From Wikipedia, the free encyclopedia
| Tennis elbow | |
| Classification and external resources | |
Left elbow-joint, showing posterior and radial collateral ligaments. (Lateral epicondyle visible at center.) | |
| ICD-10 | M77.1 |
| ICD-9 | 726.32 |
| DiseasesDB | 12950 |
| eMedicine | orthoped/510 pmr/64sports/59 |
| MeSH | D013716 |
Tennis elbow, also known as "Shooter's elbow" and "Archer's elbow", is a condition where the outer part of the elbowbecomes sore and tender. The accurate medical term is lateral epicondylalgia. It is a condition that is commonly associated with playing tennis and other racquet sports, though the injury can happen to almost anybody.[1]
The condition is also known as lateral epicondylitis ("inflammation to the outside elbow bone"),[2] a misnomer as histologic studies have shown no inflamatory process. Other descriptions for lateral epicondylalgia are lateral epicondylosis, or simply lateral elbow pain.
Runge is usually credited for the first description in 1873 of the condition.[3] The term tennis elbow was first used in 1883 by Major in his paper Lawn-tennis elbow[4][5]
[edit]Symptoms
- Pain on the outer part of elbow (lateral epicondyle).
- Point tenderness over the lateral epicondyle – a prominent part of the bone on the outside of the elbow.
- Gripping and movements of the wrist hurt, especially wrist extension and lifting movements.
- Activities that use the muscles that extend the wrist (e.g. pouring a pitcher or gallon of milk, lifting with the palm down) are characteristically painful.
- Morning stiffness.
tennis-elbow
The strongest risk factor for lateral epicondylosis is age. The peak incidence is between 30 to 60 years of age. No difference in incidence between men and women or association between tennis elbow and the dominant hand has been demonstrated.
The pathophysiology of lateral epicondylosis is degenerative. Non-inflammatory, chronic degenerative changes of the origin of the extensor carpi radialis brevis muscle are identified in surgical pathology specimens.[6] It is unclear if the pathology is affected by prior injection of corticosteroid.
Among tennis players, it is believed to be caused by the "repetitive nature of hitting thousands and thousands of tennis balls" which lead to tiny tears in the forearm tendon attachment at the elbow.[2]
The following speculative rationale is offered by proponents[who?] of an overuse theory of etiology: The extensor carpi radialis brevis has a small origin and does transmit large forces through its tendon during repetitive grasping. It has also been implicated as being vulnerable during shearing stresses during all movements of the forearm.
While it is commonly stated that lateral epicondlyosis is caused by repetitive microtrauma/overuse, this is a speculative etiological theory with limited scientific support that is likely overstated.[6] Other speculative risk factors for lateral epicondylosis include taking up tennis later in life, unaccustomed strenuous activity, decreased reaction times and speed and repetitive eccentric muscle contractions (controlled lengthening of a muscle group).
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