About tennis elbow

What is tennis elbow?

The medical term for tennis elbow is lateral epicondylitis, which refers to the onset of pain on the outside aspect of the elbow joint. The humerus bone of the upper arm has bony protrusions on the inside and outside of the elbow called epicondyles.

Tennis elbow develops when the tendon on the outside (lateral) aspect of the elbow becomes damaged or suffers traumatic tearing at its attachment to the bone.

The diagram below shows the area of tendon that is affected by a tennis elbow

Why does it happen?

Tennis elbow is most commonly caused by the overuse of muscles in the forearm that extend the wrist and fingers. Racket sports such as tennis or other activities which involve repeated extension or twisting of the wrist may result in the onset of pain in the outside of the elbow, for example, using a screwdriver or a keyboard. Carrying heavy loads with the elbow straight and the palm facing the floor may also cause traumatic tearing of the tendon.

Sudden increases in activity or repeated strain can also lead to tendon degeneration such as starting a DIY project, a new job or sporting interest.

What are the symptoms?

The main symptoms are pain and local tenderness on the outside aspect of the elbow. Initially, pain may only occur with sudden forceful activity involving grasping or certain sporting or work activities. As the condition develops, dull aching symptoms may become more constant. There are usually no external symptoms present such as swelling or redness of the skin.

How is the condition treated?

• Initially treatment involves limited the aggravating activities that stress the tendon
• This may involve adjusting sporting or working activities, for example, making changes to the position of the wrist whilst using a keyboard
• A wrist brace may be worn to help unload the tendon
• The use of an ice pack applied to the painful area may help to control pain
• Physiotherapy treatment may also help to reduce symptoms with the use of muscle stretching and strengthening exercises
• Injections/surgery may be used as a last resort

How do I prevent symptoms re-occurring?

• Symptoms are usually caused by overuse of the forearm extensor muscles, so they can be prevented
• Activities involving repeated or prolonged grasping with the elbow straight, carrying heavy objects or high force pulling may lead to the onset of symptoms. It may be necessary to find an alternative method of completing these tasks or stopping them completely
• Continue to perform the exercises provided by your physiotherapist to maintain flexibility and strength in the muscles of the forearm