Tennis elbow

Tennis elbow

Dr. Vic Weatherall
Updated December 2014

Classic tennis elbow, or lateral epicondylitis, is a repetitive strain injury (RSI) affecting the common extensor tendon at the lateral (outside) area of the elbow. An RSI, also known as a cumulative trauma disorder (CTD), is damage to the tendons, nerves, muscles, and other soft tissues of the body caused by specific repeated movements which overstress the tissues.

Watch this tennis elbow video. The common extensor tendon connects muscles which bend your hand and fingers backward with your arm bone, the humerus. Tennis elbow is a very common cause of elbow and forearm pain. It can cause mild to severe pain in the lateral aspect of the elbow region and may be aggravated by grasping and wrist and finger motions. The pain may also
radiate up the arm or down into the forearm.

Tennis elbow is an overuse injury that occurs most frequently in the dominant arm during middle life. It is very common among tennis players, especially those with a faulty backhand swing. Forty-five percent of tennis players who play or practice daily will experience tennis elbow. However, tennis elbow also afflicts carpenters, mechanics, office workers, cashiers, maids, and anyone else who performs repeated hammering, grasping, and rotary forearm motions.

Tennis elbow is diagnosed by clinical findings alone. There is local tenderness on pressing the area and pain on contracting the involved muscles against resistance. The elbow range of motion is normal and there is no swelling. Unless severe degeneration has occurred, the elbow appears normal on an x-ray.

This condition can be slow to respond to treatment, especially if the aggravating motions are continued. Initial treatment includes resting the elbow, ice, anti-inflammatory medication or supplements, Vitamin C, and orthopedic supports such as tennis elbow braces. Follow-on treatment includes eliminating or modifying the offending activity and similar activities, manipulating the elbow joint, associated therapies, massage, and changing equipment or tools if required. Most importantly, stretches and exercises for the involved muscles and other elbow muscles are performed to regain the flexibility, strength, and endurance to rehabilitate the injury and prevent recurrence.

Elbow pain also can be caused by a variety of other reasons. Muscle strains, joint sprains, joint degeneration and inflammation, nerve involvement at the spine or anywhere along the course of the nerve are all possible culprits. More directly, muscle weakness due to nerve involvement can predispose a person to an injury such as tennis elbow; therefore, the neck area should be examined and if necessary treated while the elbow area is being treated.

Tennis elbow, and all other cases of persistent pain and suspected injury, should be examined by a qualified practitioner who can diagnose the problem and initiate the proper treatment as soon as possible.

Contact Dr. Weatherall if you have any specific questions.

Image citation

Tennis elbow: Creative Commons Attribution-NoDerivatives 4.0