Lateral elbow tendinitis -- also called lateral epicondylitis or tennis elbow -- is a condition affecting tendons that attach to the outside of the elbow. Commonly caused by overuse of muscles that move the wrist, elbow tendinitis significantly impacts daily function. Therapeutic exercises specifically structured to address the injured area are used to restore movement and strength to improve function.
The extensor muscles bend the wrist backward and straighten the fingers. A large tendon called the common extensor tendon connects these muscles to the lateral epicondyle -- the pointy bone on the outside of the elbow. Lateral elbow tendinitis develops from overuse of these muscles, typically activities that require repeated wrist movements combined with gripping. Lateral elbow tendinitis was traditionally thought to be caused by inflammation of the common extensor tendon on the outside of the elbow. However, according to a study published in 2008 in "Clinical Orthopaedics and Related Research," little to no inflammation was present when the tissue was examined. It is now believed that this condition is caused by microtears in a portion of the common extensor tendon.
Forearm stretches reduce pain and tightness in the forearm extensor muscles. Although there are many variations of these exercises, they are frequently held for 20 to 30 seconds and repeated three times in a row, two to three times each day. The affected arm is held out in front of the body in a palm-down position with the elbow straight. The opposite hand applies gentle pressure to the back of the hand, pressing the fingers down toward the floor until a stretch is felt along the back of the forearm. Stretching should not be painful -- this is a sign of overstretching, which can lead to muscle damage.
Weak forearm muscles can increase strain on the tendons, leading to tendinitis. Therapeutic exercise programs strengthen multiple wrist and forearm muscles that attach to the elbow. The flexors -- muscles that bend the fingers and wrist -- are strengthened with wrist curls in a palm-up position. This position is held for approximately three seconds, then lowered back down. Wrist curls in a palm-down position target the extensors. A small bottle of water held in the palm can provide resistance for these exercises. A hammer can be used to strengthen forearm rotation by holding the handle and slowly rotating into a palm-up and palm-down position with the elbow bent to 90 degrees and held next to the body. Many variations of these programs are available. However, these exercises are frequently performed in sets of 10 repetitions, up to three sets in a row, one to two times each day.
Although the muscles that perform gripping are located on the opposite side of the elbow, they often become weak, as the arm is used less due to lateral elbow tendinitis. Squeezing a tennis ball or therapy putty, or using equipment designed to increase grip are options for this exercise. Grip exercises can be performed for five minutes at a time, several times each day.
- Clinical Orthopaedics and Related Research: Treatment of Tendinopathy -- What Works, What Does Not, and What is on the Horizon
- Journal of Orthopaedic Science: Current Concepts of Elbow-Joint Disorders and their Treatment
- The Journal of the Canadian Chiropractic Association: Lateral Epicondylosis and Calcific Tendonitis in a Golfer -- A Case Report and Literature Review
- National Institute of Sports Medicine and Athletic Trauma: Tennis Elbow -- Lateral and Medial Epicondylitis
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