Lateral epicondylitis, also known as tennis elbow, is an injury to the outside part of the elbow which involves the wrist extensor tendons. The name “tennis elbow” comes from one-handed tennis players who, after contact with the ball, go from a concentric motion (extension of the wrist) to an eccentric contraction (rebound of the racquet).
The presence of symptoms outside of the elbow are not always a tendonitis. The term lateral “epicondylalgia” would be a better way to describe initial outside elbow pain. Other causes of lateral elbow pain include tendinopathy, joint pathology such as arthritis, a nerve entrapment, or merely a subluxation of the elbow.
Loading of the wrist extensor muscles in a forceful way through an extrinsic reaction force can gradually cause elbow pain. Over time, the excessive loading can cause inflammation in the extensor tendon, leading to lateral epicondylitis.
Although the primary stress is taken in the forearm extensor muscles during the tennis serve, it is not always the cause of the epicondylitis. It is important to have the biomechanics of the upper extremity evaluated to determine if there are muscular adhesions, trigger points, dysfunction in range of motion, and joint restrictions present that are contributing to improper functioning.
The five most common muscles involved in dysfunction associated with tennis elbow are:
- Extensor Carpi Radialis Brevis
- Extensor Carpi Radialis Longus
- Brachioradialis
- Triceps Brachii
- Supinator
Repetitive wrist extension, radial deviation, and forearm supination can cause strain to the outside of the elbow.
Injury Prevention Training for Tennis Elbow Includes:
- Supination and pronation mobility
- Concentric external rotation of the shoulder
- Eccentric internal rotation of the shoulder
- Wrist extension mobility and strengthening
Treatment Includes but is Not Limited to:
- Dry Needling: Systematic reviews show dry needling had the most positive effect on treatment
- Myofascial Techniques
- Mobilization of the Elbow
- Strengthening of the Dysfunctional Muscles in the Upper Extremity
At FRWD Sports Therapy, Dr. Cappelletti takes a comprehensive look at what is causing your elbow pain and will get you back to playing tennis or pickleball in no time!