The forearm muscles that are involved in gripping, squeezing, and lifting are attached both to the wrist and to the elbow. If those muscles are overloaded, or overstressed, they can partially tear at either end. Frequently the muscle attachment (tendon) becomes injured at its insertion on either the inside or outside of the elbow (epicondylitis).
Common Causes
Excessive gripping or squeezing; too much tennis, golf, weightlifting, gardening, hammering, etc. Chronic overuse of the wrist extensor muscles; excessive keyboarding.
Symptoms
Pain in the outside (lateral) or inside (medial) aspect of the elbow, exacerbated with gripping or squeezing. Usually pain free at rest.
Physical Findings
Tender at either the medial or lateral epicondyle of the elbow.
Workup
Diagnosis is almost entirely made by history and physical examination. Occasionally x-rays are helpful.
Non-operative Treatment
Rest and anti-inflammatory medication will reduce symptoms. The use of forearm bands and wrist splints allows the injured tendon to rest. Corticosteroid injections are often very helpful in speeding recovery. Physical therapy too early can actually aggravate symptoms; Gentle strengthening is helpful once the pain has resolved.
Surgical Treatment
Fasciotomy, or the release/removal of injured tissue.