Tennis elbow: Associated psychological factors
Abstract
Background The etiology of tennis elbow is multifactorial. Overuse of the wrist extensors along with anatomic factors, such as flexibility problems, aging, and poor blood circulation, may play a role. This study investigated whether patients with tennis elbow have a different psychological profile compared with healthy controls.Methods Patients with clinical signs of tennis elbow, consulting at the Ghent University Hospital between September 2015 and January 2017, were offered a paper-and-pencil questionnaire about Big Five personality traits, perfectionism, anxiety, depression, work satisfaction, and working conditions. Healthy controls in the same risk group were offered the same questionnaires.Results We recruited 69 patients (35 men, 34 women) and 100 controls (44 men, 56 women). Tennis elbow patients scored significantly lower on the personality traits extraversion and agreeableness. Men, in particular, scored significantly higher on perfectionism and were more likely to develop an anxiety disorder or a depression. Concerning work, patients indicated a significantly higher workload (especially men) and a significantly lower autonomy (especially women). Female patients also indicated less contact with colleagues. However, work satisfaction was relatively high in both groups.Conclusion The results suggest that there is a relationship between complaints related to tennis elbow and psychological characteristics.
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Psychosocial status, lifestyle, and occupational demands are important risk factors for elbow pain.
“Psychosocial status [9,10], lifestyle [11,12], and occupational demands (such as heavy load handling and highly repetitive movements with the wrist/hand) [11,13,14,15,16] are important risk factors.”
From Digital Rehabilitation for Elbow Pain Musculoskeletal Conditions: A Prospective Longitudinal Cohort Study (2022) · cites this paper as [9]
Cites
The validity of the Hospital Anxiety and Depression Scale
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00296-3 · Cited by 9,779 · see citing works
A very brief measure of the Big-Five personality domains
Gosling, S. D., Rentfrow, P. J., & Swann, W. B. (2003) · Journal of Research in Personality · doi:10.1016/s0092-6566(03)00046-1 · Cited by 8,307 · see citing works
The dimensions of perfectionism
Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990) · Cognitive Therapy and Research · doi:10.1007/bf01172967 · Cited by 4,279 · see citing works
Construction and Initial Validation of a Multidimensional Measure of Work–Family Conflict
Carlson, D. S., Kacmar, K. M., & Williams, L. J. (2000) · Journal of Vocational Behavior · doi:10.1006/jvbe.1999.1713 · Cited by 2,516 · see citing works
Prevalence and Determinants of Lateral and Medial Epicondylitis: A Population Study
Shiri, R., Viikari-Juntura, E. R. A., Varonen, H., & Heliövaara, M. (2006) · American Journal of Epidemiology · doi:10.1093/aje/kwj325 · Cited by 755 · see citing works
Ahmad, Z., Siddiqui, N., Malik, S. S., Abdus-Samee, M., Tytherleigh-Strong, G. M., & Rushton, N. (2013) · The Bone & Joint Journal · doi:10.1302/0301-620x.95b9.29285 · Cited by 263 · see citing works
The Epidemiology and Health Care Burden of Tennis Elbow: A Population-Based Study
Sanders, T. L., Maradit Kremers, H., Bryan, A. J., Ransom, J. E., Smith, J., & Morrey, B. F. (2015) · The American Journal of Sports Medicine · doi:10.1177/0363546514568087 · Cited by 257 · see citing works
Management of Lateral Epicondylitis: Current Concepts
Calfee, R. P., Patel, A., DaSilva, M. F., & Akelman, E. (2008) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/00124635-200801000-00004 · Cited by 198 · see citing works
Occupation and epicondylitis: a population-based study
Walker-Bone, K. E., Palmer, K. T., Reading, I., Coggon, D., & Cooper, C. C. (2011) · Lara D. Veeken · doi:10.1093/rheumatology/ker228 · Cited by 171 · see citing works
Lateral epicondylitis of the elbow
Vaquero-Picado, A., Barco, R., & Antuña, S. (2016) · EFORT Open Reviews · doi:10.1302/2058-5241.1.000049 · Cited by 160 · see citing works
Pain, Functional Disability, and Psychologic Status in Tennis Elbow
Alizadehkhaiyat, O., Fisher, A. C., Kemp, G. J., & Frostick, S. P. (2007) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31805f70fa · Cited by 110 · see citing works
Herquelot, E., Bodin, J., Roquelaure, Y., Ha, C., Leclerc, A., Goldberg, M., Zins, M., & Descatha, A. (2013) · American Journal of Industrial Medicine · doi:10.1002/ajim.22140 · Cited by 91 · see citing works
Factors Associated With Failure of Nonoperative Treatment in Lateral Epicondylitis
Knutsen, E. J., Calfee, R. P., Chen, R. E., Goldfarb, C. A., Park, K. W., & Osei, D. A. (2015) · The American Journal of Sports Medicine · doi:10.1177/0363546515590220 · Cited by 67 · see citing works
Fan, Z. J., Silverstein, B. A., Bao, S. S., Bonauto, D. K., Howard, N. L., & Smith, C. K. (2013) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1177/0018720813492327 · Cited by 52 · see citing works
Systematic diagnosis and therapy of lateral elbow pain with emphasis on elbow instability
Kniesel, B., Huth, J., Bauer, G. J., & Mauch, F. (2014) · Archives of Orthopaedic and Trauma Surgery · doi:10.1007/s00402-014-2087-4 · Cited by 38 · see citing works
Lee, D. O., Gong, H. S., Kim, J. H., Rhee, S. H., Lee, Y. H., & Baek, G. H. (2014) · Journal of Shoulder and Elbow Surgery · doi:10.1016/j.jse.2014.01.020 · Cited by 17 · see citing works
Psychosocial Factors Related to Lateral and Medial Epicondylitis
Thiese, M. S., Hegmann, K. T., Kapellusch, J. M., Merryweather, A., Bao, S. S., Silverstein, B. A., Tang, R., & Garg, A. (2016) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000000701 · Cited by 15 · see citing works
Sherman, T. I., Golshani, K., Emmerich, K., Cai, L., Gu, W., & Kessler, M. (2015) · Progress in Orthopedic Science · doi:10.5455/pos.20150601113733 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Management of lateral epicondylitis
Lenoir, H., Marès, O., & Carlier, Y. (2019) · Orthopaedics & Traumatology Surgery & Research · doi:10.1016/j.otsr.2019.09.004 · Cited by 189 · see citing works
Tang, S., Wang, X., Wu, P., Wu, P., Yang, J., Du, Z., Liu, S., & Wei, F. (2019) · PM&R · doi:10.1002/pmrj.12287 · Cited by 48 · see citing works
Karanasios, S., Tsamasiotis, G. K., Michopoulos, K., Sakellari, V., & Gioftsos, G. (2021) · Clinical Rehabilitation · doi:10.1177/02692155211006860 · Cited by 41 · see citing works
Zhou, Y., Guo, Y., Zhou, R., Wu, P., Fan-rong, L., & Yang, Z. (2020) · Pain Research and Management · doi:10.1155/2020/8506591 · Cited by 36 · see citing works
Karanasios, S., Korakakis, V., Moutzouri, M., Xergia, S. A., Tsepis, E., & Gioftsos, G. (2022) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2022.11211 · Cited by 37 · see citing works
Auliffe, S. M., Bisset, L., Chester, R., Coombes, B. K., Fearon, A., Kirwan, P., McCreesh, K. M., Mitham, K., Morrissey, D., O’Neill, S., et al. (2022) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2022.11005 · Cited by 20 · see citing works
Stegink‐Jansen, C. W., Bynum, J. G., Lambropoulos, A., Patterson, R. M., & Cowan, A. C. (2021) · Journal of Hand Therapy · doi:10.1016/j.jht.2021.05.005 · Cited by 23 · see citing works
Ju, Y., Chu, W.-T., Shieh, W., & Cheng, H. K. (2021) · Sensors · doi:10.3390/s21196576 · Cited by 18 · see citing works
Epicondylopathia humeri radialis
Leschinger, T., Tischer, T., Doepfer, A. K., Glanzmann, M. C., Hackl, M., Lehmann, L. J., Müller, L. P., Reuter, S., Siebenlist, S., Theermann, R., et al. (2021) · Zeitschrift für Orthopädie und Unfallchirurgie · doi:10.1055/a-1340-0931 · Cited by 17 · see citing works
A meta-analysis of the risk factors for lateral epicondylitis
Chen, Q. Y., Shen, P., Zhang, B., Chen, Y., & Zheng, C. (2023) · Journal of Hand Therapy · doi:10.1016/j.jht.2023.05.013 · Cited by 17 · see citing works
Shoulder and elbow pathology in the female athlete: sex-specific considerations
Wessel, L. E., Eliasberg, C. D., Bowen, E., & Sutton, K. M. (2020) · Journal of Shoulder and Elbow Surgery · doi:10.1016/j.jse.2020.10.020 · Cited by 14 · see citing works
Ge, L., Liu, X., Zhang, R., Chen, Z., & Cheng, F. (2022) · Journal of Orthopaedic Surgery and Research · doi:10.1186/s13018-022-03323-x · Cited by 12 · see citing works
Chiarotto, A., Gerger, H., van Rijn, R. M., Elbers, R. G., Søgaard, K., Macri, E. M., Jackson, J. A., Burdorf, A., & Koes, B. W. (2022) · Applied Ergonomics · doi:10.1016/j.apergo.2022.103952 · Cited by 12 · see citing works
Ikeda, K., Ogawa, T., Ikumi, A., Yoshii, Y., Kohyama, S., Ikeda, R., & Yamazaki, M. (2022) · Diagnostics · doi:10.3390/diagnostics12081871 · Cited by 10 · see citing works
Janela, D., Costa, F., Molinos, M., Moulder, R. G., Lains, J., Bento, V., Scheer, J. K., Yanamadala, V., Cohen, S. P., & Correia, F. D. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159198 · Cited by 8 · see citing works
“Psychosocial status [9,10], lifestyle [11,12], and occupational demands (such as heavy load handling and highly repetitive movements with the wrist/hand) [11,13–16] are important risk factors.”
BackgroundAnxiety and depression are associated with poor outcomes in open elbow arthrolysis
Sun, W., Chen, C., Jiang, X., Hua, K., Zha, Y., Gong, M., Xiao, D., & Zhao, X. (2023) · Injury · doi:10.1016/j.injury.2023.03.041 · Cited by 7 · see citing works
Elbow, wrist kinematics and shock transmission of backhand stroke in wheelchair tennis players
Ju, Y., Chu, W.-T., Shieh, W., & Cheng, H. K. (2021) · Sports Biomechanics · doi:10.1080/14763141.2020.1862903 · Cited by 7 · see citing works
Acupuncture therapy for tennis elbow
Zhou, Y., Chen, C., Yang, Y., Yu, H., & Yang, Z. (2021) · Medicine · doi:10.1097/md.0000000000024402 · Cited by 7 · see citing works
ARTHROSCOPIC TREATMENT FOR LATERAL EPICONDYLITIS: OUTCOMES IN 104 CASES OF A SINGLE INSTITUTION
do Nascimento, A. T., Claudio, G. K., Rocha, P. B., Zumárraga, J. P., & de Camargo, O. P. (2019) · Acta Ortopédica Brasileira · doi:10.1590/1413-785220192703216249 · Cited by 6 · see citing works
Filippo, L. D., Pennella, D., Maselli, F., & Arrigoni, P. A. (2020) · Muscles Ligaments and Tendons Journal · doi:10.32098/mltj.01.2020.07 · Cited by 6 · see citing works
The efficacy of Botulinum Toxin in Tennis Elbow: a meta-analysis of randomized clinical trials
Barreto, E. S. R., Júnior, C. R. A., Alencar, V. B., Leandro, M. P., Leite, L. M. B., Lins-Kusterer, L., & Kraychete, D. C. (2024) · International Orthopaedics · doi:10.1007/s00264-024-06339-6 · Cited by 5 · see citing works
Abuwarda, K., & Akl, A.-R. (2023) · Sensors · doi:10.3390/s23208623 · Cited by 5 · see citing works
Minimally invasive treatment of lateral epicondylitis
Urits, I., Markel, M. J., Choi, P., Vij, N., Tran, A., An, D., Berger, A. A., Cornett, E. M., Kaye, A. D., & Viswanath, O. (2020) · Best practice & research. Clinical anaesthesiology · doi:10.1016/j.bpa.2020.08.004 · Cited by 4 · see citing works
How one treats lateral epicondylitis – a survey among Brazilian orthopedists
Lazarini, R. F., Zan, R. A., Belloti, J. C., Filho, I. A. D. A., Centenaro, L. F. S., Matsunaga, F. T., & Tamaoki, M. J. S. (2021) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04445-9 · Cited by 4 · see citing works
Rodríguez-Huguet, M., Rodríguez‐Almagro, D., Rosety, M. Á., Viñolo-Gil, M. J., Molina-Jiménez, J., & Góngora-Rodríguez, J. (2024) · Journal of Hand Therapy · doi:10.1016/j.jht.2024.02.003 · Cited by 5 · see citing works
Kato, K., Otoshi, K., Tominaga, R., Kaga, T., Igari, T., Sato, R., Kurita, N., & Konno, S. (2021) · Orthopaedic Journal of Sports Medicine · doi:10.1177/23259671211054422 · Cited by 4 · see citing works
Wang, Q., & Yao, N. (2023) · Optical and Quantum Electronics · doi:10.1007/s11082-023-05803-8 · Cited by 4 · see citing works
RetractedMest, J., Flood, A., Toufexis, C., Waddington, G. S., Malliaras, P., & Fearon, A. M. (2025) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2025.13307 · Cited by 3 · see citing works
Fifty Most-Cited Research Articles in Elbow Surgery: A Modern Reading List
Baylor, J. L., Luciani, M. A., Tokash, J. S., Foster, B. K., Klena, J. C., & Grandizio, L. C. (2023) · Journal of Hand Surgery Global Online · doi:10.1016/j.jhsg.2023.03.009 · Cited by 3 · see citing works
Association of Work-Related Risk Factors and Lateral Epicondylitis among Chefs in Lahore
Matloob, M., Fatima, T., Baig, N., Khalid, S., Irfan, H., Hashim, A., & Tabassum, M. S. (2022) · Pakistan Journal of Medical and Health Sciences · doi:10.53350/pjmhs22168220 · Cited by 3 · see citing works
Work-Related Risk Factors for Lateral Epicondylitis in Chef in Lahore
Amjad, F., Matloob, M., Javed, N. U. N., Hashim, A., Chaudhry, A., Zafar, B., & Khan, K. (2023) · Pakistan Journal of Medical and Health Sciences · doi:10.53350/pjmhs2023171241 · Cited by 3 · see citing works
Depression and Somatization in Refractory Lateral Epicondylitis
Gürçay, E., TAMKAN, A. U., KARAAHMET, Ö. Z., TOMBAK, Y., Güzel, Ş., & ÇAKCI, A. (2019) · Archives of Rheumatology · doi:10.5606/archrheumatol.2019.7139 · Cited by 3 · see citing works
Assessment of Psychiatric Disorders and Sleep quality in Chronic Lateral Epicondylitis
Sağlam, G. (2022) · Ağrı - The Journal of The Turkish Society of Algology · doi:10.14744/agri.2021.24119 · Cited by 3 · see citing works
Viñolo-Gil, M. J., García-Campanario, I., Estebanez‐Pérez, M., Rodríguez-Huguet, M., Gago, M. L., & Martín-Vega, F. J. (2024) · Healthcare · doi:10.3390/healthcare12171758 · Cited by 2 · see citing works
Zhang, Y., Tian, J., & Chen, Z. (2025) · PLoS ONE · doi:10.1371/journal.pone.0323646 · Cited by 2 · see citing works
Júnior, C. R. A., Santos, R. S. S., Barreto, E. S. R., Azevedo, G. N., Lima, E. B. D. S., Lara, P. H. S., Pochini, A. D. C., Andreoli, C. V., Ejnisman, B., & Belangero, P. S. (2026) · The American Journal of Sports Medicine · doi:10.1177/03635465251383039 · Cited by 2 · see citing works
Luna-Villouta, P. F., Ribeiro, I. L., Faúndez-Casanova, C., Matus Castillo, C., Vásquez Gómez, J., & Vitoria, R. V. (2022) · Cultura Ciencia y Deporte · doi:10.12800/ccd.v17i53.1853 · Cited by 2 · see citing works
Liñan, J. M. A., Pérez, M. I. M., González, J. P., & Möller, I. (2021) · Apunts Sports Medicine · doi:10.1016/j.apunsm.2021.100353 · Cited by 2 · see citing works
Effects of sex and age on work-related upper extremity musculoskeletal disorders in Ontario, Canada
Tilley, P. M., Mulla, D. M., & Keir, P. J. (2023) · Work · doi:10.3233/wor-220175 · Cited by 1 · see citing works
EFFECTS OF ATHLETE PERSONALITY ON VARIABLES RELATED TO TENNIS INJURIES
Güler, M., & Abdioğlu, M. (2022) · European Journal of Physical Education and Sport Science · doi:10.46827/ejpe.v9i1.4463 · Cited by 1 · see citing works
Lateral Epıkondılıt Hastalarında Boyun Kasları Kuvvetı ve Enduransı
Uysal, H. H., & Öztürk, Ç. P. (2023) · Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi · doi:10.22312/sdusbed.1319112 · Cited by 1 · see citing works
Jokiel, M., Kaźmierczak, K., Czarnecki, P., Bartkowiak-Graczyk, A., Madziewicz, A., Bręborowicz, M., Miedzyblocka, M., Adamski, M., Kaczmarek, K., Kaczmarek, L., et al. (2024) · Medicina · doi:10.3390/medicina60071184 · Cited by 1 · see citing works
Prise en charge des épicondylites latérales
Lenoir, H., Marès, O., & Carlier, Y. (2019) · Revue de Chirurgie Orthopédique et Traumatologique · doi:10.1016/j.rcot.2019.09.005 · Cited by 1 · see citing works
Ge, L., Cheng, F., Zhang, R., Chen, Z., Yao, X., Xie, Y.-P., Li, G., & Liu, X. (2022) · Research Square · doi:10.21203/rs.3.rs-1881909/v1 · Cited by 1 · see citing works
Psychological Characteristics of 16-18-Year-Old Tennis Players
Kichenok, N. (2021) · Ukraïnsʹkij žurnal medicini bìologìï ta sportu · doi:10.26693/jmbs06.04.226
Kirithika, G., Kamalakannan, M., Ramana, K., & Anitha, A. (2024) · Indian Journal of Physiotherapy and Occupational Therapy - An International Journal · doi:10.37506/v1zm1714
Facteur d’association entre l’épicondylite latérale et la dyskinésie scapulaire
Bouissou, C., & Mandigout, S. (2023) · Revue scientifiques des travaux de fin d'étude en rééducation et réadaptation. · doi:10.25965/rse2r.224
Psychological profiles of patients reporting with musculoskeletal shoulder or elbow pain
Xing, C., Lane, M. B., Feik, M. L., Taylor, J., Gregory, J. M., & Myers, N. L. (2025) · JSES International · doi:10.1016/j.jseint.2025.02.006
Szajewski, P., Roszkowski, B., Kotowicz, M., Ciećwierz, J., Zagórska, A., Zielińska, M., Bieniak-Pentchev, M., & Koczkodaj, M. (2025) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.4(48).2025.4200
Tümtürk, İ., Mehrioğlu, M., & Başkurt, Z. (2026) · Sağlık akademisyenleri dergisi/Sağlık akademisyenler dergisi · doi:10.52880/sagakaderg.1655883
A Literature Review of Lateral Epicondylitis: Diagnosis, Risk Factors, Management and Treatment
Biedroń, E., Pitra, M., Chmura, J., Zieliński, M., Fibiger, G., Plutecki, D., Dubrowski, A., Możdżeń, K., Walocha, J. A., Fibiger, W., et al. (2026) · Life · doi:10.3390/life16071043 · Cited by 1 · see citing works
Sharif, F., Rabello, R., Neal, B. S., Newman, P., Fearon, A., Swinton, P. A., Cooper, K., Lack, S. D., & Morrissey, D. (2026) · Physiotherapy · doi:10.1016/j.physio.2026.102383
- Authors
- Aben, A., De Wilde, L., Hollevoet, N., Henriquez, C., Vandeweerdt, M., Ponnet, K., & Van Tongel, A.
- Affiliations
- Ghent University Hospital (BE)
- Ghent University (BE)
- Venue
- Journal of Shoulder and Elbow Surgery
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 27
- Issue
- 3
- Pages
- 387-392
- ISSN
- 1058-2746 (ISSN-L)
- OpenAlex
- W2790936907
- Cited by
- 55
- References
- 18
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 13 · 2021: 11 · 2020: 4 · 2019: 5
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Shoulder and Elbow Surgery (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
- Keywords
- lateral epicondylitis, psychological factors, Big Five personality traits, perfectionism, anxiety, depression, job satisfaction, working conditions, workload, employee autonomy, sex differences, wrist extensors
- MeSH terms
- Adult, Anxiety Disorders, Belgium, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Surveys and Questionnaires, Risk Factors, Tennis Elbow, Incidence, Case-Control Studies
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