Tennis elbow is also known as lateral epicondylosis and is the most common cause of elbow pain in adults. The injury involves the origin of the common extensor tendon and occurs from the accumulation of microtrauma from repetitive stress resulting in tendinosis. Repeated micro-tearing can result in degeneration and even tears within the muscle. The muscles that join into the common extensor tendon are the extensor carpi radialis brevis (ECRB), extensor digitorum communis (EDC), and extensor carpi ulnaris (ECU). The ECRB the a part of the tendon that is most often affected.
Risk factors for tennis elbow include faulty biomechanics with racquet sports, overexertion, and repetition with repeated wrist extension and forearm supination and pronation (turning the hand up and down). However, this common condition is most often seen in individuals who do not play tennis.
Symptoms include pain with wrist extension and gripping, which makes even simple things like holding a coffee cup, fixing your hair or signing your name very uncomfortable. There can also be tenderness and selling at the elbow where these tendons attach.
For acute pain ice and anti-inflammatory medication (NSAIDs) is helpful. I prefer starting with a topical anti-inflammatory because they have fewer side effects than oral NSAIDs, and it can be placed right where you need it. A counterforce brace may also be beneficial. Transcutaneous nerve stimulation (TENS) and ultrasound as part of a physical therapy program also relieve pain and may speed up the healing process. Once the acute pain is decreased a gentle stretching program can begin followed by strengthening of the affected tendon. Activity modification, for example changing the way you swing a racquet or a hammer, is also important to prevent the symptoms from returning. Approximately 80% of patients with tennis elbow report improvement at one year.
