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Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 63 Keep in mind, tennis elbow is not necessarily caused by playing tennis, nor is golfer's elbow caused only by playing golf. Indeed, any of the joint actions or joint stabilizations mentioned here could cause these conditions. Lifting a container of milk or holding a steering wheel or pen for prolonged periods of time could result in golfer's and/or tennis elbow. In fact, when we look at the long periods of time we spend gripping and holding a smartphone, we can see that the predisposition to develop these conditions is tremendous. Also, repetitive flexion or extension motions of the hand at the wrist joint (such as working as a cashier or performing manual labor, such as carpentry) could cause golfer's or tennis elbow. Indeed, most every daily activity places physical stresses into the upper extremity that could contribute to the incidence of these conditions. This is why golfer's and tennis elbow are so prevalent. Joseph E. Muscolino, DC, has been a manual and movement therapy educator for more than 30 years. He is the author of multiple textbooks, including The Muscular System Manual: The Skeletal Muscles of the Human Body (Elsevier, 2017); The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns, and Stretching (Elsevier, 2016); and Kinesiology: The Skeletal System and Muscle Function (Elsevier, 2017). He is also the author of 12 DVDs on manual and movement therapy and teaches continuing education workshops around the world, including a certification in Clinical Orthopedic Manual Therapy (COMT), and has created LearnMuscles Continuing Education (LMCE), a video streaming subscription service for manual and movement therapists, with seven new video lessons added each week. For more information, visit, or reach him directly at Finger flexors ECRB Contraction of flexor digitorum superficialis and/or profundus to flex the fingers and grip an object would also cause the hand to flex at the wrist joint. To prevent this, wrist extensor musculature (ECRB) must isometrically contract to stabilize the wrist joint. Permission Joseph E. Muscolino. Anterior view of the lateral and medial epicondyles of the humerus on the right side of the body. Note how much smaller the lateral epicondyle is than the medial epicondyle. Permission Joseph E. Muscolino. Lateral epicondyle of humerus Medial epicondyle of humerus that grip strength is optimal, the wrist joint must be stabilized. This is primarily accomplished with isometric contraction of the extensor carpi radialis brevis of the tennis elbow group (Image 5). For this reason, in addition to extension motions of the wrist and hand, tennis elbow is also caused by finger flexion whenever we grip an object. This is another asymmetry between golfer's and tennis elbow. Whereas golfer's elbow is caused solely by flexion, tennis elbow is often thought of as being caused solely by extension, but is also caused by activities of life that involve finger flexion. This may account for why tennis elbow tends to occur more often than golfer's elbow. Another reason might be that the size of the tennis elbow lateral epicondylar attachment is so much smaller than the golfer's elbow medial epicondylar attachment. Therefore, the force of the contraction of the tennis elbow musculature is more concentrated over a smaller surface area of bone (Image 6). 5 6

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