Lateral Epicondylitis

Pathophysiology

Also known as tennis elbow is an overload of the tendon which attaches to the lateral epicondyle which is a bony prominence on the outside of the elbow. Tendon attaches muscle to bone which is why pain can also radiate into the forearm muscle on activity. Generally affects those aged 30-50 years.

Symptoms

  • Pain over the outside of the elbow which may radiate into the forearm
  • Pain on lifting, twisting, wrist extension and gripping tasks e.g. turning keys, lifting kettle
  • Worse with repetitive actions e.g. jobs such as chef’s or gardener’s
  • Weakness in gripping activities
  • Movement of the elbow generally full although painful

Management

  • Activity modification
  • Ice or heat
  • Pain relief
  • Physiotherapy to include range of movement exercises and strengthening exercises
  • Tennis elbow brace to wear when performing aggravating activities
  • Orthopaedic options include injection if symptoms not improving in expected timeframes

Investigations

  • Generally not appropriate

Helpful Documents

Exercises to try:

Wrist extension

Wrist Extension Exercise 

Sitting next to a table with your forearm supported 

Your wrist and hand should be over the edge (with or without a weight)

Palm facing downwards

Slowly raise your wrist up and return to the starting position

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