About Lateral Epicondylitis
Lateral epicondylitis, or “tennis elbow,” is an overuse injury characterized by an inflammation of the muscle tendons that attach to the outside of the elbow. The lateral epicondyle is a bone marking on the distal humerus that serves as the origin for several muscles of the forearm. Of these muscles, the extensor carpi radialis brevis (ECRB) muscle is most commonly involved with tennis elbow. When the ECRB gets weakened from overuse, micro tears can form in the tendon near the lateral epicondyle, resulting in pain and inflammation. 
As with many overuse injuries, the symptoms of lateral epicondylitis develop gradually. As symptoms worsen over time, lateral epicondylitis patients commonly report pain or burning sensations on the outside of the elbow, which may radiate to the forearm and wrist. Other common symptoms include forearm weakness, weak grip strength, and pain during simple motions such as shaking hands or turning a doorknob. Risk Factors
Unlike many overuse injuries, tennis elbow is not associated with a long list of risk factors. There does not appear to be any form of predisposition to this condition, nor is it higher in incidence among women than men. Studies have noted that most patients with lateral epicondylitis are between the ages of 30 and 50, but with overuse anyone can experience symptoms.
Though overuse is the only truly known risk factor, the forearm tendons of the lateral epicondyle can be overworked in many ways. Unsurprisingly, lateral epicondylitis has a high incidence among tennis players and generally occurs as a result of repetitive backhand strokes with poor technique. However, though the condition has earned the nickname “tennis elbow,” lateral epicondylitis very often occurs as a result of painting, plumbing, raking, and other common forearm motions. Generally speaking, individuals who perform these types of repetitive motions for at least two hours a day are at a higher risk of developing lateral epicondylitis.
Treatment
- Pain and Inflammation Relief: As with most inflammatory conditions, lateral epicondylitis can be treated at home with ice and nonsteroidal anti-inflammatory medications, such as ibuprofen or naproxen. However, tennis elbow can take 6 months to several years to go away on its own, and often times patients seek out additional treatment methods to ensure a quicker recovery.
- Physical Therapy: Physical therapy for tennis elbow focuses on strengthening the muscles of the forearm, which perform wrist extension. Stretching routines are also an important component of physical therapy.
- Corticosteroids: Corticosteroid injections can have very powerful anti-inflammatory effects and are often able to provide great amounts of pain relief in the short term. Corticosteroids can also be taken orally, or absorbed topically through treatments known as phonophoresis and iontophoresis. However, these treatments have not yet proven as effective as physical therapy exercises.
- Surgery: Only 10% of lateral epicondylitis cases progress to the point where surgery is necessary. Typical surgical procedures involve removing diseased muscle and reattaching healthy muscle to the humeral lateral epicondyle. Rehabilitation in the form of physical therapy almost always follows surgery.
An Ounce of Prevention
- Use Proper Technique: Since many lateral epicondylitis injuries do occur in tennis players, these athletes may reduce their risk of developing this painful condition by insuring proper technique in their strokes. Tennis players concerned with preventing lateral epicondylitis should consult with a coach or tennis professional to review their techniques and determine whether proper form is being maintained. Tennis players should focus on using more of their entire body in their strokes, rather than just the wrist.
- Check Equipment: Along the same lines, athletes who participate in racquet sports looking to prevent lateral epicondylitis should check to make sure they are using the right equipment for their purposes. Smaller racquets and racquets that are strung more loosely can reduce the amount of stress placed on the forearm muscles, and thus reduce the risk of developing tennis elbow.
- Stretch and Strengthen: Doing very basic exercises with free weights can be an effective way to reduce the risk of lateral epicondylitis. Simple wrist flexion and extension motions can be done at home. It is also important to do some gentle stretching exercises as part of a warm up before repetitive forearm activities.