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Lateral Epicondylitis Of The Elbow

Lateral Epicondylitis Of The Elbow
Lateral Epicondylitis Of The Elbow

Tennis Isn’t Always The Cause Of Tennis Elbow

Lateral epicondylitis also commonly known as tennis elbow is a relatively prevalent condition particularly in adults between 30 and 50 years of age. Despite its name less than 5% of cases are actually linked to playing tennis.
Other Common Causes Of Lateral Epicondylitis Include:

  • Any excessive gripping or wringing activities.
  • Unaccustomed activity involving the hands such as painting or general carpentry including hammering, using a screwdriver or sawing…
  • Playing musical instruments.
  • Weight lifting.
  • Cricket, golf, baseball, hockey…
  • Excessive typing

If the individual has insufficient forearm muscle strength or conditioning for performing the above (or similar) activities, poor technique during the activities coupled with overloading the tissue by going to heavy too soon, to much at one time or not enough recovery time for the tissues between successive loading periods this can all cause stress to the tissues and lead to the onset lateral epicondylitis.

Loading Changes Within A Tennis Game That Could Cause Tennis Elbow

The above loading risk also applies to tennis or other racquet sports such as squash, badminton or racquet ball as a cause:

  • Changing racquet and racquet weight.
  • Changing grip size.
  • Changing grip technique.
  • Playing on a different surface.
  • A change in ball weight (playing tennis in the wet with heavy tennis balls).
  • Changing playing partner (playing someone who hits harder).
  • Altering playing frequency.
  • Changing your stroke technique, such as trying to go from a double handed backhand to a single handed backhand technique.
  • Taking up tennis as a new sport or returning to playing after an extended hiatus

Among other things the above situations in tennis can all play a role in the sport being a potential cause of lateral epicondylitis and elbow pain.

Acute Verses Chronic Lateral Epicondylitis

Acute lateral epicondylitis as a result of over loading the tissue may have inflammation follow the injury, which leads to swelling and elbow pain. This can occur to normal healthy tissue that is overloaded where more force is applied to an area than the normal healthy tissues can handle. But this inflammation may also occur as an acute on chronic problem, where there is a chronic non-inflammatory tennis elbow that is again overloaded with more force than the tissue (this time tissue of poor health) can cope with and sets of acute inflammation in the area on top of an old chronic tennis elbow complaint.

Unlike an acute lateral epicondylitis, chronic tennis elbow is not actually due to inflammation but is associated with degenerative changes in the tissue around the lateral epicondyle. Hence although lateral epicondylitis is frequently used as the medical term for all tennis elbow conditions this refers to inflammation of the lateral epicondyle it is not accurately representing what we now understand is frequently going on at the tendon. Testing of chronic tennis elbow sufferers has shown no evidence of the chemicals normally associated with inflammation. Instead, you see degenerative changes in the extensor tendon, where the tendon structure starts to break down. A blanket term of extensor tendinopathy would be more accurate covering the possibility of there being inflammation, degeneration and or tears of the tendon tissue.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Lateral Epicondylitis Of The Elbow should consult his or her physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.


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