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Pronunciations epicondylitis popliteus tendinitis

Medial epicondylitis (forehand tennis elbow, baseball elbow, suitcase elbow) is damage to the tendons that bend the wrist toward the palm, causing pain on the palm side of the forearm from the elbow toward the wrist.

This injury is caused by bending the wrist toward the palm with excessive force. Factors that produce such force include having weak shoulder or hand muscles; serving with great force in tennis; using an overhand and a top spin serve; hitting heavy, wet balls; using a racket that is too heavy, has a grip that is too small, or has strings that are too tight; pitching a baseball; throwing a javelin; certain golf swings, and carrying a heavy suitcase. Continuing to exercise with pain can pull the tendons from the bone, causing bleeding.

Pain is felt in the palm side of the elbow and forearm on the same side as the smallest finger when bending the wrist toward the palm against resistance or when squeezing a hard rubber ball. To confirm the diagnosis, a doctor asks the person to sit in a chair with the injured arm resting on a table, palm up. The doctor holds the wrist down and asks the person to raise the hand by bending the wrist. A person who has medial epicondylitis feels pain at the elbow.

Any activity that causes pain when the wrist is bent toward the palm or turned so that the little finger is next to the body should be avoided. After the injury has healed, the person should strengthen the wrist and shoulder muscles, as well as the injured muscles. Surgery is rarely needed. Surgery is more common on the lateral side; the Nirschl procedure removes scar tissue from the muscle to promote healing.

Strengthening the Wrist Muscles For lateral epicondylitis (backhand tennis elbow) Sit on a chair next to a table. Place the injured forearm on the table, palm down, with the elbow straight and the wrist and hand hanging over the edge. Hold a 1-pound weight in the hand. Slowly raise and lower the hand by bending and straightening the wrist. Repeat 10 times. Rest 1 minute, then do 2 more sets of 10. If the exercise causes pain, stop immediately and try again the next day. Do this exercise every other day. Increase the weight as the exercise becomes easier. With the palm down, hold a piece of wood the diameter of a broomstick with a 1-pound weight attached to it by a rope. Wind the weight up. Repeat 10 times. Stop if any pain is felt. Do this exercise every other day. Gradually increase the weight but not the number of repetitions. Place back of hand on a table with fingers directed toward the body and the elbow bent. Slowly extend the elbow, keeping the hand in contact with the table and hold this position for 10 seconds. Repeat 10 times. Stretch only to the point that it causes pain. For medial epicondylitis (forehand tennis elbow) Sit on a chair next to a table. Place the injured forearm on the table, palm up, with the wrist and hand hanging over the edge. Hold a 1-pound weight in the hand. Slowly raise and lower the hand by bending and straightening the wrist. Repeat 10 times. Rest 1 minute, then do 2 more sets of 10. If the exercise causes pain, stop and try again the next day. As the exercise becomes easier, increase the weight. With the palm up, hold a piece of wood the diameter of a broomstick with a 1- pound weight attached to it by a rope. Wind the weight up. Repeat 20 times. Stop if the exercise becomes painful. Gradually increase the weight but not the number of repetitions. Several times a day, gently squeeze a soft sponge ball, then relax.

Last full review/revision February 2003