Tennis/Golfer’s Elbow
Introduction:
Lateral epicondylalgia, commonly referred to lateral epicondylitis or tennis elbow, usually presents as a small area of chronic pain on the lateral aspect of the elbow. Other characteristic symptoms are pain on wrist extension, pain when shaking hands, and frequently a weakened grip.
Anatomy:
Lateral epicondylalgia affects the lateral or outside portion of the elbow. This is the attachment site for the muscles responsible for extension of the wrist and fingers as well as the muscles that assist in rotation of the forearm. Although there are many muscles that share this site of origin, there are two muscles that are commonly associated with this condition, the extensor carpi radialis brevis (ECRB) and the extensor carpi radialis longus (ECRL). Overuse of these muscles results in microtearing at the junction where their shared tendon inserts into the lateral epicondyle of the humerus.
Discussion:
Whatever the cause of this overuse injury, lateral epicondylalgia affects 1% to 3% of the population. It is thought to be an overuse injury, originating in the wrist extensor muscles, rather than an inflammatory problem. It is commonly brought on by activities and sports that involve repetitive wrist extension and/or gripping motion. Some examples of occupations and activities that demand extension of the wrist are plumbing, playing a musical instrument, painting, weaving, raking, using screwdrivers, pliers, hammers, cutting meat, turning doorknobs, fishing, playing racket sports, and lifting objects with an extended wrist. Most often there is not one specific incident that produces the symptoms. Repeated use of the hand will maintain and often increase the discomfort. An abrupt onset of symptoms is uncommon and initially the pain gets worse for several weeks and even months, sometimes radiating down the forearm. Although it can occur at any age, tennis elbow is said to be more common between 30 and 50 years of age.
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