Tennis Elbow

Elbow  Anatomy

The elbow is a joint made up of three bones: the upper arm bone, the humerus, and the two forearm bones, the radius and ulna. The lower end of the humerus has bony prominences called epicondyles that serve as sites of attachment for major tendons and muscles that help with arm movement. The prominence on the outside of the elbow is called the lateral epicondyle. It helps in the attachment of the tendons and muscles that help extend your fingers and wrist. 

What is Tennis Elbow?

Tennis elbow is a common name for the elbow condition lateral epicondylitis. It is typically an overuse injury that causes microtearing and degeneration of the tendons that attach to the lateral epicondyle. 

Tennis elbow is a painful condition occurring from repeated muscle contractions at the forearm. The condition is common with sports activities such as tennis, painting, hammering, typing, gardening and playing musical instruments. 

Tennis elbow and golfers elbow are similar, except that golfers elbow occurs on the inside of the elbow and tennis elbow occurs on the outside of the elbow.

Causes of Tennis Elbow

Tennis elbow is usually caused by overuse of the forearm muscles but may also be exacerbated by direct trauma such as with a fall, car accident or work injury.

Tennis elbow is commonly seen in tennis players, hence the name. Other common causes include any activity that requires repetitive motion of the forearm such as painting, hammering, typing, raking, weaving, gardening, lifting heavy objects and playing musical instruments.

Symptoms of Tennis Elbow

The signs and symptoms of tennis elbow can include the following:

• Pain on the outside of the elbow
• Pain that radiates to the forearm and wrist with grasping objects
• Weak or painful grip
• Pain in the elbow that is exacerbated when the wrist is bent back

Diagnosis of Tennis Elbow

Your doctor will evaluate tennis elbow by reviewing your medical history and performing a thorough physical examination. X-rays or advanced imaging may be necessary.

Treatment of Tennis Elbow

Your doctor will first recommend conservative treatment options. These may include:

• Limiting use and resting the arm from activities that worsen symptoms. 
• Splints or braces to decrease stress on the injured tissues.
• Apply ice packs on the elbow to reduce swelling.
• Avoid activities that bring on the symptoms and increase stress on the tendons.
• Anti-inflammatory medications and/or steroid injections may be ordered to treat pain and swelling.
• Physical therapy may be ordered for strengthening and stretching exercises to the forearm
• Pulsed ultrasound may be used to increase blood flow and promote healing to the injured tendons.

If conservative treatment options fail to resolve the condition and symptoms persist for 6 -12 months, your surgeon may recommend a surgical procedure called lateral epicondyle release surgery. Your surgeon moves aside soft tissues to view the extensor tendon and its attachment on the lateral epicondyle and then trims or releases the degenerated portion of the tendon. Any scar tissue present will be removed and the bone may be debrided as well to stimulate healing.