By Alexander Germanis
During the 18th dynastic period of Egyptian rule in 1500 B.C., the game of tennis originated. Christian monks of the eighth century then brought the game into the monasteries of Europe. Tennis saw more alterations after the advent of rubber balls, and tennis was moved outside for the first time. The resultant ‘lawn tennis’ saw its first tournament played in the town of Wimbledon in 1877, inaugurating the modern era of the sport.
With outdoor play came the malady known as lateral epicondylitis. Possibly first recognized in Germany in 1873, the first printed evidence of the term “lawn tennis arm” came from the British surgeon Henry Morris in 1882. The name, of course, saw its eventual change to what it is commonly called today: tennis elbow.
The great irony is, although the sport enjoys such an ancient pedigree, and the term ‘tennis elbow’ has a fairly clear origin, the cause of the malady itself does not share its unclouded history. Indeed, “the most common thing a doctor will tell you,” says Dr. Jerome Oakey of McLean County Orthopedics, “is there’s no known cause. Nobody knows.”
An orthopedic surgeon specializing in the hand, wrist, and elbow, Dr. Oakey declares that, quite often, the actual reason tennis elbow pain first surfaces in most patients is a mystery. Although someone can suffer a direct blow or trauma to the elbow, he says, “The majority of people have no one-time inciting event.” In fact, only about five percent of the people who complain of tennis elbow pain actually play tennis.
A common problem among those in their 40’s and 50’s, tennis elbow often, “starts as an achy pain on the outside of the elbow near the bump on the elbow,” Dr. Oakey explains.
The bump on the elbow of which the doctor speaks is also called the lateral condyle. It is “a portion of the humerus, or upper arm bone, that has an attachment of a fan-shaped tendon,” he begins. “This tendon is very short and attaches broadly to the side of the humerus at the elbow. So it goes from the elbow bone to the tendon to the muscle [in the forearm] to the long tendon that extends down the wrist.”
“What that muscle tendon unit does is, it curls the wrist back or cocks the wrist up,” he continues. “So, the tennis elbow is an unhealthy layer of tissue that forms between the normal tendon and the insertion on the bone.”
But, as the doctor states, the pain in the elbow is sometimes only the first way tennis elbow makes itself known. The pain, Dr. Oakey adds, “usually goes down the arm, but doesn’t typically reach all the way to the wrist.”
Despite there not being a single cause of tennis elbow, the doctor shares a theory that tennis elbow could be a result of assigning the wrong muscles to do certain everyday jobs. “Imagine sitting and leaning toward the phone,” Dr. Oakey says. “When your core muscles are engaged and you reach out, the small muscle [in the forearm]—which has the cross sectional area of a tube of toothpaste—does not have to do as much work. If you’re sitting slouched in your chair, and you do not engage those core muscles, that small muscle is being asked to do something that a basketball-sized core muscle would do. So, it’s a misuse of a small muscle, which is not designed to do these activities in the repetitive fashion that we ask it to do.”
Furthermore, tennis elbow can make those simple tasks like answering the phone or opening a jar painful to perform. But as many possible causes as there may be for tennis elbow, there are easily as many ways in which physicians choose to treat it.
For information on the current and future treatments, pick up next month’s issue of Healthy Cells Magazine.
For more information, you may contact Dr. Oakey at McLean County Orthopedics, 309-663-6461 or www.mcleancountyorthopedics.com. The practice treats all types of orthopedic conditions and offers a comprehensive range of services. Their office is located at 2502 E. Empire in Bloomington.