Lateral epicondylitis, commonly refered to as tennis elbow, affects 1% to 3% of the population. It is thought to be an overuse injury, originating in the wrist extensor muscles, rather than an inflammatory problem. It is brought on by occupational activities and sports that involve a repetitive wrist motion or a power grip The condition is most commonly associated with work related activities, such as cutting meat, plumbing, and working on cars, rather than with playing tennis.
The overuse causes microtears near the origin of the extensor carpi radialis brevis(ECRB) at the lateral epicon- dyle. This leads to the formation of fibrosis and granula- tion tissue. Infiltration of inflammatory cells takes place early on but is probably absent in more chronic cases. There are various treatment options available, includ- ing local steroid injections, strapping, extracorporeal shock wave therapy, and acupuncture; however, many cases are difficult to treat successfully. Although exer- cise treatments are often recommended, the descrip- tions of these exercises lack sufficient detail. The following article describes a muscle-strengthening program that involves progressive eccentric and concen- tric resistance exercises for treatment of lateral epicon- dylitis. The exercises can be done at home, and require only dumbbells, an instruction sheet, and the will to get better. Several of our patients who participated in this program have experienced long-term pain relief