Only Around 5% Tennis Elbow Cases Are Actually Related To Tennis
Tennis Elbow is a condition involving the tendons that work to extend your wrist and fingers. The site of discomfort is generally experienced at or around the the lateral epicondyle (a bony bump on the outside of the elbow, where the muscles that extend the fingers and wrist attach in a common tendon). Tennis Elbow is also referred to as lateral epicondylitis or extensor tendinopathy and is a relatively easy to diagnose without the need for any imaging. The history of the discomfort including the onset and behavior gives strong clues towards making a diagnosis of extensor tendinopathy and is easily confirmed with some simple clinical assessment of the elbow and associated areas.
No Scans Required To Confirm Extensor Tendinopathy
As mentioned above generally investigations such as an ultrasound scan, X ray imaging, or an MRI are not necessary to assist in diagnosis. A physiotherapist can generally confirm the diagnosis from their assessment alone. Although the size and presence of tendon tears and inflammation can influence best management meaning at times when treating tennis elbow imaging can be of benefit for stubborn conditions or help with implementing a treatment plan when a speedy recovery is necessary. In these situations then as a rule an MRI and Ultrasound are the best tests we have available to assist in identifying tendon tears and swelling.
Tennis Elbow Classically An Overloading Issue
Tennis elbow is a common condition in adults aged between 30-50yrs old. Extensor tendinopathy is frequently the product of repetitive overloading. When your arm used in a repetitive motions performing activities over and over again that place strain the muscles around the elbow this can cause tennis elbow. Your extensor carpi radialis brevis muscle (which can be abbreviated to ECRB) is widely considered to be the main muscle-tendon complex involved in extensor tendinopathy of the elbow. Tendinopathy of this ECRB and the common extensor tendon in tennis elbow may include small tears, degeneration or inflammation depending on the type-stage of injury.
Recovery Can Be A Slow Burn
Left untreated extensor tendinopathy of the elbow can become chronic. Although most symptoms will settle in weeks it is not uncommon for people to experience ongoing symptoms for months and months… I would consider an acute tennis elbow condition as being an injury in the first six weeks from onset, becoming “subacute” around 6-12 weeks. Tennis elbow could be classified as chronic after three months or persistence symptoms and functional limitation. Most physios will have certainly come across patients experiencing ongoing symptoms extending beyond 6 months – 1year. This is not necessarily a barrier to being pain free again as over the years I have assisted numerous people kick their chronic elbow pain.
Common Triggers For Causing Extensor Tendinopathy
Any excessive gripping or wringing activities or unaccustomed activity involving the hands such as painting or general carpentry such as including hammering or using a screwdriver could trigger the onset of tennis elbow symptoms. Some other examples of triggers people have relayed to me for the cause of their symptoms include:
- Playing musical instruments
- Weight lifting
- Cricket, golf, baseball, hockey
- Excessive typing
Any of the above or similar activities performed with poor technique, incorrect equipment, insufficient forearm strength-conditioning, insufficient recovery time between loading sessions can potentially cause stress to the tissues and lead to the onset of lateral epicondylitis.
Tennis Elbow Symptoms
The primary bother is typically pain, with any associated pain experienced performing gripping activities. The site of maximum tenderness is generally felt directly at the lateral epicondyle, or about 1-2 cm down the forearm from this bony landmark. The forearm may be tender on palpation with “trigger points” present as the cervical spine may also be tighter and more sensitive to palpation than normal is some episodes of lateral epicondylitis.Summary Of Symptoms:
- Elbow pain felt on one side of the body (however tennis elbow can affect both arms concurrently)
- Pain at the elbow gripping and lifting objects
- Associated neck and shoulder discomfort
- Elbow mobility is typically well maintained however discomfort straightening the elbow is not uncommon.
- Discomfort stretching the forearm muscles (specifically, performing the action of making a fist with a straight elbow and bending the knuckles down towards the floor).