Liberto Therapy, LLC

For Appointments Call: (561) 420-3273

Thomas Liberto, LMT
Advanced Treatment for Muscular Pain and Disorders
Auto, Work, Sports Injuries, Chronic Pain

Tennis / Golf Elbow

Overuse Injuries / Repetitive Stress Injuries

DO YOU SUFFER WITH symptoms of pain on your outer or inner elbow, painful grip, trouble turning a door knob?

"It is a widely held belief that the muscles of the mobile wad of three ( the extensor carpi radialis brevis in particular ) are involved in "tennis elbow", a condition in which the extensor muscles, strained by an unusual amount of stress, cause pain at the lateral epicondyle¹ of the elbow and along the course of the muscles."
Physical Examination of the Spine and Extremities
Stanley Hoppenfeld, M.D.

¹ A rounded projection at the end of a bone that serves as an attachment for ligaments and muscle tendons.

It is called Tennis Elbow or lateral epicondylitis when there is an injury to the outer elbow tendon. It is called Golfer's Elbow or medial epicondylitis when there is an injury to the inner elbow tendon.

However, elbow tendinopathy can be caused by sports other than golf and tennis, as well as work-related activities that involve heavy use of the wrist and forearm muscles.


Lateral epicondylitis

An inflammatory condition of the lateral (thumb-side) epicondyle of the elbow.

Also, it could be in the cells of the tendon itself, called tendonosis, which may result in formation of scar tissue. This leaves the injured area weak and painful.

Pain and tenderness felt at the area of the lateral epicondyle brought on by wrist extension with supination (turning your palm up) or pronation (turning your palm down) and is aggravated by gripping.

The cause is usually repeated minor traumas that strain the wrist extensor musculature at the lateral epicondyle.

Also known as "radial epicondylitis"

Symptoms are initiated by any repetitive or sustained supination especially with the elbow straight, or forceful elbow flexion when in pronation (palm facing down).

Aggravating Actions

Carrying a briefcase with the elbow straight, flipping the briefcase onto the desk (with the forearm in pronation), turning stiff doorknobs, wringing out clothes, ironing, unscrewing a tight jar lid, walking a dog, repetitive handshaking, washing the walls by hand, raking leaves.

CAUSES (Cyriax)

  1. Teno-periostial: Partial tear of the hand and finger extensor muscles which produces a painful scar.
  2. Muscular: Extensor carpi radialis longus belly.
  3. Tendinous: Lesion of the common extensor and supinator tendon. (especially extensor carpi radialis brevis).
  4. Supracondylar: Extensor carpi radialis longus along the supracondylar ridge. Also, triceps involvement.
  5. Reflex pain from cervical radiculopathy.


Medial epicondylitis

An inflammatory condition of the medial (pinky finger-side) epicondyle

Also called Pitcher's Elbow and Climber's Elbow

Aggravated by wrist flexion and pronation (turning the wrist so that the knuckles point toward your head)


Pain and tenderness on the inner side of your elbow, sometime in the inner side of your forearm.
Stiffness/trouble making a fist.
Sometimes you will experience tingling and numbness into your ring and pinky fingers. You may experience weakness in your wrist and hand.

Aggravating Actions

Swinging a golf club. Shaking hands. Turning a door knob.
Picking up an object with your wrist pronated (palm facing down).


Forceful, repetitive wrist and finger motions

Activities such as golf, racket ball, some weightlifting exercises improper baseball pitching form, and EVERYDAY ACTIVITIES such as painting your house, hammering, typing on your computer, hammering at work or at home.

SOURCE: Dr. Robert Wertz. Seminar notes and personal communication

CALL TODAY for a consultation:

Thomas Liberto, LMT

309 Lake Avenue

Lake Worth, FL 33460

Telephone: 561-582-2306