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Epicondylitis (Lateral & Medial)
Lateral Epicondylitis (Tennis Elbow)
- Occurs from excessive elbow and wrist extension.
- This injury occurs through excessive wrist extension and elbow extension (esp. in forearm supination) with gripping. Think of gripping a tennis racquet and hitting a backhand tennis stroke.
- Note that numerous activities other than tennis can induce this tendinosis (eg, house painting, carpentry, etc...)
- Pain is felt over the lateral epicondyle and radiates into the forearm and wrist.
- Strain occurs at the extensor carpi tendons (especially extensor carpi radialis brevis) at the lateral epicondyle.
- Pathology demonstrates invasion of fibrotic tissue and diminished vascularizaiton. This pathology is called chronic angiofibroblastic tendinosis.
- X-Ray may demonstrate calcifications at the injury site.
- Treatment includes:
- Rest, Brace, Stretching, & Counter-measures such as forearm pronation.
- Steroid injection
- Surgical release of the common extensor tendon, if conservative measures fail.
Medial Epicondylitis (Golfer's Elbow)
- Occurs from excessive elbow and wrist flexion.
- This injury occurs through excessive wrist and elbow flexion (esp. in forearm pronation) with gripping. Think of over-gripping a golf-club.
- Pain is felt over the medial epicondyle and radiates into the forearm and wrist.
- Strain occurs at the origins of pronator teres and flexor carpi ulnaris over the medial epicondyle.
- The pathology, X-Ray findings, and Treatment are all similar to lateral epicondylitis (except focused on the wrist flexors and forearm pronators, which attach at the medial epicondyle).