Musculoskeletal disorders of the elbow

Musculoskeletal disorders of the elbow

Ice application – A demonstration

The elbow pain can come from the joint itself, bones, or tissues attached to the joint, such as tendons. This sheet covers the 2 types of injuries to elbow tendons the most frequent. They are commonly referred to as the tennis player’s elbow (tennis elbow) and golfer’s elbow (golfer’s elbow), but they do not only affect these athletes. Usually, it is the act of soliciting the wrist repeatedly or with unusual intensity which may become harmful.

These injuries most often affect people in their forties or fifties, and as many women as men.

Types

“Tennis player’s elbow” or external epicondylalgia (formerly called epicondylitis)

It affects 1% to 3% of the population. However, tennis is not the main cause of external epicondylalgia. Moreover, players today are rarely affected since the majority of them perform their backhand with both hands and use racquets much lighter than before.

The pain is mainly localized in the outer part of the forearm, in the region of the epicondyle (see diagram above). THE’epicondyle, also called the external epicondyle, is a small bony protrusion on the outside of the humerus, located near the elbow.

The tennis player’s elbow is the result of overworking muscles extenseurs of the wrist. These muscles make it possible to bend the wrist upwards, and to straighten the fingers.

“Golfer’s elbow” or internal epicondylalgia (formerly called epitrochleitis)

This condition is 7 to 10 times less common than the tennis player’s elbow1. It affects golfers, but also people who play racquet sports, baseball pitchers and manual workers. The pain is located in the inner part of the forearm, in the region of the epitrochlea (see diagram above). THE’epitrochlée, also called internal epicondyle, is a small bony protrusion on the inside of the humerus.

The golfer’s elbow is the consequence of overworking flexor muscles of the wrist. These muscles are used to bend the wrist and fingers downward.

For more details, see our article entitled Joint Anatomy: The Basics.

Causes

When we often reproduce the same gestures or that we force inadequately, to small wounds appear in the tendons. These microtraumas cause a decrease in the elasticity of the tendons because the collagen fibers produced to repair the tendons are not of as good quality as the original tendon.

The “wear and tear” of elbow or irritation of the nerves adjacent to the elbow could also be the cause of pain and inflammation. Although these lesions do not systematically cause inflammation of the tendons, the surrounding tissues can become inflamed and damage the elbow joint.

Evolution

The pain usually persists for a few weeks, sometimes several months. It is rare that it lasts more than 1 year (less than 1% of cases).

Possible complications

Untreated or poorly treated epicondylalgia leaves lesions that can lead to chronic pain, which is much more difficult to heal.

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