What is Lateral Epicondylitis?

Lateral epicondylitis, commonly known as tennis elbow, is a condition characterized by pain and tenderness on the outside (lateral side) of the elbow. It primarily involves microtears and irritation in the extensor tendons of the forearm where they attach to the lateral epicondyle of the humerus. Although frequently associated with racquet sports, it can also occur in any activity or occupation that involves repetitive wrist extension or gripping motions.

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Common Causes and Contributing Factors:

• Overuse and Repetitive Strain: Repeated wrist extension, gripping, or lifting with the palm facing downward can stress the extensor tendons.
• Poor Mechanics and Technique: In sports (e.g., tennis) or daily tasks, improper technique can increase strain on the outer elbow tendons.
• Occupation-Related Activities: Manual labor involving repetitive hand or arm movements, prolonged computer use, or use of hand tools can contribute to tendon irritation.
• Age-Related Degeneration: Tendon elasticity and healing capacity may decline with age, increasing susceptibility.

Symptoms to Recognize:

• Pain on the Lateral Elbow: Tenderness at the lateral epicondyle, which may radiate into the forearm.
• Pain Worsening with Activity: Discomfort often increases with gripping, lifting, or wrist extension activities, such as turning a doorknob, shaking hands, or holding a cup of coffee.
• Reduced Grip Strength and Stiffness: Clients may notice a weaker grip or stiffness in the elbow and forearm, especially after periods of rest.

What Massage Therapists Should Know:

• Assessment and Palpation:
  • Gently palpate the lateral epicondyle and forearm extensors to identify tender spots and taut bands.
  • Check for pain reproduction with resisted wrist extension or passive wrist flexion—this helps confirm the involvement of the extensor tendons.
• Treatment Strategies:
  • Use gentle myofascial release, friction, and trigger point techniques on the forearm extensors to reduce muscular tension and improve tissue quality.
  • Consider cross-fiber friction near the tendon insertion to promote localized circulation and support tissue remodeling, but avoid excessive pressure that exacerbates pain.
  • Gradually introduce deeper techniques as tolerated and encourage the client to give feedback to prevent over-treatment.
• Client Education and Self-Care:
  • Teach clients gentle stretching for the wrist extensors and forearm muscles.
  • Suggest self-massage techniques (e.g., using a massage ball or gentle forearm rolling) to maintain gains between sessions.
  • Encourage activity modification to reduce repetitive strain and advise on ergonomic adjustments—such as adjusting workstation height, using ergonomic keyboards or tools, or modifying sports techniques.
• Strengthening and Balance:
  • Recommend that clients, once pain allows, introduce light strengthening exercises for the forearm muscles (e.g., using a resistance band) to improve tendon resilience.
  • Balance forearm flexors and extensors to reduce unilateral strain.
• Referral When Necessary:
  • If the condition persists, worsens, or significantly interferes with daily function, suggest clients seek medical evaluation.
  • Physical therapy, bracing, or other interventions may be necessary for more severe or stubborn cases.

By understanding lateral epicondylitis, massage therapists can help alleviate pain, support tendon health, improve forearm muscle balance, and guide clients in prevention strategies to minimize recurrence.