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TENNIS ELBOW(LATERAL EPICONDYLITIS)

TENNIS ELBOW :

Tennis elbow is is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons becomes damaged from overuse .

It happens when you work your elbow too much by repeating certain movements.

Playing tennis or other racquet sports can cause this condition , however several other sports and activities can also put you on risk.

                                        There is video of exercise attached



ANATOMY OF THE ELBOW JOINT:

Elbow joint is a joint made up of three bones:
  • Humerus(upper arm bone)
  • Two bones in forearm(radius and ulna)
There are bony bumps at the bottom of the humerus called epicondyles. 
The bony bump on the outside (lateral side) of the elbow is called lateral epicondyle.
Muscles , ligaments and tendons hold the elbow joint together.
The forearm muscles extend your wrist and fingers , the forearm tendons often called extensors attach the muscles to bone. They attach on the lateral epicondyle.
The tendon usually involved in tennis elbow is called Extensor Carpi Radialis Brevis(ECRB).

CAUSE:

OVERUSE - 

The studies show that tennis elbow is often due to damage to a specific forearm muscle. 
The ECRB muscle helps to stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke , for example when the ECRB is weakened from overuse , microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.

ACTIVITIES-

Athletes are not the one who get tennis elbow , many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forerarm muscle.

Painters, plumbers and carpenters are particularly prone to developing tennis elbow.
It is thought that the repetition and weight lifting required in these occupations leads to injury,

AGE - 

It occurs mostly between the people who are to 30 and 50 years of age , although anyone can get tennis elbow if they have the risk factors.
In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.

UNKNOWN-

It can occur without any recognized repetitive injury, this occurence is called insidious or of an unknown cause.

SYMPTOMS:

The symptoms of tennis elbow develop gradually. In most cases the pain begins as mild and slowly worsens over a week and months.
There is no specific injury associated with the start of the symptoms.

Common signs and symptoms of tennis elbow include:
  • Pain or burning on lateral side of the elbow.
  • Weak grip strength.
The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. The dominant arm is most often affected , however both arms can be affected.

DIAGNOSIS:

  • X-rays : These tests provide clear images of dense structures like bone. These may be taken to rule out arthritis of the elbow.
  • MRI : It shows details of the soft tissue and help to examine if there is any possible herniated disc or arthritis in your neck , both of these conditions often produce arm pain.
  • Electromyography(EMG) : It may help to rule out any nerve compression.

TREATMENT:

Approximately 80% to 90% of patients have tretaed with non surgical tretament.
  • REST : The first step toward recovery is to give your arm proper rest and you have to stop participating in sports or heavy work activities for several weeks.
  • NSAIDS : Drugs like aspirin or ibuprofen reduce pain and swelling
  • PHYSICAL THERAPY : Specific exercises are helpful for strengthening the muscles of the foreram. The therapist may also perform ultrasound , cryotherapy , or muscle stimulating techniques to improve muscle healing.
  • BRACE : Using a brace centered over the back of your forearm may also help releive symptoms. This can reduce symptoms by resting the muscles and tendons.
  • STEROID INJECTIONS : Steroids such as cortisone  are very effective anti- inflammatory medicines.




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