What is it?

Lateral epicondylits is the most common overuse injury of the elbow. It is an irritation of the tendons that join into a common area on the outside of the elbow. The forearm muscles become damaged from repetitive motion that leads to pain and difficulty with gripping and lifting.

Lateral epicondyltis involves the muscles and tendons of your forearm that extend your wrist and fingers. The tendons attach the muscles to the lateral epicondyle of the elbow where pain is often felt.

Why did I get it?

Risk factors:

  • Age 35 to 50 years old
  • High levels and frequent use of the wrist and hand (often from sport or work)

Symptoms

  • Lateral elbow pain
  • Weaken grip strength and difficulty lifting objects
  • Early stages: pain with activities such as grasping, pulling, carrying or lifting objects
  • If problem has been present for a longer period, a constant dull ache is common

How is it diagnosed?

A thorough clinical examination by a physiotherapist will most commonly diagnose the condition. The physiotherapist will also perform a neck assessment to rule out any referral from the cervical spine.

Treatment options

  • Activity modification: avoid pain provoking activities
  • Counterforce Brace: reduce the load on the lateral elbow and reduce pain
  • Strengthening exercises: tendons require tension and motion to promote healing
  • Injections: Physiotherapy has been shown to be more effective than a cortisone injection when followed up at 6 weeks and 52 weeks. They can be helpful initially for pain relief but repeated injections are not recommended.

Prognosis

Although lateral epicondylitis, can be extremely painful, approximately 95% of cases will respond successfully to conservative treatment. The timeframe will vary depending on how severe your pain is and how long you have had it for, however it may take up to 6 months.

Exercises:

Stage 1

  1. Self Friction
  2. Eccentric Wrist Extension

Stage 2

  1. Wrist Flexion
  2. Forearm supination/ pronation
  3. Radial/ulnar deviation
  4. Ball Squeeze

Work within pain range of mild soreness/stiffness prior exercise, NO pain during activity. Mild soreness after activity that lasts more than 24 hours

Progression:

– Begin with no weight 10 repetitions
– Slowly progress the repetitions in sets of 10 every few days as soreness allows until doing 3 sets of 10 for 2 days without increasing symptoms
– Add 1kg weight and slowly progress to 3 sets of 10 again
– Continue this progression