[Muscle Monday] How Can I Have Tennis Elbow If I Don't Even Play Tennis?

With summer in full force, we're all looking for ways to get out, stay active and get some much-needed Vitamin D.  As we venture outdoors and get back into various types of physical activities, it's always important to do it gradually.  Weekend warrior-ing is totally fine and acceptable, as long as you are a smart and wise warrior.

One of the more common injuries people experience in the upper portion of their bodies is the infamous "tennis elbow", AKA Lateral Epicondylitis.  "Tennis Elbow" is a bit of a misnomer, because only 10% of the patients who suffer this injury actually attribute the pain to playing this sport (source).  This week, we introduce the muscles that are affected in this condition - Extensor Carpi Radialis Longus (green) and Brevis (red).

Image Credit: Kenhub.com

A lot of times, you hear the term "tendinitis" thrown around.  Tendinitis merely describes "inflammation of the tendon" but doesn't necessarily tell you which muscle tissues are hot and angry at you.  Where the symptoms are, tells you a lot about which muscles need the most help.  Lateral epicondylitis is one of the most common overuse injuries in the upper body.  It describes tendinitis of the common extensor tendon which attaches on the outside (lateral) of your elbow​.  The Extensor Carpi Radialis Longus (ECRL) and Brevis (ECRB) both share this common extensor tendon, but attach at different points in the hand.  ECRB attaches on the middle/long finger and the ECRL attaches on the index finger.  Both work to extend the wrist and their corresponding fingers.  

Of the two, the muscle that is most commonly affected in lateral epicondylitis is the ECRB.  Both wrist extensors are responsible for assisting with gripping in order to stabilize the wrist while the wrist/finger flexors are working to hold the object. 

People with tennis elbow will typically present pain in the lateral elbow with any/all of the following activities:

• Gripping
• Wrist extension
• Elbow extension
  

As previously mentioned, this injury is most commonly a result of overuse and not due to trauma (although I suppose anything is possible....)  Think in terms of a grocery clerk scanning items for several hours in a shift, practicing an instrument for several hours, using a computer mouse for long periods of time, etc.  People with lateral epicondylitis will commonly have pain with lifting a coffee mug, carrying a bag/briefcase (does anyone actually own briefcases anymore??), playing an instrument, and... dare I say it?  Playing tennis....

The good news is that this condition can typically be overcome with the right amount of rest, modification of your activities and guidance from your friendly physical therapist.  Make sure that you give your muscles a break and don't abuse them too much.  Or, if you do an activity or job that requires you to use these muscles a lot, make sure you treat them to some TLC afterwards.