“Though we don’t think about our elbows, or how much we use them, they are crucial to the way we live our lives. Imagine not being able to ever bend your arm, or ever stretch it out,” observed orthopedic physician’s assistant Carla Robinson. Yet, when a person develops tennis elbow, he or she will probably think about the joint often. Since billions of dollars are spent on this painful condition each year, it is important to be familiar with its causes so a person may avoid such an injury.
1. Repetitive Motions
A person does not have to play tennis to suffer from this injury. One of the main causes of this condition is any type of repetitive motion involving the arm and elbow joint. In fact, when this condition was first described by German physician Dr. F. Runge in 1873, it was termed “writer’s cramp.” Later, it was known as “washer woman elbow.” Any motion that involves a repetitive strain on the tendon that connects the extensor muscle to the humerus bone of the elbow can cause this injury. This can happen when a person over exerts the elbow, forcefully overextends his or her arm, or makes a sudden strong pull with the arm.
Activities or occupations that involve repeated wrist and hand motions can overwork the elbow and its associated muscles and tendons. This includes painters, artists, butchers, and carpenters. Using plumbing tools, cutting up meat, driving screws, and using a computer mouse are all types of actions that can lead to tennis elbow. Once the tendon and muscle is injured, it will cause severe pain to the outside of the elbow, where the tendon attaches to the bone. The pain can even spread down the arm and toward the hand. It can make it painful to shake hands, twist a door knob, or hold a cup of coffee.
2. Overuse
This condition often is caused by overuse of the arm, wrist, and hand in certain activities. When a person over uses the forearm muscles that pull the wrist back from the palm, the tendons can become inflamed with small tears developing. Since many sports require extensive practice to develop the skills and strength necessary for competition, athletes are especially susceptible to tennis elbow. Occupational activities like painting with a brush or using a chainsaw also can lead to overuse injuries like this condition. Fortunately, the damage to the muscles and tendons can be reversed often just with rest of the arm and joint. Improvement can be seen in as short at two to three weeks. At times, more aggressive treatment is necessary to correct the condition.
3. Age
Age is another cause of this painful condition. This can be seen by reviewing the statistics of tennis players with this condition. Over 39% of tennis players suffer from tennis elbow, but age directly affects the severity of the condition. Of those who reported that they suffered severely from the condition, 24% were under 50, while 42% of those over 50 suffered significant disability. This is because tennis elbow is partly a degenerative condition. For years, the injury was attributed mainly to the inflammation that occurred through overuse.
Yet, recent research has found that degenerative tissue may play a larger role. “…Biopsies of the sore tissues, shows little inflammation, except in the very early stages of the injury. Instead, [tennis elbow] is thought to involve degeneration of the tissues…the body cannot repair any resulting minor damage before more damage occurs, and the tendons that hold the elbow together begin to fray and buckle,” writes Gretchen Reynolds.
4. Occupation
Studies have shown that one percent of all workers suffer from injury at any given time. Some occupations are prone to cause the condition in workers. These would include jobs that require repeated and constant wrist, hand and arm motions. A 2011 study of 9,696 workers found that jobs requiring manual labor or repetitive bending/straightening of the elbow more than one hour a day increased the occurrence of tennis elbow. Other studies have shown a higher incidence of tennis elbow in occupations such as meat-cutting, construction work, and automobile assembly jobs. The condition is a serious productivity issue as 5% of workers have prolonged absences annually due to tennis elbow.
5. Stress
Tennis elbow has also been associated with two types of stress. First, physical muscle stress is connected to this condition. When the forearm muscle and tendon are under chronic stress, a person is a prime candidate for tennis elbow. Sometimes this chronic stress comes from more than just repetitive activity. The forearm muscle can become so injured itself that it fails to function properly. This in turn puts stress on the tendon. “It’s when your muscle has restrictions in it – because layers within the muscle are getting stuck together.
And those restrictions reduce your muscle’s flexibility and lead to more tension,” explains neuromuscular therapist Allen Willette. Second, psychological stress is related to this injury. Rheumatologist Karen Walker-Bone and a team of researchers found that psychological stress was significantly associated with the condition. Another study found that workers suffering from tennis elbow were much more depressed and anxious.
6. Sports
Finally, sports are a well-known cause of tennis elbow. This association with sports was recognized first in 1883 by H.P. Major when he referred to “lawn tennis elbow” in an article in the British Medical Journal. However, tennis elbow is not restricted to just tennis players. Any type of sport that requires repeated use of the forearm and wrist can lead to tennis elbow. This would include other racquet sports like racquet ball. Sports that involve a swinging motion also cause the condition. These would include golf, cricket, and baseball. Other sports that can cause tennis elbow are weight-lifting, throwing, boxing, archery, martial arts and bowling. Yet, only 5% of all cases of tennis elbow are caused by sports.
Tennis elbow is much more than a sore arm from too many matches at the courts over the weekend. It is a common ailment that has a great economic and lifestyle impact on many people. Therefore, it is important to understand the causes of tennis elbow so one may avoid much pain and suffering.
