Tennis elbow is a common condition in adults in their 40s and 50s. Known formally as lateral epicondylitis of the elbow, it is more commonly known as tennis elbow. While most commonly associated with tennis (10-50 per cent of regular tennis players experience it during their playing careers), hence its name, it can occur in any sport or work that requires forceful and/or repetitive forearm usage.
Tennis elbow causes
Tennis elbow occurs due to a small tear / microtear in the tendon(s) on the outside of the elbow (lateral side) that attach the forearm muscles to the elbow joint (lateral eipcondyle). Repeated tears lead to the development of damage in the tendon known as angiofibroblastic hyperplasia. The microtear and subsequent development of the damaged tissue is due to forceful and repetitive forearm use.
Tennis elbow symptoms
- Pain and tenderness over the lateral epicondyle (elbow joint), often radiating down the forearm.
- Pain is worse on resisted wrist and finger extension with the elbow in full extension.
- Initially, symptoms may be activity related but in chronic cases, the pain and tenderness may become constant. Risk factors of tennis elbow.
Age: You are at higher risk if > 40 years.
Activity: Regular tennis of more than two hours playing time each session, or a similar activity.
Technique: Tennis players with poor stroke technique (hitting the ball with a flexed elbow) and improper grip size.
Other factors: Hard court players are more likely to develop a problem compared to those who use other surfaces.
Tennis elbow diagnosis
When the pain and tenderness become frequent, and recur despite adequate rest and analgesics, you should seek medical advice.
Diagnosis of this condition is essentially made on clinical signs and symptoms. X-rays are done more to evaluate the bone surrounding the muscles and to exclude other potential causes of pain. An x-ray may also reveal calcification or the development of bone spurs of the lateral epicondylar region in chronic cases.
Tennis elbow treatment
Generally, a period of observation with conservative management of at least 6 months’ duration is recommended. Conservative management includes activity modification, correction of playing technique in sports, improved ergonomics in work-related tennis elbow, analgesics, stretching exercises, counterforce bracing and topical injections of steroids.
Failure of a trial of conservative management may require surgery to treat symptoms. There are various surgical options available, including open release of the affected tendon with excision of the damaged tissue, arthroscopic release, and newer techniques that stimulate improved blood supply to the affected area.
Tennis elbow prevention tips
Make sure that you do adequate warm-up exercises and stretching before any strenuous or repetitive activity to the forearm. Also limit continuous duration of play or activity, and use correct technique. The proper sizing of racquets is important.