Nina Laidlaw Rumler, B.A.
This is Amuhrica, right? We power-through, man-up, and tough it out. Well, that’s not always a good strategy. We hear constantly about the benefits of physical activity but often overlook the drawbacks. While physical activity has positive effects in prevention or reduction of a number of illnesses (diabetes, hypertension, cardiovascular disease, osteoporosis, some types of cancer, etc.), there is also a strong association with injury. Some, such as spinal cord injuries, are tragic and long-lasting but fortunately not that common. Others appear to be common and simply annoying. Inflammation of the epicondyle (epicondylitis) is one of those.
Epicondylitis of the arm (“tennis elbow”) starts out small – you may find yourself massaging or icing your forearm or elbow frequently and then continuing your regular activities – but it can become severe enough to require surgery. Surgery, of course, includes the possibilities of infection, nerve and blood vessel damage, possible prolonged rehabilitation, loss of strength or flexibility, and the need for further surgery, along with definite expense and recovery time. However, if managed appropriately, epicondylitis can self-heal in a couple of years, avoiding surgery. This is the time to pay attention to those small aches and pains.
To understand what epicondylitis is and how to prevent or deal with it, a bit of anatomy is necessary, focusing strictly on the arm, although epicondyles are also found in the leg. The armbones include a single, sturdy upper arm bone (humerus) and two long slender bones in the forearm, the radius and the ulna. The radius is the bone nearest the thumb, while the ulna is on the outer side. The bony bumps at the elbow joint are called epicondyles. The bony bump on the outer (lateral) side is called the lateral epicondyle, while the bony bump on the inner side is the medial epicondyle. The elbow’s prominent point, in the middle, is the olecranon. And naturally there are muscles – triceps and biceps – to move the bones. Tendons attach the muscles of the forearm to the lateral epicondyle.
How does this work together – or “diswork” – in epicondylitis? Doesn’t “itis” mean inflammation? The first thing to understand is that, although “inflammation” is often associated with infection and immunity issues, that’s not the case in this situation. This “itis” is a matter of overuse. In fact, some authorities currently refer to it as epicondylosis. With repetitive motions, such as those used in tennis, microscopic tears form in the tendon where it attaches to the lateral epicondyle, thus the condition is often called “tennis elbow”. But epicondylitis is not confined to the hallowed grounds of Wimbledon. It is found among gardeners, carpenters, writers, painters, knitters, cooks, keyboarders, and athletes in archery, baseball, golfing, weightlifting, and other sports.
Epicondylitis may be the cause of those minor annoying forearm pains. If attended to early, then icing, stretching, and taking a break from the causal motions could prevent some major complications. Check with your doctor, who may send you to a physical therapist. If that’s the case, do the exercises, reduce the activity temporarily, and follow the rules to ensure a good recovery. Don’t tough it out – check it out.
For more information:
Tan AM, Lamontagne AD, Sarmugam R, Howard P. A cluster-randomised, controlled trial to assess the impact of a workplace osteoporosis prevention intervention on the dietary and physical activity behaviours of working women: study protocol. BMC Public Health. 2013 Apr 29;13(1):405. http://www.biomedcentral.com/1471-2458/13/405
Plancher KD, Halbrecht J, Lourie GM. Medial and lateral epicondylitis in the athlete. Clin Sports Med. ;15(2):283-305. http://www.ncbi.nlm.nih.gov/pubmed/8726318
Bishai, Shariff K.; Plancher, Kevin D. The Basic Science of Lateral Epicondylosis: Update for the Future.Techniques in Orthopaedics. 21(4):250-255, December 2006. http://www.researchgate.net/publication/228885077_The_basic_science_of_lateral_epicondylosis_Update_for_the_future