What is it?
Tennis elbow is the greatly loathed companion of many players. It is clinically referred to as lateral epicondylitis, which is believed to be a series of micro-tears occurring in the tendons of the forearm attaching to the elbow. The result, as many players have experienced, is inflammation and pain in the elbow region.

The structure involved with "tennis elbow" is the musclotendonis junction, which allows extension of the wrist and gripping motion of the hand. The most common structure involved is the extensor carpi radialis brevis tendon and is located on the outside of the elbow.

When are you at risk?
The micro-tears -- or degeneration of tennis elbow -- are caused by repetitive movements such as gripping (a racket) and twisting. In tennis, the most common activity that causes this injury is the backhand stroke.

The backhand stroke is the most common cause for tennis elbow.(Allsport)

What are the symptoms of tennis elbow?
Primary complaints: Tenderness along the outside of the elbow and tightness down the forearm. The pain worsens with gripping or wrist extension movements. At onset, the pain may increase during specific activities, like hitting a backhand. As the condition worsens, non-athletic activities may be affected too (such as picking up a cup of coffee or turning doorknobs).
Secondary complaints: Weakness with wrist extension and gripping activities and loss of range of motion of the elbow and wrist.

How do I know if it is tennis elbow that is causing my pain?
It is important to have a proper diagnosis by a physician specializing in orthopedics and/or sports medicine. The diagnosis is made by an examination of the shoulder, elbow, wrist and hand.

If the condition is not responding to treatment, further tests may be needed to rule out radial tunnel syndrome, which can present itself similar to tennis elbow.

Why does it occur?
Tennis elbow can occur due to a variety of factors:

• Improper selection of equipment, including type and fit (stiff racquets, high string tension and improper grip size)
• Poor stroke technique (wrist extension or flipping the ball on contact)
• Poor lower body positioning or mechanics on the court
• Poor training routine resulting in lack of strength and flexibility
• Repetitive wrist and forearm movement and overuse
• Overload from sports or work activities
• Change in activity from usual routine

Kathleen A. Stroia, MS, PT, A.T.,C. is the Associate Vice President of Sports Sciences and Medicine for the WTA. Miss Stroia earned a B.A. in Athletic Training from Purdue University, an M.S. in Athletic Training from West Virginia University and a B.S. in Physical Therapy from Chicago Medical School. Her position with the WTA includes setting standards for tournament physicians and overseeing the tour's Player Development Program.

Injury Prevention Archive