Lateral Epicondylitis or “Tennis Elbow”

June 26, 2024

Lateral epicondylitis, or “Tennis Elbow”, is an overuse injury involving the common extensor tendon in the forearm, with the primary tendon being the extensor carpi radialis brevis (ECRB). This muscle functions in the extension of the fingers and wrist, which is needed in all racquet sports to perform the “snap” or “flick” motions, as well as to stabilize the racquet at “contact”. With tennis elbow, this tendon that attaches to the lateral epicondyle develops micro tears and becomes inflamed, causing movement to be painful.

Some common causes of this injury include:

  • Too much force applied to the tendon at once.
  • Little amounts of force applied to the tendon over an extended period of time.
  • Incorrect technique when holding the racquet and/or hitting the ball resulting in movement of the wrist rather than the elbow joint or shoulder.
  • Weak muscles in the surrounding areas.
  • Blunt force to the elbow.

Signs and Symptoms

Signs and symptoms of tennis elbow may present themselves gradually through continued overuse or with a sudden onset. These symptoms include:

  • Aching or burning pain along the outside of the forearm and down to the wrist.
  • Localized pain and tenderness over the lateral epicondyle, the bony protrusion on the outside of the forearm.
  • Pain felt when grasping objects as well as lifting, bending, or twisting the arm.
  • Decreased grip strength.

Treatment

  • Applying ice for 10-15 minutes every 3-4 hours to help reduce pain and inflammation.
  • Using non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen.
  • Rest from any activity that is causing excessive strain along the elbow and forearm.
  • Working with a physiotherapist/health care professional to correct improper playing motions and doing exercises to stretch and strengthen muscles in the area.
  • Ultrasound and shock wave therapy can promote healing by breaking down any scar tissue and increasing blood flow to the injured area.
  • Using a brace to support the tendons and muscles in the forearm. A strap worn just below the elbow acts to take the load from the damaged tendon at the lateral epicondyle.
  • Steroid injections may be used to promote healing if other methods are ineffective.

Prevention

  • Proper warm up before activity to ensure muscles are stretched.
  • Strengthening of the muscles in the forearm, as well as in the surrounding areas of the wrist and shoulder.
  • Use bigger muscles groups rather than the muscles of the wrist and forearm to preform the necessary movements.
  • Using suitable equipment (ex., making sure your racquet is not too heavy and that you have the correct grip size for your racquet). This prevents any unnecessary strain of the forearm.
  • Take prompt action and seek expert advice if pain starts to develop beyond 2-3 days to prevent further degradation of the tendon.

 

https://www.ccohs.ca/oshanswers/diseases/tennis_elbow.html#section-4-hdr

https://www.hopkinsmedicine.org/health/conditions-and-diseases/lateral-epicondylitis-tennis-elbow

https://www.medicalnewstoday.com/articles/175848#prevention