The elbow is a complex hinge and pivot joint comprised of the humerus of the upper arm and ulna and radius bones in the lower forearm. A thin layer of articular cartilage covers the ends of these bones that form the elbow joint. A joint capsule surrounds these articulations and contains a slick synovial fluid that lubricates and protects the joint surfaces from friction, wear and tear. An extensive network of ligaments surrounding the elbow joint helps resist mechanical stresses and acts as stabilizers. Powerful tendons and muscles originate and insert on the elbow bones which and provide forces allowing for flexion, extension and rotation of the forearm. The main function of the elbow is to allow the hand to be placed in different areas in space by allowing 0-180 degrees of flexion and extension range of motion, as well as 180 degrees of forearm rotation (supination and pronation).

The elbow is a common site of acute and chronic injury. The anatomy of the joint articulations, muscles, tendons, ligaments, nerves and blood supply make it a difficult and, therefore, sometimes very unappealing area of the body to treat, but Dr. Viola is specialized in and even enjoys treating challenging elbow issues.


Lateral Epicondylitis, or Tennis Elbow, is a painful condition whereby the extensor tendons of the forearm become degenerative at their attachment site at the elbow. The site of pain is the extensor carpi radialis brevis (ECRB) muscle, which is on the lateral condyle side of the humerus.  Most people who get tennis elbow are in their 30s-50s.

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Medial Epicondylitis, or golfer’s elbow, is similar to Lateral Epicondylitis, or tennis elbow, in that it is also a painful condition where the tendons of the forearm become degenerative at their attachment site on the inside of the elbow. The site of pain is the Flexor Pronator Mass (FPM), which is on the medial condyle side of the humerus.  The FPM is a group of tendons and muscles that help flex the wrist.

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