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Tennis Elbow (Lateral Epicondylitis) is a condition when the outer part of the elbow becomes painful and tender, usually as a result of a specific strain, overuse, or a direct bang.

Symptoms

The outer part of the elbow is painful and tender to touch. Movements of the elbow, and also movements which involve lifting, with the hand on top, hurt.

Possible Causes

Although called tennis elbow, lateral epicondylitis is also commonly seen in people who are over using their arm doing every day activities.

The most common cause is over use of the muscles which are attached to the bone at this part of the elbow. These muscles pull the hand backwards (the wrist extensors). All the extensor muscles of the hand attach to the elbow at the outer part (the lateral epicondyle). If they are strained or over used they become inflamed, which means they are swollen, painful and tender to touch.

Commonly experienced by the amateur player, this injury can be a result of :

• A one-handed backhand with poor technique (the ball is hit with the front of the shoulder up and power generated from the forearm muscles)
• A late forehand swing preparation with resulting wrist snap to bring the racquet head perpendicular to the ball
• While serving, the ball is hit with full power and speed with wrist pronation (palm turned downward) and wrist snap which increases the stress on the already taught extensor tendons.

Sometimes the inflammation is caused by a direct injury or bang. Sometimes, especially when the cause is direct injury or strain, the muscles are actually partially torn.

Diagnosis

Your doctor or physiotherapist will test for tenderness over or near to the bony bump on the outside of the elbow. He or she will also test to see whether the pain gets worse when you bend the wrist back (extend it) against resistance. In the event of both these signs being present, it is likely that you have tennis elbow.

Your doctor may also examine your neck, as this may be the cause, or part of the problem. After all many of the things that might strain your elbow might also put a strain on your neck.

Treatment

• Rest helps, with avoidance of the activities which over use the elbow.

• Physiotherapy treatments, which may include heat or ultrasound therapy.
• Use of anti inflammatory drugs and ordinary pain killers (analgesics).
• Your doctor may suggest an injection of a small dose of steroid to the affected area. This is not the sort of steroid banned for athletes. If used it can last for up to three months, and although it may need to be repeated you seldom need more than two or possibly three injections.
• You can buy a brace from a sports shop or pharmaceutical supplier, which can be helpful. This is probably largely because it reduces the amount you can use your elbow.