon (attachment point of the muscle to the bone) and these lesions can develop into tears. This causes the development of tennis elbow.
Tennis elbow can affect people of all ages, but it more commonly occurs between the ages of 35-50. There are several signs and symptoms that patients report with tennis elbow. Some of the common ones include: achiness, morning stiffness, pain on the outside of the elbow, and occasionally patients may experience night pain. Patients may also notice they are dropping objects more often and grip strength is usually weak and painful.
Examination will often reveal tenderness to palpate the outside of the elbow, pain with resisted movements especially wrist extension, and usually pain with bending the wrist down and creating a stretch on the wrist extensor muscles. The neck and shoulder should also be examined, as many tennis elbows are due to dysfunctions in these areas. Dysfunction of the neck can lead to poor input from the nerves to the muscles causing decreased muscle function, weakness, and a lower threshold before injury occurs. The shoulder can play a similar role in which pressure around the shoulder can impede nerve function leading to the development of tennis elbow. Poor biomechanics can also cause us to overuse the elbow and specifically the wrist extensor muscles.
Many treatments exist. Some of the types of treatment that can be effective include: electrotherapy, thermotherapy, manipulations, stretching, progressive resistive exercises, bracing, IMS (intramuscular stimulation), corticosteroids, and education on body mechanics such as recruiting the shoulder to do more work. Surgical intervention can be used in cases where conservative treatment isn’t working. Tennis elbow is a very stubborn injury but treatment can provide optimal healing and reduced down time.
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