The physical exam is often most helpful in diagnosing tennis elbow. You will need to answer questions about your pain, how your pain affects you, your regular activities, and past injuries to your elbow. When you visit Endurance Rehabilitation and Wellness Center, PC, our therapist will first take a detailed medical history. How can my health care provider be sure I have tennis elbow? The scar tissue never has a chance to fully heal, leaving the injured areas weakened and painful. After a while, the tendons stop trying to heal. The tears try to heal, but constant strain and overuse keep re-injuring the tendon. Some doctors think that the forearm tendon develops small tears with too much activity. No one really knows exactly what causes tendonosis. Eventually, the tendon becomes thickened from extra scar tissue. Each time the collagen breaks down, the body responds by forming scar tissue in the tendon. It becomes fragile and can break or be easily injured. When this happens, the collagen loses its strength. Instead of inflammatory cells, the body produces a type of cells called fibroblasts. A degenerated tendon usually has an abnormal arrangement of collagen fibers. In tendonosis, wear and tear is thought to lead to tissue degeneration. Rather, the problem is within the cells of the tendon. However, tennis elbow often does not involve inflammation. Inflammation around the lateral epicondyle is called lateral epicondylitis. For example, inflammation in a tendon is called tendonitis. Conditions that involve inflammation are indicated by -itis on the end of the word. Special inflammatory cells make their way to the injured tissues to help them heal. In an acute injury, the body undergoes an inflammatory response. Hammering nails, picking up heavy buckets, or pruning shrubs can all cause the pain of tennis elbow. These activities are not necessarily high-level sports competition. Repeating some types of activities over and over again can put too much strain on the elbow tendons. Overuse of the muscles and tendons of the forearm and elbow are the most common reason people develop tennis elbow. Related Document: Endurance Rehabilitation and Wellness Center, PC's Guide to Elbow Anatomy The forces that pull on these tendons can build when you grip things, hit a tennis ball in a backhand swing in tennis, or do other similar actions. The contracting muscles pull on the extensor tendon. When you bend your wrist back or grip with your hand, the wrist extensor muscles contract. The other end of the tendon pulls on the bone, causing the bone to move. When muscles work, they pull on one end of the tendon. This means they can withstand high forces that pull on both ends of the tendon. Collagenīecause the collagen strands in tendons are lined up, tendons have high tensile strength. The collagen strands are lined up in bundles next to each other. Tendons are made up of strands of a material called collagen. The forearm muscles that bend the wrist back (the extensors) attach on the lateral epicondyle and are connected by a single tendon. Tennis elbow causes pain that starts on the outside bump of the elbow, the lateral epicondyle.
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