Tennis Elbow

• Most common cause for elbow symptoms in patients with elbow pain

• Commonly in dominant arm

• Inflammation leads to tendinosis at origin of Extensor Carpi Radialis Brevis (ECRB). May also involve microtears of Extensor carpi Radialis Longus (ECRL) and Extensor Carpi Ulnaris (ECU)

• Clinical findings

  • Pain on palpation 3-4 cm distal and anterior to the lateral epicondyle

  • Pain with resisted third-finger extension or wrist extension (elbow should be fully extended)

  • Pain with resisted forearm supination

  • Radial tunnel syndrome is present in 5% of the cass ( compressive neuropathy of the posterior interosseous nerve ( no motor or sensory dysfcuntion ( EMG not useful).

• TTT

  • Activity modification, ice, NSAIDS, physicial therapy, extracorporeal chock wave therapy, steroids injection

  • Surgery  : release and debridement of ECRB origin