Tennis elbow


What does tennis elbow mean? What are its causes, clinical presentation and its treatment modalities?

Let’s answer the first question

What does tennis elbow mean?

It is a condition known as lateral epicondylitis. The lateral epicondyle is the lateral upper part of the ulna (a bone of 2 bones of the forearm). Precisely, it is at the lateral aspect of the elbow.

It was called so because it is common to affect tennis players, but actually it can affect people who are not playing any racket game.

Tennis elbow is caused by small tears in the tendons attaching the forearm muscles to the bone secondary to the repeated contraction and relaxation, especially the extensor carpi radialis muscle. 

Tennis elbow is not always secondary to playing tennis

Causes of tennis elbow

It is due to repetitive action and movement of muscles of the wrist and forearm. The continuous alternating contraction of these muscles such as twisting and gripping leads to strain on the muscles, pain and signs of inflammation. Usually it affects people above 30 years.

Patients liable to develop tennis elbow are

  • Improper using rackets
  • Using saws and knives in cutting of trees and meat
  • Carpenters
  • Computer type writers and mouse using
  • Painters
  • Plumbers
  • Playing music

Clinical features of tennis elbow

  • The commonest symptom is pain and burning sensation at the elbow joint that would be worse by continuation of using the muscles in a wrong manner.
  • Patient may have tender or swollen elbow or experience difficult flexion and gripping also.
Tennis player

Methods of prevention

The persons at risk of developing tennis elbow should learn the appropriate use of their muscles.

For example: tennis game players should know the appropriate use of their muscles and how to perform the accurate contraction and movement of the wrist and forearm.

One who is at risk should try to keep their hand flat during their work and to flex the elbow during movement of the forearm.

Practicing some physical exercises to increase the strength of muscles of the forearm and prevent the muscle spasm

Helpful exercises

Towel twisting

You can hold the two ends of a folded towel by your two hands, and twist the towel by your hands in opposite direction as if you want to get water out of the towel. This exercise is done with the shoulders are relaxed and elbows are flexed

Elbow bend

It is a simple exercise done by easy slow flexion of the elbow from the extension position, till the fingers touch the shoulder, then extend it and repeat the exercise several times.

Wrist turn with lifting weight

Is done by gripping a hand dumbbell, flex the elbow and slowly flex the wrist towards the shoulder, hold it in place then relax and repeat it at least 10 times

Hand dumbbell for tennis elbow

***This exercise can be done with the palms facing up and the without holding the dumbbell.

How to treat yourself if you are suffering from tennis elbow?

  • Have some rest of the affected limb for two weeks at least.
  • Apply cold or ice foments will reduce pain sensation and other signs of inflammation
  • Hot foments can reduce the pain felt
  • The patient can use analgesics such as non-steroidal anti-inflammatory medications for pain relief

Do you have to seek for medical advice?

You should ask for medical help if you are not sure of the diagnosis or still suffering of pain in spite of rest and analgesics.

Physiotherapy is the last resort of the management of tennis elbow: this would be an accurate solution; because the exercises done under physician’s care will prevent the strain on muscles and help to relief the spam, relax the muscles and strengthen them.

The physician may recommend using certain brace to support the elbow and allow the muscles to rest.

Differential diagnosis of tennis elbow

  • Fracture or fissure of the forearm bones
  • Tear of a tendon or ligament
  • Inflammation of the elbow joint
  • Entrapment of a nerve like carpal tunnel syndrome, but the patient may experience numbness sensation
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