What is Lateral Epicondylitis (Tennis Elbow)?

Lateral Epicondylitis also more commonly known as Tennis Elbow is an inflammatory response due to a series of microscopic tears of the common extensor tendon and its associated muscle groups on the outside of the elbow. Lateral epicondylitis can sometimes be confused with a Myofascial Trigger Point or Osteoarthritis.

It is a tendinopathy injury from repetitive straining of forearm tendons (most often extensor carpi radialis brevis muscle) attaching to the outside (lateral) side of the elbow. The condition is common amongst tennis players, especially beginners, but also manual workers who often exercise their wrist and forearm at work. However, it is not limited to tennis players, as the repetitive action of the elbow use is a part of normal daily activities. For example, using hand tools, painting, or using a mouse for long periods of time can lead to lateral epicondylitis. This repetitive action causes microscopic tears in the ligament of the common extensor muscles of the wrist due to the continuous microtrauma. An overload or overuse of the muscle causes incomplete healing of the forearm tendons in strain. People commonly get tennis elbow at around 35 and 55 years old (Aben 2018). As mentioned above, tennis players and manual workers are at risk of experiencing tennis elbow due to repetitive arm movements that strain and overload the forearm muscles, thus the tendon as well. Smoking, overuse of dominant hand, diabetes mellitus could be risks that can increase chances of getting tennis elbow. Other non-modifiable risk factors could be gender (females) and old age (Sayampanathan 2020).

Patients experience pain when performing one-sided arm movements such as tennis or heavy lifting due to forearm tendons in strain. Other symptoms include a weaker hand grip and discomfort on bending the wrist backwards. Pain may travel up or down the forearm and is made worse with movement, a loss of grip strength and an aching feeling in the forearm can also be present.

Tendons do not like sudden changes as they have little to no direct blood supply, meaning they tend to recover slowly. Tennis elbow can resolve spontaneously between 2 weeks to 2 years. A chiropractor can provide short term relief by applying mobilisation or manipulation of the elbow and wrist joint, soft tissue work, acupuncture and transcutaneous electrical nerve stimulation (TENS). Icing of the elbow is not recommended as it can cause cold hyperalgesia, meaning there is increased sensitivity to experiencing pain due to the cold temperature. A full recovery for long term relief would involve physical rehabilitation that focuses on muscle lengthening and strengthening (eccentric) exercises of the extensor muscles and tendons.

Here at Precision Health we offer services such as Chiropractic care which can aid in your recovery from Tennis Elbow. Call (02) 9639 7337 or visit our website to book an appointment now!

Lenoir, H, Mares, O, & Carlier, (2019) Management of lateral epicondylitis – Orthopaedics & Traumatology – Surgery & Research, vol. 105, no. 8, pp. S241–S246, doi: 10.1016/j.otsr.2019.09.004.

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