Also known as lateral epicondylitis, the muscle tendons that attach to the outside of the elbow function in extending the wrist. This action helps to position the arm for functions that require grip strength, such as holding a tennis racquet.
Overuse of the tendons to extend the wrist can lead to inflammation and pain at the outside of the elbow, improper muscle strength and repetitive movement of the wrist and elbow where the tendons at the elbow become stressed due to poor mechanics.
Although this is a common tennis injury, it can occur with overuse of the muscles in a lot of different sports, as well as in normal everyday function.
Weakness in the shoulder muscles can contribute to improper lifting mechanics which can lead to overuse of the wrist extensor tendons.
Signs and Symptoms
Localized pain with resisted wrist extension and passive wrist flexion
Tenderness with deep pressure on outside part of elbow
Rest, Ice Massage, NSAID’s to decrease inflammation and give tendons time to heal
Can initiate pain-free shoulder strengthening to help correct lifting mechanics after the tendons heal
Gentle soft tissue mobilization and ice massage
Stretching of extensor tendons
Thermal or electrical modalities may be used to decrease inflammation in order to promote tissue healing.
Splinting of the wrist may also be utilized to rest the muscles around the elbow during this time of healing
After pain has subsided, initiate strengthening of wrist extensor tendons
Encourage proper lifting mechanics using the shoulder instead of the elbow.
Proper positioning at computer desk with neutral wrists
Tennis elbow can be difficult to relieve if mechanics/strength issues are not addressed.
Proper backhand stroke in tennis without being making contact with the ball after neutral.
Ulnar Nerve Injury
Definition and Occurrence
The ulnar nerve travels in a small tunnel on the inside of the elbow. The path of the ulnar nerve can be felt each time the “funny bone” is hit and the pain sensation travels down the arm and into the hand. With overuse of the muscles that flex the wrist, inflammation can result that crowds the tunnel and decreases the amount of space that the nerve needs to function properly. This can lead to compression of the nerve and symptoms down the arm and into the hand.
This injury can commonly occur with baseball players who pitch sidearm and place a lot of stress on the inside part of the elbow
Signs and Symptoms
Pain (shooting, numbness, tingling) down the outside of the arm and into the fourth and fifth fingers. Often times, tapping of the tunnel which contains the nerve can bring on these symptoms
Swelling on inside part of elbow
Pain with resisted wrist flexion
Rest, Ice, NSAIDs, and activity modification
Soft tissue massage of muscles that may be crowding the space where the nerve runs
Shoulder strengthening to encourage proper lifting mechanics of the arm
After pain subsides, strengthening of muscles that flex the wrist
Stretching of wrist flexor muscles
Proper shoulder strengthening to encourage proper lifting mechanics
Proper form during striking and pitching to decrease likelyhood of overuse of muscles attaching to inside part of elbow.
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