Tennis Elbow
26
Aug
Lateral Epicondylitis
Tennis Elbow, lateral epicondylitis
Elbow Pain
Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Activities like playing tennis or racquetball can cause this condition hence the name tennis elbow. However several other sports and activities can cause repetitive trauma to the elbow and result in the same condition
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 and repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow. It’s related to a muscle and tendons in your forearm. Tendons connect your muscles to your bones. When you constantly use your arm in a repetitive motion, the tendons at the elbow end of a certain muscle -- the extensor carpi radialis brevis (ECRB) muscle --- may develop small tears. Tennis elbow affects up to 3% of the population, particularly adults between 30 and 50 years of age. But less than 5% of cases are linked to tennis.
What causes it?
The tears lead to inflammation and may put stress on the rest of your arm, making it painful to lift and grip things. Left untreated, it can become chronic
Tennis elbow is a classic repetitive stress injury caused by overuse. Any activity that strains the muscles around the elbow over and over again can cause it.
In tennis, hitting a backhand puts some stress on your forearm muscles, which repeatedly contract when you hit the ball. If you have poor technique or grip the racquet too tightly, that stress may increase in the tendons that connect the forearm muscles to the elbow. The tendons may get small tears.
The more you do it — and tennis is a game of repeated strokes — the greater the chance for tennis elbow.
You can get it from other racquet sports, such as squash or racquetball. You can also get it from jobs or activities that involve repetitive arm motion, such as:
- Tree-cutting (repetitive use of a chain saw)
- Painting
- Carpentry
- Playing some types of musical instruments
- Butchers, cooks, and assembly-line workers are among the groups that get it often.
Symptoms
The most common symptom of tennis elbow is an ache on the outside of the elbow. Over time -- from a few weeks to a few months -- the ache turns into a chronic pain. The outside of your elbow may become too painful to touch. Eventually, you may find it harder or more painful to grip or lift things. Sometimes tennis elbow affects both arms.
How is it Diagnosed?
A detailed examination and history is required. Generally x-rays are performed in order to rule out any underlying pathologies. Sometimes lab work is required to also rule out possible complicating factors such as rheumatoid arthritis or osteoarthritis. In some cases MRI scans are required if we suspect tears or ruptures. And at times EMGs are required in order to rule out the possibility of nerve compression.
Treatment
In many cases conservative care works well. In my office we combine Electro-Medicine with mobilization techniques. Most patients usually get relief within 3 – 5 visits, however depending on the extent of injury and inflammation this can be longer. At times bracing may be utilized for control of acute episodes. As this is a repetitive trauma injury, it tends to come back if you repeat the activity. So it becomes important to modify your techniques/activity in order to avoid repeating the injury to the area. In our office we try to instruct you on techniques to help avoid further injury. With rest and time combined with treatment most conditions will respond.
