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Do you have Epicondylitis?

Are you sure you have Epicondylitis?

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Posterior view of left Humerus

EPICONDYLITIS EPICONDYLOSIS

Epicondylitis – means inflammation of the epicondyle or the structures attached to it. Epicondylosis is probably the more correct term to use as the condition is more often longstanding and this involves degenerative changes in the structures involved.

At the elbow you have two epicondyles one on the inner aspect of the lower humerus – the medial epicondyle (A in fig 1) and one on the outer aspect of the lower humerus the lateral epicondyle (B)

An epicondyle is an bony prominence near the “knuckle end” or rounded surface of the bone that forms the joint. It is there simply to make it easier for muscles or ligaments to attach close to the joint. An epicondyle is a raised bump of bone which has a greater surface area than a flat area of bone so generally you will find several muscles attached to an epicondyle because there is more space.

To control your elbow you actually have 16 muscles which cross the joint. There are four or sometimes five muscles that attach to the lateral epicondyle and four that attach to the medial epicondyle.

Lateral Epicondyle of Left Elbow

ELBOW LATERAL EPICONDYLITIS

In Elbow Lateral Epicondylitis it is the tendon of muscles on the outer elbow that may become inflamed or more likely undergo degenerative changes (generally through overuse or excessive strain) and painful whenever you use them.

The main muscles that attach to the lateral epicondyle are called :-

Extensor Carpi Radialis Brevis & Extensor Digitorum

TENNIS ELBOW LATERAL EPICONDYLITIS

Tenis elbow and lateral epicondylitis are one and the same thing with possible inflammation of the elbow tendons in the acute case, and more commonly, degeneration of the small tendons that connect these muscles to the lateral epicondyle. Tennis Elbow injuries are caused by repeated gripping tasks like DIY jobs and hitting numerous backhand volleys with bad technique. Also recently a very common cause of Tennis Elbow injury is playing the Nintendo Wii for hours. See my post on Wii Elbow.

REFERRED PAIN FROM NECK AND SHOULDER

Irritation of of the nerves in your neck from a disc bulge or some joint inflammation can cause pain to travel down your arm to the elbow and can feel like and present as Tennis Elbow.

Inflammation of soft tissues around the shoulder joint can refer pain down the arm to the elbow which can complicate the diagnosis of Tennis Elbow.

In addition there are a few sites in the arm where one of the the main nerves – the Radial Nerve – can get trapped or irritated and this specifically can replicate the pain and signs of Tennis Elbow!

Are you still sure you have Tennis Elbow?

Take my comprehensive FREE Assessment Tool HERE!

TENNIS ELBOW MUSCLES

These muscles are involved primarily in movements of the wrist and hand, but as they are attached to the humerus they cross both the wrist and elbow joints. In the body the muscles most susceptible to injury generally cross more than one joint. Think of the most common muscles to get injured and you get Hamstrings, Calf, Biceps etc – they all cross more than one joint.

The muscles attached to the lateral epicondyle are

1. Extensor Carpi Radialis Brevis
2. Extensor Digitorum
3. Supinator
4. Extensor Carpi Ulnaris

For More Information – see ESSENTIAL ANATOMY OF FOREARM MUSCLES 

or

TENNIS ELBOW – YOUR TOP 10 QUESTIONS ANSWERED