Tennis Elbow (Lateral Epicondylitis): Symptoms, Causes and Diagnosis
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What is Tennis Elbow?
Tennis elbow also referred to as lateral epicondylitis, is caused by the overuse of muscles which connect your forearm to your elbow. It is also a degenerative condition characterised by inflammation, microscopic tears, and pain in the affected area. Despite its name, this condition does not only affect tennis players but can develop in individuals who engage in occupations or hobbies that involve repetitive movements.
What are the Symptoms of Tennis Elbow?
As the condition worsens, you may experience difficulty in performing everyday tasks which require gripping or lifting. This can cause simple actions such as holding a cup, using tools, and opening jars to be challenging.
Tennis elbow may cause the elbow joint to swell, and can be accompanied by redness and warmth.
Stiffness in the elbow joint is commonly felt after periods of rest or upon waking up in the morning. This can affect your range of motion, making it difficult to fully extend or bend your arm.
Activities that include twisting and grasping motions, such as shaking hands or turning a doorknob may worsen the condition and lead to discomfort.
What are the Differences Between Tennis Elbow and Golfer's Elbow?
Tennis elbow and golfer’s elbow are commonly mistaken for one another due to their similar names, but they are distinct conditions that affect different tendons and areas of the elbow. Below are the main differences between both conditions presented in a table.
Characteristic | Tennis Elbow | Golfer's Elbow |
|---|---|---|
Medical Term | Lateral Epicondylitis | Medial Epicondylitis |
Location of Pain | Outer side of the elbow | Inner side of the elbow |
Affected Tendons | Extensor tendons of the forearm | Flexor tendons of the forearm |
What are the Common Causes of Tennis Elbow?
Activities that involve repetitive gripping and wrist movements, such as playing tennis, painting, cutting meat, and weight lifting, can strain the tendons in the elbow over time.
Overuse or overexertion of the forearm muscles can lead to strain on the tendons. This is especially common in individuals who perform repetitive tasks or activities that require a strong grip or wrist movement. When combined with a lack of proper rest and recovery, the tendons can become inflamed and painful.
Using incorrect techniques during physical activities can also contribute to the development of tennis elbow. For example, using a backhand stroke in tennis with improper wrist position or grip can strain the tendons in the elbow. Therefore, it is important to use proper form and technique to reduce the risk of injury.
A previous injury to the elbow or forearm can increase the risk of developing tennis elbow. This is because the tendons may not heal properly after an injury, making them more susceptible to strain and injury in the future.
How is Tennis Elbow Diagnosed?
The medical professional will examine your elbow for signs of inflammation, tenderness, and swelling. You may also be guided through a series of physical tests to gauge the range of motion of your elbow. Two common tests used to diagnose tennis elbow are:
- Cozen’s Test
During the Cozen's test, your healthcare provider will instruct you to sit or stand with your forearm resting on a table and your palm facing downward. The doctor will then stabilise your forearm with one hand while placing the other hand over the back of your hand. You will be asked to extend your wrist and fingers against resistance as if you were trying to lift your hand off the doctor's hand. This action places stress on the extensor tendons of the forearm, particularly those attached to the lateral epicondyle of the elbow. If you have a tennis elbow, this manoeuvre may elicit pain or discomfort along the lateral epicondyle.
- Mill's Test
The Mill's test is performed with you seated or standing, and your arm relaxed by your side. Your healthcare provider will then passively pronate your forearm (rotate it inward), flex your wrist (bend it downward), and extend your elbow (straighten it). This combination of movements places tension on the common flexor tendon of the forearm, which attaches to the medial epicondyle of the elbow. If you have a tennis elbow, this manoeuvre can reproduce pain or discomfort near the medial epicondyle.
- MRI
An MRI can identify any tears or inflammation in the tendons by providing detailed images of the soft tissues in and around your elbow.
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- X-ray
X-rays can be used to rule out other conditions, such as fractures or arthritis, that may be causing your symptoms. While X-rays cannot show soft tissue damage, they can help assess the alignment and structure of the bones in your elbow.
How to Treat Tennis Elbow
Tennis Elbow Release
Tennis elbow release surgery is a procedure used to treat severe cases of tennis elbow that have not responded to conservative treatments.
Elbow Arthroscopic Surgery
Elbow arthroscopic surgery is a minimally invasive procedure involving the use of a tiny camera called an arthroscope, which is inserted into the elbow joint through small incisions.
Corticosteroid Injections
These injections are used to relieve redness and swelling, as well as provide temporary relief from discomfort.
platelet-Rich-Plasma (PRP) Injections
PRP injections involve injecting a concentration of the patient’s plasma into the affected.Â
Read more about Tennis Elbow treatments in Singapore.
Our Orthopaedic Doctor for Tennis Elbow Treatment
Dr. Ramesh Subramaniam
MBBS (NUS, SG) | MRCS (Edinburgh, UK) | M Med (Ortho) (NUS, SG) | FRCS (Ortho) (Edinburgh, UK)
Dr Ramesh, a fellowship-trained orthopaedic surgeon, focuses on shoulder, knee, and arthroscopic sports surgery.
Dr Ramesh obtained his MBBS and Master’s in Orthopaedic Surgery from the National University of Singapore and completed Advanced Surgical Training. He earned his Fellowship from the Royal College of Surgeons of Edinburgh in Trauma and Orthopaedics. He was awarded the HMDP scholarship for a clinical fellowship in Shoulder and Knee Surgery in Dublin, followed by the Tan Tock Seng Scholarship for a Sports Fellowship in Knee Surgery in Barcelona. He also completed a Shoulder Surgery Fellowship at Hospital Del Mar and was trained in arthroscopic joint reconstruction and joint replacement surgeries.
Are You or Your Loved Ones Suffering from Tennis Elbow?
Tennis elbow can develop into a condition that affects the daily lives of you and your loved ones. Simple activities such as turning a doorknob and drinking from a cup may become challenging as the condition worsens. Book an appointment with us at Avant Orthopaedics to receive a personalised consultation to diagnose and identify the source of your discomfort.
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