Risk Factors for Epicondylitis
The primary risk factors for epicondylitis include age over 40, repetitive wrist extension/flexion activities, occupational overuse, and forceful activities involving the forearm. 1
Demographic Risk Factors
- Age: Most common in individuals aged 40-60 years 2
- Sex: Women appear to be affected more frequently than men 2
- Dominant arm involvement: Lateral epicondylitis affects the dominant arm in 75% of cases 1
Occupational and Activity-Related Risk Factors
High-Risk Occupational Factors
- Forceful activities involving the forearm and wrist 2
- High force combined with high repetition or awkward postures 2
- Repetitive wrist extension and flexion movements 1
- Occupations requiring repetitive arm movements 1, 2
- Manual laborers
- Workers who perform overhead activities
- Jobs requiring repetitive wrist flexion and extension
Sports-Related Risk Factors
- Racquet sports (especially tennis - "tennis elbow") 1, 3
- Golf ("golfer's elbow" for medial epicondylitis) 3
- Sports with overhead or repetitive arm actions 3
- Improper technique in sports activities 3
- Inappropriate equipment (e.g., wrong grip size, excessive string tension) 3
Biomechanical Risk Factors
- Improper functioning and muscle weakness 1
- Poor forearm muscle strength 3
- Biomechanically unsound technique in sports or work activities 3
- Awkward wrist postures during work activities 2
Prevalence and Epidemiology
- Lateral epicondylitis: Affects approximately 1.0-4.0% of the general population 2
- 1.0-1.3% in men
- 1.1-4.0% in women
- Medial epicondylitis: Affects approximately 0.3-1.1% of the general population 2
- 0.3-0.6% in men
- 0.3-1.1% in women
- Lateral epicondylitis is 7-10 times more common than medial epicondylitis 1
Prognostic Factors
Poorer prognosis is associated with:
- High level of physical strain at work 2
- Non-neutral wrist postures during work activity 2
- Dominant elbow involvement 2
Prevention Strategies
- Modification of physical factors at work or during sports 2, 3
- Improved joint strength through targeted exercises 3
- Biomechanically sound technique in sports and occupational activities 3
- Use of appropriate equipment for sports activities 3
Clinical Implications
For patients presenting with epicondylitis, a thorough assessment of occupational and recreational activities is essential to identify modifiable risk factors. Addressing these factors through activity modification, proper technique, and appropriate equipment can help prevent recurrence and improve outcomes.