Tennis elbow not just for the Serena Williams’ of the world

"Tennis elbow" has less to do with tennis as you might think. This painful condition, in more medical terms referred to as "lateral epicondylitis," develops on the outer portions of the elbow as a result of repetitive overuse.

During the warm weather months when people are more active, we commonly see in our office an increase of "over use" injuries and tendinitis, especially tennis elbow. Interesting enough, everyone seems to have at least heard of this condition, but not many can actually describe what it is.

Did you know that you can get "tennis elbow" without ever lifting a tennis racquet in your life? It can result from simple repetitive activity where an elbow is bent and straightened with the wrist bent and hand turned.

Lateral epicondylitis is a tendinitis of the common extensor origin to the fingers (EDC- Extensor DigitorumCommunis). This tendon begins at the prominent bone around the elbow called lateral epicondyle; it then turns into a muscle belly around the forearm and then thins out into a tendon again and helps extend the fingers, especially the long finger.

Lateral epicondylitis occurs in approximately 1-3% of population annually. Men and women are equally affected. Typically it affects individuals after the age of 40, but it does occur in younger age groups.

Although this condition can come from playing tennis, it may also arise from other racquet sports, fencing, weight lifting etc. Repetitive activity at work such as carpentry, typing, raking, and painting are also common culprits. This past winter we saw a lot of patients complaining of elbow pain from shoveling snow.

Patients usually present with significant pain on the outer surface of the elbow about 1.5 inches below the elbow bone (lateral epicondyle). We usually will perform several provocative maneuvers in the office to confirm the diagnosis. One of them is pain with resisted wrist flexion, hand supination (rotating the hand so the palm faces up) and long finger extension.

Other than history of presentation and physical exam, additional studies may be needed, and plain radiographs may be required in cases of previous injury to the elbow or suspicion for underlying osteoarthritis (degeneration of cartilage and bone). MRI imaging of the elbow may be needed in cases of failed conservative treatment or recent injury to rule out extensor tendon tear or other soft tissue trauma.

Good news is that only about 5% of patients with lateral epicondylitis will require surgery. Most cases are treated conservatively with different types of injections, physical therapy, medications and bracing. Some types of lateral epicondylitis may resolve without any intervention.

Read more Sports Doc for Sports Medicine and Fitness.