Tennis Elbow

Tennis elbow, or lateral epicondylitis, is a condition where the elbow becomes tender at the lateral epicondyle of the humerus, due to repetitive movements and overuse of the forearm. The lateral epicondyle is a small connection between the radial collateral ligament of the elbow joint and an extensor muscle tendon. The forearm muscles and tendons become damaged from overuse, which leads to pain and tenderness on the outside of the elbow. Repetitive movements that contribute to lateral epicondylitis can also cause other tendon pains, such as medial epicondylitis. Medial epicondylitis, or golfer’s elbow, is a condition in which the medial epicondyle, another tendon of the humerus bone, is overused and cannot heal. Because the forearm tendons and joints are very complex, the continued overuse of the elbow may contribute to permanent pain, and the only treatment available is surgery.

The condition was first documented and described in 1873 by German physician F. Runge, who called it “Schreibekrampf”, or “writer’s cramp”. Because writers were subject to the same repetitive movements in writing, the continued onset of writing contributed to the degradation of the lateral epicondyle. Later, in 1883, British surgeon Henry Morris published an article in “The Lancet”, a peer reviewed general medical journal, in which Morris described it as “lawn tennis arm”. That same year, another paper was published in H.P. Major, describing the condition as “tennis elbow.”

Signs and symptoms of lateral epicondylitis, as well as medial epicondylitis, include pain on the outside of the elbow, joint tenderness, pain from gripping, and wrist movement or extension. Simple tasks such as shaking hands, washing dishes, or carrying heavy items become painful, due to the repetitive overuse of the forearm and elbow. Recent studies show that microscopic and macroscopic tears in the elbow, specifically between the common extensor tendon and the periosteum of the lateral humeral epicondyle, are the main cause of tennis elbow. There are also conditions that increase the likelihood of developing tennis elbow. These conditions include carpal tunnel syndrome, which is the compression of the median nerve through the wrist at the carpal tunnel. Disorders such as calcification of the rotator cuff and bicipital tendinitis may also increase the likelihood of lateral epicondylitis. Calcification of the rotator cuffs is a condition in which calcium deposits form on the tendon of the supraspinatus tendon. This causes inflammation and irritation of the rotator cuff, contributing to pain. Bicipital tendinitis is inflammation of the tendon at the long head of the bicep muscle. Overhead motions and the aging process both contribute to the degradation of this tendon, causing biceps tendinosis.

Treating tennis elbow is a mostly proactive solution. Decreasing the amount of involvement in athletic programs when experiencing joint pain, can help ease the developing inflammation of the tendons. Strengthening the forearm muscles, such as the pronator quadratus, pronator teres and supinator muscle, the biceps and triceps, and the deltoid and trapezius muscles of the shoulder. The importance of weight-lifting becomes increasingly important with age, and with the development of obesity in Americans, many Americans are opting out of athletic exercise. According to the National Institute of Diabetes and Digestive and Kidney Diseases, “35.7% of adults in the United States are considered obese”. It is also very important to stretch major and minor muscles to decrease the risk of injuries, such as tennis elbow. According to Harvard Health Publications, “stretching keeps the muscles flexible, strong, and healthy, and we need that flexibility to maintain a range of motion in the joints. Without it, the muscles shorten and become tight”. When muscles become inflexible and tight, there is a higher risk of stretching a muscle too far, and a tear forms. Many tears can form to cause an injury in a muscle, and joints can also be damaged due to the lack of stretching. Stretching is a vital part in sports and weightlifting, and without it, a person will risk damage and pain to muscular function.

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