What is Tennis Elbow?
The elbow joint is formed at the junction of three bones: the humerus, which is the upper arm bone, and the radius and ulna, the forearm bones. At the lower end of the humerus are two bony protuberances called epicondyles. The bump that you can feel on the outside of your elbow is the lateral epicondyle, and it fits into a cup-shaped depression at the upper end of the ulna.
Muscles, tendons, and ligaments hold the three arm bones in position and allow the forearm, wrist, and fingers to move, within certain limits.
Tendons are tough cords of connective tissue called collagen. They originate in muscles and attach the muscles to bones. When muscles are contracted, tendons pull on bones, causing movement. The muscles of the forearm are attached to the humerus by means of tendons that insert into the lateral epicondyle. The forearm tendon called the extensor carpi radialis brevis helps to stabilize the wrist, as well as extend it.
Stress placed on a tendon can damage some or all of the collagen fibers that make up the tendon, fraying or breaking them. Given time, collagen fibers can heal themselves, but without sufficient rest the tendon fiber cells cannot properly regenerate. Damage to the extensor carpi radialis brevis can weaken the attachment of the tendon to the humerus and increase stress on the area.
Tennis elbow, medically known as lateral epicondylitis (inflammation of the lateral epicondyle), is the term used to describe the painful condition caused by the overuse of the forearm muscles and the subsequent damage to the tendon. Anyone can develop it, although tennis players are particularly susceptible due to the specific repetitive motions that are used when playing the sport. People who are carpenters, painters, guitar players, or plumbers can also be at risk, along with anyone whose work or leisure activities require repetitive, twisting movements of the wrist.
Tennis elbow usually affects the dominant arm, although it can occur in either arm. Men are affected more often than women, and sufferers are likely to be aged between 30 and 50. About half of all tennis players suffer from this condition at some point during their playing career, often due to poor backhand stroke technique.
Although it usually develops over a period of time, it can also occur as the result of a sharp blow to the elbow, or a sudden, extreme movement. And, occasionally, it can develop without any obvious cause, when it is known as insidious tennis elbow.
When the injury is the result of overuse, the symptoms become gradually apparent, and gradually worse. If it is a sudden injury, the symptoms will also be of sudden onset. Either way, pain is felt at the outside of the elbow and sometimes extending down into the forearm and wrist. The outside of the elbow is tender to the touch. The pain is made worse when trying to grip or squeeze an object, and when turning the wrist, for example, trying to turn a doorknob or open a jar.
Although tennis elbow is a painful condition, 80 percent to 95 percent of the time it responds to non-surgical treatment. Rest, the use of a good forearm brace, anti-inflammatory medication, and eventual stretching and strengthening exercises comprise the usual treatment program.