Chronic Tennis Elbow Might Be an Instability Issue

Chronic tennis elbow might involve instability in elbow joint. I remember being taught to always inject the radio-humeral joint and I can see why if much of the time pathology exists there. Might explain recurrence rates.

Knee Surg Sports Traumatol Arthrosc. 2017 in press.
doi: 10.1007/s00167-017-4530-x.
Intra-articular findings in symptomatic minor instability of the lateral elbow (SMILE).
Arrigoni P et al.
https://www.ncbi.nlm.nih.gov/pubmed/28341879

  • 35 cases between 20 and 60 years
  • recalcitrant lateral epicondylitis
  • without overt elbow instability

scenario is as follows:

  • Certain movements strain elbow joints

  • annular ligament elongation and instability radial head
  • Impingement radial head – I presume part of what they call radial head ballottement – seen in near 1/2 cases
  • Cartilage damage to Capitellum (CLAC lesion)
  • Capsular tears
  • Extensor Carpi Radialis Brevis dynamic stabilizing overstrain with your tennis elbow

With Elbow arthroscopy they found

  • ~ 1/2 recalcitrant lateral epicondylitis¬† have¬† signs of lateral ligamentous instability
  • > 85% demonstrate at least one intra-articular abnormality synovitis or capitellar chondropathy

Comment – makes a case for prolotherapy to elbow joint to stabilize condition though they did not mention. They mentioned a lesion called snapping plica syndrome – a band in joint that snaps – I have that condition which can be annoying but seems to settle with use in gym.

 

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One Response to Chronic Tennis Elbow Might Be an Instability Issue

  1. Pingback: Resistant Tennis Elbow – Open Release or Radiofrequency Microtenotomy – and More | Pain Medical Musing

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