Introduction-
Tennis elbow is also known as Lateral Epicondylitis. It is the most common overuse syndrome in the elbow, involving the extensor muscles of the forearm. These muscles originate on the lateral epicondyle of humerus. The muscle most affected is extensor carpi radialis brevis.
Overuse injuries occur due to Contractile overloads that chronically stress the muscle tendons. It occurs often in repetitive arm activities such as computer use, heavy lifting, forceful forearm pronation and supination, and repetitive vibration. Apart from tennis, it is commonly seen in other sports such as squash, badminton, baseball and field throwing events. People with repetitive one-sided movements in their jobs such as electricians, carpenters, gardeners, might also be affected.
Causes of tennis elbow-
It occurs due hyaline degeneration of the origin of the extensor muscle tendon.Also, Overuse of the muscles and repeated contractions put too much strain on the elbow tendons. Thus maladaptations in tendon structure occur that lead to pain over the lateral side of elbow.
Pathological insights-
Inflammation– in early stages of disease, inflammatory processes occur around the muscle tendon due to overuse.
Tearing-There is macroscopic tearing and structural failure of common extensors. This is characterised by collagen disorientation, increased proteoglycans and also by local necrosis
Degenerative Process– The condition is degenerative with increased fibroblasts, vascular hyperplasia, proteoglycans and immature collagen.
Hypovascularity– Because this tendinous region contains areas that are hypovascular, the tendinous unit is unable to respond adequately thus resulting in declining functional tolerance
Risk factors for tennis elbow-
most risk factors are occupation related.
- Handling heavy tools multiple times a day
- Arm repetitive movements for longer hours on a daily basis
- Muscle overuse
- training errors
- misalignments
- strength deficits or muscle imbalance.
The clinical scenario seen-
The most prominent symptom is pain, which can radiate upwards along the upper arm and also downwards along the forearm. Muscle strength and flexibility is reduced. Moreover, Grip strength is reduced. People might experience difficulty carrying objects in their hand, especially with the elbow extended.
Treatment options-
- NSAIDs
- Supportive brace
- Rest and activity modification in early stages
- Physical therapy exercises
- Surgery in case of severe cases
Conclusion-
Tennis elbow is the most common overuse syndrome in the elbow. It is an injury involving the extensor forearm muscles. Contractile overloads are the primary cause of tennis elbow. Non-operative management may consist of ice, elevation and the use of an elbow counterforce brace. If the symptoms are resistant, surgical treatment may be indicated. With physical therapy management, there are different types of methods to treat it, which varies between patients.
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