External epicondylitis of the elbow (Tennis elbow) belongs to the injuries due to overuse. More specifically, the extensor muscles of the wrist and fingers that emerge from the outer surface of the elbow (outer epicondyle) are the ones affected. The repeated loading of these tendons under resistance, as happens in the backhand stroke in tennis, gradually leads to microtears in the extensor tendons, while the extensor carpi brevis tendon seems to be mainly affected.
External epicondylitis is not tendonitis, but an overuse syndrome. This means that it is not an inflammation of the extensor muscles, but a process of continuous micro-injuries to them. The body is constantly trying to heal and rebuild these tendons and for this reason histologically, there is a disorganization of the collagen architecture, hypertrophy of fibroblasts and hyperplasia of the vessels in the area.
Symptoms of external epicondylitis are:
- pain on the outside of the elbow on extension of the wrist and fingers that worsens with fatigue;
- muscle weakness in movements, such as that of grasping.
In some cases, however, there may be pain even during simple daily activities.
The diagnosis is based on the clinical examination, where with stress tests of the wrist and finger extensors, the symptoms are reproduced. Imaging is not necessary, but in some cases an electromyogram may be needed to rule out other conditions, such as entrapment of the sciatic nerve branch.
The treatment is basically conservative and includes modification of the sports technique, transverse massage, use of Kinesio Tape, special Manual Therapy & Mulligan techniques and obviously therapeutic exercise, etc.
