Tennis Elbow

Tennis elbow is most common in people aged 30 to 50. Lateral epicondylitis is a degenerative disease of the tendons caused by microtraumas.

Elbow Anatomy

The elbow joint is made of three bones: the two forearm bones (the radius and ulna) connect with the upper arm (the humerus) by ligaments and tendons to create the elbow joint. The forearm muscles, ligaments and tendons control the movement of the elbow, wrist and hand. Tendons fasten muscle to the bones. There are bumps at the bottom of the upper arm bone called epicondyles where forearm muscles attach by their tendons. The bump on the outside of the elbow is called the lateral epicondyle.

What is tennis elbow?

Tennis elbow is a painful condition that involves the tendons that attach to the lateral epicondyle on the outside of the elbow. Tennis elbow is degeneration of the tendon’s attachment which creates stress on the muscles in the forearm and causes pain when the muscle is activated to lift, grip and grasp. The muscle affected is the extensor carpi radialis brevis or ECRB.

What are the symptoms of tennis elbow?

Symptoms develop slowly and usually worsen over time. The dominant arm is usually the most affected, but it can affect both arms.

• Pain and tenderness on the outside of the elbow
• Pain that radiates down the forearm to the hand
• Pain and weakness with gripping and lifting

What causes tennis elbow?

Overuse of the muscles and tendons that control wrist and finger movements cause inflammation of the ECRB. This typically occurs from repeated motions of the arm, such as those used for playing sports like tennis that involve gripping or throwing movements.

It is widely known as tennis elbow because it affects 50% of tennis players. However, only 10% of those with tennis elbow actually play tennis! People who perform manual labor including painters, plumbers, and carpenters frequently develop lateral epicondylitis. It is a work-related injury for any job that requires repetitive forearm motions or fine motor skills including cooks and butchers, and auto workers. Sometimes there is no known cause.

How is tennis elbow diagnosed?

Your OANC orthopedic surgeon will review your medical history considering all factors including occupational risk and recreational sports. They will ask about activities that cause your symptoms and perform a physical exam testing range of motion and pain level and strength.

You will be asked to perform certain tasks during diagnosis to evaluate your pain and grip strength. They will palpate the area for tenderness, and pain with wrist flexion against resistance. They may order imaging studies including x-rays to check the bones and rule out arthritis, and an MRI to view the soft tissues including the muscles and tendons and rule out other injuries and the extent of the damage.

Sometime arthritis of the neck or a herniated disc in the neck can causes similar symptoms. If they think that may be possible, they may also order an MRI of the neck to determine to rule out those conditions as the cause of your problem. Nerve compression can produce symptoms similar to lateral epicondylitis, so they may also order a test to reveal nerve compression, called an electromyography.