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Condition. Lateral Epicondylitis (Tennis Elbow)

By Editorial Team (Y)
November 24, 2021
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What is tennis elbow?

Tennis elbow, known in medical terms as lateral epicondylitis, is usually caused by overuse of the elbow. It causes elbow pain. As the term suggests, playing racket sports like tennis can lead to the condition, but other activities can also cause tennis elbow.


Tennis elbow occurs when the tendons involved in the forearm muscles located on the outside of the elbow become inflamed. The tendons and muscles of the forearm are injured when they are overused. Injury leads to inflammation which causes elbow pain and tenderness on the outside portion of the elbow.


There are several ways to treat tennis elbow. Most of the time, treatment for tennis elbow involves several members of the health care team. Primary care physicians, physical therapists, and sometimes surgeons all work together in order to provide the best treatment.

Anatomy

Three bones constitute the elbow joint: the upper arm bone, which is the humerus, and the two forearm bones, which are the ulna and the radius. At the bottom of the humerus, there are hard bumps which are called epicondyles. The hard bump found on the lateral aspect or outside of the elbow is known as the lateral epicondyle.
Muscles, tendons, and ligaments hold the elbow joint together.


Tennis elbow affects the tendons and muscles of the forearm. The muscles of the forearm extend the wrist and fingers. The tendons of the forearm tendons, which are called extensors, connect the muscles to the bones. They attach to the outside or lateral epicondyle (the bony bump). The tendon most often involved in cases of tennis elbow is the ECRB or the Extensor Carpi Radialis Brevis.

Causes of tennis elbow

Overuse

Damage to a specific muscle in the forearm is often the cause of tennis elbow. The ECRB (extensor carpi radialis brevis) muscle helps to stabilize the wrist when your elbow is extended. When playing tennis, this happens with a groundstroke, for instance. If the ECRB is weak due to overuse, tiny tears can occur in the tendon where it connects at the lateral epicondyle. These tears then cause painful inflammation.

The position of the ECRB may also place it at increased risk for injury. For example, when you straighten your elbow, the ECRB rubs against the bone. Over time, this can create wear-and-tear damage to the muscle, leading to tennis elbow. 

Activities

Sports activities are not the only types of activities that lead to tennis elbow. Many times tennis elbow occurs in people whose hobbies or work activities require vigorous and repetitive overuse of the ECRB muscle.

Carpenters, plumbers, and painters are especially at risk for tennis elbow. In addition, research shows that cooks, butchers, and auto workers develop tennis elbow more frequently than the general population. It is believed that the weight lifting and repetition required in these jobs lead to injuries.

Age

Most individuals who develop tennis elbow are between 30 and 50 years old, but people of any age can develop tennis elbow if they are at risk for the condition. Using improper equipment and improper techniques can place people who participate in racket sports such as tennis at increased risk for tennis elbow. 

Unknown

Tennis elbow sometimes happens for no known reason. This is called “insidious.” \

Prevalence

The incidence of tennis elbow in the general population annually is 1-3%.
The average age at which tennis elbow occurs is between 35 and 54 years. It typically does not occur in individuals who are less than 30 years old. Most of the time, symptoms last anywhere from 6 to 24 months. Most patients (89%) see symptoms of tennis elbow resolve within a year without specific treatment other than avoiding movements that cause pain.

Tennis elbow risks

Any activity that strains the elbow joint can increase the risk of tennis elbow. These activities include:

  • falls on an extended arm 
  • playing racket sports 
  • using a screwdriver for extended periods
  • casting a fishing line or net if unaccustomed to doing so can cause tennis elbow 

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