What causes tennis elbow

Overview

Tennis elbow, medically known as lateral epicondylitis, is a common and often painful condition affecting the tendons that connect your forearm muscles to the bony prominence on the outside of your elbow. Despite its name, it doesn't only affect tennis players. Anyone who engages in repetitive motions involving the wrist and forearm can develop this condition. The pain can be mild at first but can worsen over time, potentially impacting daily activities like lifting, gripping, and even shaking hands.

What is Tennis Elbow?

Tennis elbow is an overuse injury. It occurs when the tendons that attach your forearm muscles to the outside of your elbow become inflamed and irritated. These tendons are crucial for extending your wrist and fingers, enabling you to grip objects and perform many everyday tasks. When these tendons are subjected to excessive stress, they can develop tiny tears, leading to pain and tenderness around the lateral epicondyle, the bony bump on the outside of the elbow.

Primary Causes of Tennis Elbow

The fundamental cause of tennis elbow is the repetitive strain placed on the forearm extensor muscles and their tendons. This strain can arise from a variety of activities:

1. Repetitive Motions

The most common cause is the overuse of the forearm muscles through repeated motions. In tennis, this often involves the backhand stroke, especially if executed with poor technique or excessive force. However, this principle applies to many other activities:

• Sports: Beyond tennis, sports like badminton, squash, racquetball, weightlifting, and even golf can contribute.
• Occupational Activities: Many jobs involve repetitive forearm movements. Examples include plumbers, carpenters, painters, butchers, chefs, and assembly line workers. Tasks like using a screwdriver, hammering, or lifting heavy objects repeatedly can lead to tennis elbow.
• Hobbies and DIY: Engaging in activities such as gardening, knitting, playing musical instruments (especially string instruments), or extensive computer use (typing and mouse manipulation) can also be contributing factors.

2. Sudden Injury or Trauma

While less common than overuse, a sudden forceful movement or direct blow to the outside of the elbow can also cause damage to the extensor tendons, leading to tennis elbow.

3. Poor Technique or Biomechanics

Incorrect form during sports or other activities can place undue stress on the forearm tendons. For example, using a racquet that is too heavy or has the wrong grip size, or swinging with improper body mechanics, can significantly increase the risk of developing tennis elbow.

4. Inadequate Equipment

Using equipment that is not suited for your strength or skill level can be a major contributor. In tennis, a racquet with too much string tension or a grip that is too small can increase the force transmitted to the elbow.

5. Age and Degeneration

As people age, tendons can become less flexible and more prone to injury. While tennis elbow can affect people of all ages, it is most commonly diagnosed in individuals between 30 and 50 years old, a period when degenerative changes in tendons may begin.

6. Weakness or Poor Conditioning

Muscles that are not adequately conditioned or are weak may not be able to withstand the demands placed upon them, increasing the likelihood of injury to the associated tendons. This includes a lack of flexibility and strength in the forearm and shoulder.

Risk Factors

Several factors can increase your likelihood of developing tennis elbow:

• Age: Most common between 30 and 50 years old.
• Occupation: Jobs involving repetitive arm motions.
• Activity Level: Engaging in sports or activities that require forceful or repetitive wrist and arm movements.
• Improper Technique: Poor form in sports or work.
• Inadequate Equipment: Using tools or sporting equipment that is ill-suited.

Understanding these causes and risk factors is crucial for prevention and effective management of tennis elbow. It highlights that while the name suggests a link to tennis, the condition is far more widespread and can affect a diverse range of individuals due to the prevalence of repetitive arm motions in modern life.