tennis elbow
Is it really tennis elbow? What doctors don't tell you.
Pain in the lateral part of the elbow is one of the most common reasons for consultation in physiotherapy. And almost by inertia, many call it tennis elbow o epicondilitis. But what if I told you it's not always??
The rapid and automatic diagnosis of “tennis elbow” can lead to ineffective treatments or, even, wrong. Today I explain why elbow pain does not always come from the elbow…and what other factors should we consider before labeling it?.
🎯 What really is tennis elbow?
The call tennis elbow It is a tendinopathy that affects the extensor tendons of the forearm, mainly to extensor carpi radialis brevis, that insert into the lateral epicondyle of the humerus. It is related to repetitive wrist extension and grasping movements., like hitting with a racket or writing for many hours on the computer.
But although this explanation seems logical, Not all lateral elbow pain fits this definition.. And here the problem begins.
❗️Not all lateral elbow pain is epicondylitis
Many patients arrive with this diagnosis beforehand. But when evaluating them well, we find completely different causes. Some examples that we frequently see in consultation:
✅ 1. Cervical irritation (C5-C6)
The nerve roots of C5 y C6 innervate muscles of the shoulder and arm. An injury or irritation at the cervical level can cause a pain radiating to the elbow that has nothing to do with the tendons of the forearm. this pain, sometimes, accompanied by a tingling sensation, weakness or even lack of precision when moving the hand.
✅ 2. Lack of shoulder mobility
Lack of mobility or stability (especially in internal or external rotation) It can also irritate the nerve and even the tendon.. Over time, This can generate microtrauma that ends up generating pain… but the origin is still higher.
It is very common in people who have lost range of motion (For example, due to having had a previous injury, a sedentary job or poor postural hygiene).
🔍 Why is it important to make a good assessment?
If we only treat the elbow with local techniques, but the real problem is in the neck or shoulder, the pain will return. The goal of physiotherapy It's not just about relieving symptoms., sino to understand y correct the real origin of pain.
In these articles they talk in depth about these relationships.:
🔍 Determining Frequency of Cervical Radiculopathy in Patients Suffering from Lateral Epicondylitis Resistant to Treatment Visiting Physical Clinic of Baghi’at-Allah Hospital
🔍 The Prevalence of Medial Epicondylitis Among Patients With C6 and C7 Radiculopathy
🔍 Epicondylitis and Cervical Radiculopathy
💡 What can we do if your elbow hurts?
Make a overall assessment: shoulder, neck, mobility, strength and function.
Check for signs of radiating pain (due to nervous irritation).
Assess how you use your arm in your day to day: gestures, postures, repetitive activities.
Design a active treatment program, not just passive: mobility, motor control and progressive strength.
✅ Conclusion
“Tennis elbow” is not always what it seems. If you have had pain on the outside of the elbow for a long time and conventional treatments do not work, Maybe the problem is in another area of your body. An appropriate physiotherapy evaluation can help you discover the true origin of your pain and recover your functionality..
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