Tennis elbow: biomechanics of the cause

One of the most well-known medical conditions that is popularly used is tennis elbow, or lateral epicondylitis. So everyone has heard of it several times, but what percentage of these people really know what this problem entails and how it arises? Here’s an attempt to increase this percentage…

Tendinitis vs tendinosis

The medical synonym for tennis elbow is lateral epicondylitis. As a general rule in the medical world, any condition ending in -itis indicates inflammation. However, epicondylitis is the exception that proves the rule. The name epicondylitis would indicate an inflammation in this case of the tendons of the wrist extensor muscles or tendonitis, while this is actually a tendinosis (irritation of the tendon tissue).

The emergence

We already know that tennis elbow refers to irritation of the tendons of the wrist extensors on the outside of the elbow. Logically it is assumed that tennis elbow occurs almost exclusively in tennis players. However, none of that is true! This condition is caused by playing tennis in only 5% of patients.

Tennis used to be a real summer sport. When temperatures started to drop and the necessary precipitation entered our country, the rackets were neatly put away again. With the arrival of spring, many tennis fans started to enjoy themselves on the court again after a winter break. As a result, people often had to deal with overload of the wrist extensors due to a sudden activity that was too strenuous. During that period, tennis elbow was very common among tennis players. The fact is that these days tennis players no longer take winter rest and can play all year round as a result of indoor tennis complexes becoming affordable. A sudden overload is therefore induced less often.

As mentioned above, nowadays only 5% of cases are caused by playing tennis. The other 95% is caused by a wide variety of activities in which the gripping function of the hand is central. This gripping function is of course used countless times (think, for example, of wringing out a dish cloth, pushing down a door handle, etc.).

The biomechanics behind its origins

If we want to clamp the racket firmly in the hand, the finger flexors (which also bend the wrist) must provide considerable force. These muscles are therefore activated, the fingers close strongly around the racket but also bend the wrist. If one played tennis with a constantly bent wrist, not many balls would be returned nicely. The wrist extensors/wrist extensors are therefore used to reduce the wrist joint to a neutral position. If you are not used to delivering that force, overload and therefore irritation will occur.

A cause that many believe also plays a role is poor physiological blood flow in that area. The damaged tendon tissue must be repaired by the body. That is why the blood removes damaged substances and supplies constructive substances. However, due to poor blood circulation in that area, this process takes place at a substandard pace, resulting in poor healing.