BACKGROUND INFO: Lateral Elbow Tendinopathy (LET) or lateral epicondylalgia or epicondylitis, is one of the most common elbow injuries. It is a common extensor tendon origin issue at the lateral epicondyle. It typically involving the Extensor Carpi Radialis Brevis (ECRB) muscle, which contributes to wrist extension and radial deviation. Most commonly people will report pain with a tennis backhand but also shaking hands, grabbing dishes, typing, gripping, writing, and lifting heavy objects.1
With true tennis elbow the issue is with the tendon. Tendinitis refers to acute overload causing damage and inflammation, or chronic degeneration that is referred to as tendinosis. These tendon changes are likely occurring because the tendon is worked and unable to fully repair/remodel before being worked again. This creates this vicious cycle of breakdown with inadequate full recovery.
It is Important to note this common extensor tendon can have degeneration without symptoms (as noted on imaging such as a MRI), but when the external load exceeds the tendon’s capacity, thats when people have symptoms. An example of this would be someone that has occasionally played tennis throughout their life decide to go out and play 6 matches in a matter of two days. Next thing you know their elbow is hot and bothered because they did too much too soon. They get a MRI done that shows inflammation and degeneration, however degeneration doesn’t just happen over a weekend, it takes more than that!
WHAT TO CHECK: There is a chance you have tennis elbow if you have pain to palpation over the lateral epicondyle, pain with gripping, pain with resisted wrist extension, middle finger extension, index finger extension, and painful stretching.
WHAT TO AVOID: People with tennis elbow may benefit from not picking things up with palm facing down and gripping heavy objects
WHAT TO EXPECT: Most cases fully resolve within a year - depends on what is involved and how involved (what is the state of the tendon). Research supports education and exercise being helpful, however there is no true consensus on exercise programming in the literature - thus we use a comprehensive approach with our program to give the best possible results!
1. Coombes BK, Bisset L, Vicenzino B. Management of lateral elbow tendinopathy: one size does not fit all. J Orthop Sports Phys Ther. 2015;45:938- 949.