Pathology - Tennis Elbow

Tennis Elbow

Etiology - Tennis elbow, also called lateral epicondylitis is a very common injury that results from overuse, injury. It can be caused by any repetitive movements that involves bending the wrist in a turning or backwards motion (e.g., tennis, painting, hammering, using a screwdriver). In some cases, no specific cause can be found. (Canada.com, 1996-2009)

Pathogenesis - The cellular or tissue damage/changes that occur that cause the injury “tennis elbow” is thought to be the forming of small tears in the tendons specifically, the extensor carpi radialis brevis that attach forearm muscles to the humerus bone at the elbow joint. (J, Cluett, 20/03/2009). From these tears they restrict movement and inflict pain, they also lead to the formation of scar tissue and calcium deposits therefore putting a lot of pressure on the muscles and nerves that can cut off blood flow to those areas (B, Walker 1999).

Morphological - Morphological abnormalities were significantly more frequent in patients than controls and included moth-eaten fibres, fibre necrosis and signs of muscle fibre regeneration as well as higher percentages of the fast-twitch oxidative (type 2A) fibre type. (B, Ljung, R, Lieber and J Friden 29/4/2002)


Histological - Some of the histological effects in tennis elbow are, the area affected area shows raised levels of neurochemicals including glutamate, substance
P, and calcitonin gene-related peptide in patients with chronic tennis elbow, Their presence provides an alternative mechanism for
pain mediation, despite the absence of inflammation (J, Fedorczyk)


Epidemiology

Incidence -About 5 in 1000 adults develop tennis elbow each year (Medical conditions, 02/2009)

Prevalence- At any one time tennis elbow on average affects 1% to 3% of the population overall (Web MD, 2005-09)

References

B, Ljung, R, Lieber and J Friden, (29/042002). Science Direct: Wrist Extensor Muscle Pathology in Lateral Epicondylitis.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJM-45PM9WX-8&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b3aa9d70a4b833f57cd5dcbb52a8a496

Jane M. Fedorczyk. Tennis Elbow: Blending Basic Science with Clinical Practice
http://idea.library.drexel.edu/bitstream/1860/2606/1/2006175372.pdf

J, Cluett, M.D, (20/03/2009). About.com: Orthopedics- Tennis Elbow. Retrieved 1st of April 2009
http://orthopedics.about.com/cs/elbow/a/tenniselbow.htm

Tennis Elbow, (02/2009). Medical conditions. Retrieved 1st of April 2009 http://www.surgerydoor.co.uk/medcons/detail.asp?Recno=23068837

Tennis Elbow, (1996-2009)., Canada.com Retrieved 1st of April 2009 http://bodyandhealth.canada.com/condition_info_details.asp?disease_id=318

Walker, B, (1999). The Stretching Institute. Tennis Elbow: Guide to the treatment and prevention of tennis elbow. Retrieved 1st of April 2009 www.thestretchinghandbook.com/archives/tennis-elbow.php

Web MD, (2005-09). Osteoarthritis Guide: Arthritis and Tennis Elbow. Retrieved 1st of April 2009 from http://www.webmd.com/osteoarthritis/guide/tennis-elbow