What is tennis elbow?
Tennis elbow is an odd name to give to a problem which affects mostly people who do not play tennis! It is also called lateral epicondylitis, lateral epicondalgia or lateral elbow pain.
The pain from tennis elbow is felt on the outer side of the elbow and the back of the forearm. Sometimes the pain radiates to the wrist or the back of the hand.
How common is tennis elbow and who gets it?
Tennis elbow affects about 1-3% of people and is more common in manual workers (7%). It also includes those using a keyboard or mouse for many hours per day. This is because tennis elbow is a mainly a problem or repetitive movements and of overuse.
Tennis elbow affects men and women equally. It can affect people of any age but is most common in the 30-50 age group.
Types of work
Professions like chefs, butchers, carpenters, and painters which involve repetitive wrist and arm motions are at a higher risk of tennis elbow. It is also common in people using a keyboard and mouse for many hours per day such as IT workers, secretaries and PAs.
Hobbies
Hobbies like knitting, typing, or playing musical instruments for extended periods can also be culprits.
What are tennis elbow symptoms?
Pain over the outer part of the elbow.
Many describe the sensation as a persistent ache, especially when lifting.
Pain worse with hand gripping or twisting activities of the hand or forearm.
A weakened grip if the problem becomes more severe.
Stiffness when trying to extend or straighten the elbow.
Tennis elbow tests
Tennis elbow can be diagnosed with examination alone in most cases. Doctors commonly use three different tests to diagnose tennis elbow.
Resisted wrist extension test
This is meant to reproduce the patient’s pain by activating the muscles and tendons that are affected. The patient is asked to extend their wrist against the doctor’s resistance. Pain or discomfort felt on the outside of the elbow during this test indicatives tennis elbow. You can reproduce this yourself using the chair test in which you try to lift a chair with your arm straight and palm facing downwards. Pain felt around the outside of the elbow whilst you do this suggests that you have tennis elbow.
Pain location
The doctor will press on or around the outside of the elbow, looking for the area of maximum tenderness or pain. This is usually around the lateral epicondyle – the bony bump on the outside of the elbow.
Grip strength
This is usually done by asking the patient to squeeze the doctor’s hands. The affected hand will have a weaker grip than the other side and may reproduce the same tennis elbow pain.
X-rays and scans
can be used to make sure you do not have other causes of pain but cannot confirm a diagnosis of tennis elbow. This is why they are rarely used in such cases.
What causes tennis elbow?
We used to think that tennis elbow was due to inflammation of the . However, we now know that it is mostly to chronic changes that occur over months or years in the tendons and muscles around the elbow. It is due to overuse.
Inflammation might still play a part in the early stages of the problem but is not present by the time tennis elbow becomes painful.
1. Repetitive Movements
Tennis and other racket sports:
The repeated motion and stress of hitting balls can strain the forearm muscles and lead to inflammation. Especially, backhand strokes without proper technique can be a significant contributor.
Manual work
Activities like plumbing, painting, carpentry, or even gardening which require repeated movements or gripping tools for extended periods can lead to the condition.
2. Improper Technique
Sports technique
Using improper techniques, especially while playing racket sports, can cause undue stress on the tendons. For example, hitting a tennis ball with a late backhand.
Using inappropriate equipment:
Utilizing rackets with a too small grip or stringing them too tightly can increase the risk. Using tools with a small a grip can have the same effect.
3. Direct Blow or Trauma
A direct blow to the lateral epicondyle, the outer part of the elbow, can lead to inflammation and pain typical of tennis elbow.
4. Lack of Flexibility or Strength
Weak wrist and forearm muscles may not provide adequate support for the tendons, making them more susceptible to injury. Similarly, lack of flexibility can strain the tendons.
5. Previous Elbow Injuries
If you’ve previously injured your elbow or had an elbow surgery, your chances of developing tennis elbow might be increased, especially if you return to repetitive activities without adequate healing.
How long does tennis elbow take to get better?
Typically, tennis elbow takes a number of months to get better. That is because it takes many months or even years of doing an activity for it to develop in the first place before the pain actually starts.
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