Preventing and Treating Tennis Elbow in Tennis players (Part-III)

Muscles Affected: Extensors / Supinator

In Tennis Elbow, pain directly on the lateral epicondyle and/or one to two (1-2) inches distal to the lateral epicondyle in a more generalized area, are the most significant areas of complaint.  The location of the pain is likely to first appear at the lateral epicondyle, and then spread distally to the proximal forearm, then to the wrist and hand.  The epicondylar pain associated with Tennis Elbow is frequently a composite pain that is referred from the supinator, extensor carpi radialis longus and the extensor digitorum muscles. (6) 

When the carpi radialis longus and extensor digitorum are highly involved, the most common symptom experienced is severe pain when performing a firm grip with the hand, especially when the hand is placed in ulnar deviation, such as when shaking hands.  When the hand is placed in ulnar deviation, not only does pain increase, but weakness of grip is greatly pronounced, resulting in the inability to grasp or hold objects.  This is seen quite often when someone holding a tennis racquet drops their wrist into ulnar deviation, whereas the subject can no longer continue holding onto the racquet due to the increased pain and weakness in this position. Pain in these muscles is also greatly increased whenever a strong grip is combined with forceful supination or pronation (Tennis backhand/forehand) and when the subject grasps a large object rather than a small object (Tennis racquet handle). (6) 
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