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Tennis Elbow

Tennis elbow, which we also commonly recognize as lateral epicondylitis. This is a very painful condition. It usually occurs when there is too much strain on the contralateral side of our elbow. It is also traditionally felt by us with repeated movements of our wrists and arms. The condition of the outer part of our elbow is more affected, which causes us to feel a lot of pain and weakness, especially when we have to lift or hold something. This disease is commonly found in tennis players, but it also becomes common in other people when their muscles are being used a lot, which are the muscles of the arm.

Types:

There are no distinct types of it, but we can classify it based on its severity, two of which are important, as follows:

Acute Tennis Elbow:
Acute tennis elbow means that our arm or forearm muscles develop pain and inflammation due to recent or sudden use, and it occurs when we overuse it.

Chronic Tennis Elbow:
Chronic tennis elbow refers to pain that lasts for a long time, lasting for months. It usually occurs when we do not get proper treatment for it or when it is the result of repeated stress without rest.

Symptoms:

• Pain: Pain on the outside of the elbow is the main symptom, and it can also radiate down the arm and wrist.
• Stiffness: We feel stiffness in our elbows, which is usually worse in the morning. This usually happens when we don't do any activities for a long time.
• Tenderness: When we press on the outside of our elbow from above, we feel the tenderness.
• Weak Grip: When we hold anything or shake hands with someone or knock, we may feel our grip weaken.
• Difficulty in Activity: We find it difficult to do even simple tasks that should be easy, such as holding a cup.

Causes:

Overuse: Repetitive movement of our arm or activities that involve gripping, twisting, or lifting can cause pressure on the tendons in the elbow.

Sports Injuries: This disease usually occurs in tennis players, but it can also be caused by other sports such as weightlifting.

Occupational Activities: Many jobs require us to use hand tools or repeatedly move our wrists and arms, which can also increase our risk of developing tennis elbow.

Age: This condition can occur at any age, but it is most common in people between the ages of 30 and 50.

Physical Examination:

The first thing we will do for a patient with such a condition is to do a physical examination. The physical examination will include some of these things:

Patient History:
First, we will take complete information from the patient about their condition, in which we will ask them when the pain started, how severe it is, and how long it lasts. Then we will ask them what movements make it worse, such as repetitive movements of the wrist and arm, etc.

Palpation:
In such a patient, we will press on the outside of the elbow to check for pain and tenderness. This is a symptom of tennis elbow.

Range of Motion Test:
Motion testing means that we will examine his elbow, wrist, and shoulder and ask him to perform various movements, and any difficulty or pain he experiences in these movements may indicate tendon strain.

Imaging Studies:

Imaging is not usually necessary for this diagnosis, but we still use it to rule out other conditions or, in complicated cases, to confirm the injury.

X-ray:
We use X-rays to look for fractures or other bone problems, but they don't detect the soft tissues of tennis elbow.

Ultrasound:
By doing an ultrasound, we can assess tendon tears or inflammation around the elbow, so it is used.

MRI:
MRI stands for Magnetic Resonance Imaging. We use it when there is no improvement during treatment or the diagnosis is unclear. At this time, we perform an MRI to look at the soft tissues and detect tears or degenerative changes in the tendons. This helps us significantly in this.

Self Assessment:

Pain During Simple Tasks: We diagnose him by whether he feels pain in holding things knocking on doors, or bending his arm. If he feels this pain, it may suggest tennis elbow.

Tenderness in The Outside Elbow: If we put a little pressure on his elbow bone and he feels pain, that also points us to this disease.

Special Test:

Cozen's Test:
We use it to identify the association of pain in the ECRB. ECRB stands for Extensor Carpi Radialis Brevis. We use it to identify most of the extensor muscles of the arm.

During this test, we have the patient sit up, extend their elbow, make a fist, and then slightly turn it outward, which is called a "Muni's" motion. Then we put a small weight on their forearm, which the patient resists.

In such a situation, if the patient feels pain on the outside of his elbow, then this test gives us positive results for the tennis elbow.

Mill's Test:
This test also allows us to identify the tennis elbow when we pull the arm muscles to identify the pain.

During this test, the patient sits with his arm relaxed, and then the doctor bends his wrist from bottom to top and fully extends his elbow or straightens it. During this time, he may also rotate the arm to stretch the muscle. If this stretch causes pain in the lateral elbow region, it leads us to confirm that the test is positive.

Maudsley's Test:
During this test, we also ask the patient to extend their middle finger and then we press their finger downward. If they feel pain in the lateral elbow during this time, it also indicates a tennis elbow.

The purpose of this test is also to apply pressure to the muscle to assess whatever is attached to the lateral epicondyle.

Finger Stretch