Tennis elbow is a condition where the outer part of the elbow becomes painful and tender, usually as a result of a specific strain or overuse. Although it is called “tennis elbow”, it should be noted that it is not restricted to tennis players.
If one hyper extends an elbow in any sport, this may be classified as tennis elbow. Anyone who does a lot of work involving lifting at the elbow or repetitive movements at the wrist is susceptible to tennis elbow. The medical term is lateral epicondylitis.
With tennis elbow, the extensor carpi radialis brevis tendon has been identified as the primary site of pathological change. The tendon of the extensor carpi brevis muscle at approximately 2cm below the outer edge of the elbow joint or lateral epicondyle of the humerus bone. There have also been pathological changes found at the extensor digitorum communis, longus and ulnaris tendons. The extensor carpi radialis brevis has a small origin and does transmit large forces through its tendon during repetitive grasping. It has also been implicated as being vulnerable during shearing stresses during all movements of the forearm. It is acknowledged that tennis elbow is caused by repetitive microtrauma/overuse. Inflammatory changes have been noted in the acute stages of the condition but have been found to be absent if symptoms become chronic (3 months +).
Specific inflammation is rarely present in the tendon but there is an increase in pain receptors in the area making the region extremely tender.
Risk factors for this condition vary from taking up tennis later in life, unaccustomed strenuous activity, decreased reaction times and speed and repetitive eccentric muscle contractions (controlled lengthening of a muscle group).
Differential diagnosis for tennis elbow includes anconeus compartment syndrome, bursitis, cervical radiculopathy, radio-humeral joint dysfunction, hypothyroidism, lateral epicondyle avulsion, musculocutaneus nerve entrapment, non-union of radial neck fracture, osteoarthritis, posterior interosseous syndrome, posterolateral rotatory instability, radial nerve tension, radial tunnel syndrome, rheumatoid arthritis, strained lateral collateral ligaments, and snapping plicae syndrome.
How long with tennis elbow take to get better?
Tennis elbow may heal quickly within two weeks but it could last for up to two years. When the symptoms have settled down it is essential full rehabilitation and strengthening of the elbow takes place.