Tennis Elbow

What is tennis elbow?

Tennis elbow is a painful elbow disorder. This term is misleading because most people who have it did not get it from playing tennis. In fact, tennis elbow seldom has any connection with fun and games.
The technical name for tennis elbow is "lateral epicondylitis". This term indicates an inflammation occurring near a small point or projection of the upper arm bone (humerus) just above the elbow joint on the outer side of the arm. However, pain can also occur in other areas of the forearm and elbow. Some experts suggest that "lateral elbow pain syndrome" is a more accurate name, but this term is not yet commonly used.
The pain from tennis elbow comes mainly from injured or damaged tendons near the elbow. Tendons are strong bands of tissue that connect muscles to bones. When repeatedly stressed or overused, tendons can become inflamed. This results in a painful condition called tendonitis, the medical term for inflammation of a tendon. Tennis elbow is simply a specific type of tendonitis that occurs in a particular part of the elbow.

How does tennis elbow occur?

The development of tennis elbow can often be traced to the way of using the forearm muscles. These muscles control hand and wrist movements. They are attached to tendons that connect them to only two small points of bone just above the elbow, one on the outer side, the other on the inner side.
Muscles connected to the outer side of the elbow are responsible for:

• straightening the fingers,
• bending the wrist upwards,
• rolling the forearm into a palms-up position.

Muscles connected to the inner side of the elbow are responsible for:

• bending the fingers,
• bending the wrist downwards,
• rolling the forearm into a palms-down position.

There are weak points in the way tendons connect these muscles to the bone above the elbow. The points where the tendons attach are sometimes too small to handle the strong force of the powerful muscles. These tendons can get overloaded when the hand and forearm are used in strong, jerky movements such as gripping, lifting, or throwing.
Tendons do not stretch when pulled. They are rope-like structures made of strong, smooth, shiny fibres. Strong forces or sudden impacts, however, can eventually tear their fibres apart in much the same way a rope becomes frayed. This type of injury is called a strain, and usually results in formation of scar tissue. Over time, strained tendons become thickened, bumpy, and irregular. Without rest and time for the tissue to heal, strained tendons can become permanently weakened.
Damaged tendons can occur on either side of the elbow. When it happens on the outside of the elbow, which is most common, it is called tennis elbow. When it happens on the inside, it is called "medial epicondylitis" or "golfer's elbow."
No one knows exactly what causes the pain of tennis elbow. Most experts believe it is due to the small tears that develop in the tendons. Other possible causes include the development of scar-like tissue under the tendon, wear and tear of the elbow joint, or irritation and inflammation of nerves that pass near the elbow region.

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