Tennis Elbow
(Lateral Epicondylitis)

The cause of tennis elbow is Tendinitis (inflammation of a tendon) a very common disorder affecting the elbow. The tendon most commonly affected is the extensor carpi (pronounced CAR-pee) radialis brevis (located on the back of the forearm at the elbow joint).

When this tendon or other tendons on the back of the forearm become irritated and inflammed it is referred to as tennis elbow or medically, lateral epicondylitis.

This disorder is by no means limited to those who play tennis. It can develop because of direct trauma to the elbow, i.e. falling on it or because of a repetitive, overuse activity that involves the muscles on the back of the forearm. The muscles on the back of the forearm, called extensors, travel from the elbow joint to the hand. When contracted, these muscles will straighten and bend the wrist and fingers up. So you could imagine any activity that uses the muscles on a regular basis repetively can cause a this disorder.

Pain comes from tiny tears in a part of the tendon and muscle. As the body is healing scar tissue is laid down. Scar tissue is not very flexible and is easily torn once activity starts up again.

Tendons (attach muscle to bone)have very little blood supply to them. Less blood means less nutrients and oxygen resulting in longer healing times. A tennis elbow can take months or sometimes years to heal completely if not treated properly.

Differentiating tennis elbow or lateral epicondylitis from other elbow conditions is quite simple. There is no visual swelling (like a bursitis)at the outside elbow bone present and the pain is quite localized to the area. However, pain can travel down the forearm to the hand and can be accompanied with some tingling.

Shaking hands, turning door knobs, lifting briefcases, holding a phone while talking can all cause significant elbow pain if you have a tennis elbow.

Treatment of Tennis Elbow

Rest is key, initially. Ice the elbow using an ice pack, frozen bag of peas or ice massage with a large ice cube. In my experience sending a patient home with ice massage instructions seems to be superior to other icing procedures.

Take a styrofoam cup filled with water and freeze it. Peel the styrofoam back and apply the ice directly to the elbow. Massage with small circles for eight minutes or until it is numb. (you will experience four stages of discomfort while doing it - remember the four stages by the acronym C.B.A.N. - cooling - burning - aching - numbness).

For some people the fourth stage, numbness, does not come soon enough. If you tough it out, you will get relief sooner).

Don't forget - if you reach numbness before eight minutes you can remove the ice.

Stretch out the forearm muscles on the front of the arm. Holding your arm out in front of you with your elbow straight and palm up, grab your fingers with your "good" hand and pull towards the floor. Hold the stretch for 15 seconds and do it 100X/day or as many as you can muster.

Wear a tennis elbow brace. This allows the painfull areas to heal quicker by not permitting the area to be stressed on a regular basis.

If all the recommendations above fail, seek out a chiropractor knowledgeable in treating upper and lower extremity dysfunction. Dr. Moore has studied extensively in upper and lower extremity dysfunction and has treated hundreds of people with tennis elbow successfully.

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