Inflammation at the point where tendons of the forearm insert into the epicondyles at the elbow, a specific type of repetetive strain injury

Epicondylitis typically occurs during the 4th and 5th decades of life. Patients describe a history of activities contributing to overuse of the forearm muscles that originate at the elbow, the Sx gradually worsen over weeks to months

Lateral epicondylitis is more common then medial.

Pathophysiology:

A combination of poor mechanics, microtears in areas of hypoperfusion, and a delayed healing response contribute to the pathophysiology of the condition

Lateral epicondylitis

(Tennis elbow)

• Pain and tenderness at the lateral epicondyle -
  • Exacerbated by wrist and digit extension and during passive wrist flexion with the elbow extended.
• Pain radiating down the forearm
• Weakness in grip strength & pain when gripping

Examination:

• Positive ECRB stretch test - Reproducible pain over the origin of the common extensor mass when the arm is placed in extension while the examiner maximally flexes the wrist
• Pain during resisted wrist and digit extension

Medial epicondylitis

(Golfer’s elbow)

• Pain and tenderness at medial epicondyle
  • Pain is exacerbated with resisted forearm pronation and resisted wrist flexion.
• Pain radiates down arm

Examination:

• Extend elbow, supinate forearm and extend wrist and fingers. Stretch the flexor muscles of the forearm while palpating the medial epicondyle. Pain = indicative of golfer’s elbow