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Lateral Epicondylitis / Tennis Elbow
Definition: Lateral epicondylitis is the result of inflammation at the common wrist extensor origin.
Causes: The primary cause of lateral epicondylitis is due to repeated mechanical stresses. Racket sports are one of the major causes of this condition. Not only do racket sports involve repeated dorsiflexion of the wrist but the leverage is increased by the racket itself. Another important cause of lateral epicondylitis is hypertonic wrist flexors leading to increased passive tension when the wrist has to be extended, thereby putting extra stress on the extensors. Other common causes include repetitive motions of the wrist or sustained postures of wrist extension with functionally shortened extensors, as is the case when using a computer mouse.
Examination: Patients will usually present with localised pain over the lateral epicondyle. Pain is commonly aggravated by movements involving wrist extension. Observation: The lateral epicondyle may be inflamed and tender to palpation.
Orthopaedic tests for lateral epicondylitis:
Mill's test: the patient is seated with the symptomatic arm bent at 90°, and the forearm pronated. The examiner than passively flexes the patient's closed fist and instruct the patient to extend their wrist. An aggravation in symptoms indicates a positive. Pain is usually experienced in the region of the lateral epicondyle.