Tennis elbow (lateral epicondylitis)
Making up the elbow joint is the bone in the upper arm (humerus) and one of the bones in the lower arm (ulna). The bony bumps at the bottom of the humerus are called epicondyles. The bump on the outer side of the elbow, to which certain forearm muscles are attached by tendons, is called the lateral epicondyle.
Lateral epicondylitis (tennis elbow) is an overuse condition in which there is pain in and around the outer bump of the elbow (lateral epicondyle).
The muscles that attach to the lateral epicondyle bump are involved in straightening and raising your hand and wrist. When the muscles are overused their tendons get repeatedly pulled at their attachment on the outer bump (lateral epicondyle). This may lead to tiny tears in the tendon that without rest from activity will result in inflammation and pain.
As it is the tendons that straighten (extend) the wrist involved this condition is also commonly called extensor tendonitis. Lateral epicondylitis is a common condition in not only tennis players but also in those doing repetitive activities that involve straightening and griping such as hammering, painting etc. especially when there has been a recent increase in activity.
• pain or tenderness on the outer side of the elbow
• pain when you straighten or raise your wrist and hand
• pain made worse by lifting a heavy object
• pain when you grip an object, shake hands, or turn door handles
• pain that shoots from the outer elbow down into the forearm or up into the upper arm
Diagnosis and treatment
Your physiotherapist will be able to diagnose and treat this condition. Initial management will involve rest from aggravating activities to allow healing of the tendons to occur. Initial physiotherapy will aim to reduce pain and inflammation through the use of electrotherapeutic modalities and gentle soft tissue techniques.
Taping or the wearing of a brace may also be used to help reduce the traction effect of the tendons on the lateral epicondyle. Once the inflammation has settled and sufficient time has been allowed for the tendons to heal then progressive strengthening and stretching of the appropriate muscles will commence to allow a return to activity.