Elbow > Tennis Elbow

What is a Lateral Epicondyle?

The two bony bumps where the bottom of your upper-arm bone (humerus) meets the elbow joint are called epicondyles. The muscles that bend your wrist backward, called extensors, run along the outside of your forearm and attach to the elbow’s outer bony bump (lateral epicondyle).
Tennis elbow is a common form of tendinitis around the bony bump on the outside of the elbow. It strikes the extensor tendon that connects the wrist extensor muscles in the forearm to the lateral epicondyle. Overuse of the wrist extensor muscles pulls on the extensor tendon, and gradually tears the connection between the elbow and forearm muscles.

Orthopedic Evaluation [top]

There are usually three parts to an orthopedic evaluation: medical history, a physical examination, and tests that your doctor may order.


Your physician likely will ask about your activities, which may be causing the pain in your elbow. He or she will probably ask when the soreness and/or pain began. If you have had any prior elbow injuries, your physician will ask about the treatments you have tried in the past.


Your physician will feel around the bony bump on the outside of your elbow to see if you have tenderness there. Physicians may use a series of physical tests to determine the extent of your tennis elbow pain:

   Coffee cup test ­ you lift a coffee cup or a textbook gripped as you would a coffee cup.

   Chair test ­ while standing with the elbow straight, you are asked to lift a chair off the ground.

   Resisted finger extension ­ with your arm extended in front of you, your elbow straight and your palm down, your physician asks you to push up with your middle finger as it is held steady.

   Resisted wrist extension ­ with an extended arm and palm down, your physician asks you to bend your wrist backwards as resistance is applied to the back of your hand.

Your doctor also may test the flexibility of the tendon that connects the forearm muscles to the outside of your elbow by lifting your arm and bending your elbow. TESTS X-rays of the elbow usually are not necessary to diagnose tennis elbow. But they may be ordered if your physician suspects that joint disease or a tumor could be causing the pain.


Imaging techniques

Considerations [top]

If left untreated, tennis elbow can lead to increased stiffness and weakness of the forearm muscles. The tendon that attaches the forearm muscles to the elbow may become more brittle. This can be caused by deposits of calcium salts that harden tissue in the elbow, or possibly arthritis and joint degeneration. Non-surgical treatment with rest, medication, ice, and physical therapy usually is effective for healing tennis elbow. In rare cases, surgery to repair and stimulate blood flow through the tendon may be prescribed.

Rest, Ice, Physical Therapy
Surgical Debridement

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