What is Lateral Epicondylitis?
Lateral epicondylitis/tendinopathy, also commonly known as “Tennis Elbow”, is one of the most common conditions found with elbow pain. It is a painful condition caused by overuse of the extensor muscles of the forearm resulting in inflammation/irritation to the tendons. The extensor muscles of the forearm originate to the outside side of the elbow. Pain from the elbow can also radiate down towards the forearm and wrist.
The elbow is made up of 3 bones: humerus, radius, and ulna. At the end of the humerus there are two bony prominence, one lateral (outside) and one medial (inside). Tenderness upon palpation is usually found at the lateral side of the elbow. It is common to have the extensor carpi radialis brevis (ECRB) involved, however, other extensors like the extensor digitorum, extensor carpi radialis longus, and extensor capri ulnaris can also be involved.
The extensor tendons mentioned above undergo a contractile overload/stress with repetitive upper extremity activities including but not limited to computer/desk work, heavy lifting, electricians, pronation/supination, sports (i.e. baseball, golf, etc). These activities listed typically involve wrist extension as well as pronation/supination during the movements. It is observed that individuals with lateral epicondylitis, often have strength and flexibility deficits to the wrist extensor and posterior shoulder muscles. In addition, individuals will report weakness in grip strength or difficulty carrying objects (i.e. groceries) while elbow extended. Furthermore, finger extensor and supinator weakness can also be present.
In terms of demographics, lateral epicondylitis is equally common in both sexes between the ages of 30-50 yrs. Development of injury and intensity of symptoms range from faint pain a few hours after the aggravating activity to constant pain inhibiting any activity.
Physical Therapy for Lateral Epicondylitis
General conservative management methods may include: education on pain control and/or modification of activities, ice, massage, laser, TENS, and exercises involving strengthening and stretching.
Physical therapy can design and prescribe specific exercises and stretches to help obtain specific therapeutic goals. The goal of therapy is to restore normal muscular function and reduce pain by improving strength, stamina, and mobility to the forearm and wrist.