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What is tennis elbow?

Tennis elbow is a painful condition of the elbow caused by overuse. As the name suggests, tennis elbow has long been associated with racquet sports and other physical activities that overuse the arms. In tennis, the condition is often caused by the force of the tennis racquet hitting balls in the backhand position. The forearm muscles and tendons become damaged from repeating the same motion over and over again.

In our computer age, tennis elbow also can happen to people who have never played racquet sports. The National Institutes of Health (NIH) reports that physicians are increasingly seeing tennis elbow caused by non-sports activities such as constant computer keyboard and mouse usage.

According to the American Academy of Orthopaedic Surgeons (AAOS), recent studies show that tennis elbow is often due to damage to a specific forearm muscle, the extensor carpi radialis brevis (ECRB). The ECRB helps stabilize the wrist when the elbow is straight. When the ECRB is weakened from overuse, microscopic tears form in the tendon at the point it attaches to the bony prominence on the outside of your elbow (the lateral epicondyle). These tendon tears lead to the inflammation and pain of tennis elbow, or lateral epicondylitis.

Symptoms

Common symptoms of tennis elbow include:

  • Elbow pain that gradually worsens
  • Pain or burning sensation that radiates from the outside of your elbow to your forearm and back of your hand when you try to grasp or twist something
  • Pain that increases down to your wrist, even at rest
  • Pain that occurs even with simple tasks like turning a doorknob, shaking hands or holding a coffee cup
  • Pain worsens with repetitive arm movements
  • Weak grip strength

Tennis elbow is usually diagnosed in both men and women between the ages of 30 and 50. Please note that these symptoms may resemble other medical problems or conditions. If your symptoms don’t respond to rest, ice and/or over-the-counter pain relievers, it is best to see a physician.

Causes

Causes of tennis elbow include:

  • Improper tennis backhand stroke
  • Hitting the ball off center on the racquet or hitting heavy, wet balls
  • Using a tennis racquet that is too tightly strung or too short, such as racquetball or squash racquets
  • Working in professions that use repeated hand motions such as meat cutters, musicians, dentists and carpenters
  • Painting with a brush or roller
  • Operating a chain saw
  • Frequent use of other hand tools on a continuous basis
  • Weak shoulder and wrist muscles

Treatment options

Tennis elbow treatments are typically nonsurgical, such as rest, icing, anti-inflammatory medications or corticosteroid injections. Surgery may ultimately be indicated if your condition hasn't improved after six to 12 months. Most procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to the bone. Recovery time after surgery is usually four to six months.

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