Featured Speaker Physiotherapy Now

Dr. Bertrand Perey

Orthopaedic Surgeon, New Westminster, BC

Dr. Bert Perey, MD, FRCPC, Orthopedic Surgeon, discusses tennis elbow causes and symptoms.

BIO: Physiotherapy Now


Dr Bertrand  Perey is currently in active practice at the Royal Columbian Hospital and Eagle Ridge Hospital in the Fraser Health Authority of British Columbia. The focus of his practice is hand, wrist and elbow surgery.

He is Chief of Surgery and Head of the Division of Orthopaedics at the Royal Columbian Hospital and currently serves as a consultant in hand surgery to WorkSafe BC.

Dr. Perey is affiliated with the University of British Columbia as a Clinical Associate Professor. He is actively involved in teaching at both the undergraduate and post-graduate levels. He is a member of the Residency Program Committee and is actively involved in hand and upper extremity surgery training for the residents of this program.

Dr. Perey is a graduate of Dalhousie University Faculty of Medicine (1986) and completed his residency training in orthopaedic surgery at the University of British Columbia in 1995.

After completing a one-year fellowship in hand surgery at the University of British Columbia in 1996, he performed a second-year fellowship in hand, wrist, and elbow surgery and upper extremity reconstruction at Harvard University in Boston, MA, under the mentorship of the world-renowned Dr. Jesse Jupiter.

Dr. Perey is a fellow of the Royal College of Surgeons of Canada and a Diplomat of the American Board of Orthopaedic Surgery. He is a member of the Canadian Orthopaedic Association, and past section head for hand, wrist and elbow surgery and the annual association meeting. In addition, he is a past president and founding member of the British Columbia Hand Society. Dr. Perey was previously the hand surgeon for the BC Lions. Now Health Network

What is Tennis Elbow and How is it Caused

Tennis elbow, also known in medical terms as lateral epicondylitis, is a painful condition to the lateral aspect of the elbow.

It was first described by a physician over a hundred years ago who cared for a bunch of tennis players in a British lawn tennis club. Today, most patients who develop lateral epicondylitis, or tennis elbow, aren’t in fact tennis players or have anything to do, in fact, with tennis. But the condition is ubiquitously diagnosed by pain over the lateral epicondyle, which is a small bone on the outside of the elbow.

Patients with tennis elbow, or lateral epicondylitis, all have pain; it’s a painful condition. Some patients may experience some associative weakness, but by and large it’s associated with pain.

Pain is present on the outside of the elbow over a bone called the lateral epicondyle. The muscles that move the wrist up and down, called the wrist extensors, attach onto this bone and this is where they pathology occurs.

Tennis elbow is caused by a tear in the muscle that inserts into the lateral epicondyle. It is the wrist extensors that attach into this bone, and patients can get a tear with a very trivial injury, or with a very heavy impact. Most of the time it’s not caused by any major trauma, patients just notice pain in the elbow, and it can be after lifting a box of groceries.

The pain that’s exhibited in the elbow rarely goes away very quickly because of a very bad healing process that occurs in that bone, due to bad blood supply; there’s usually a scar that forms. And thus a normal healing process that occurs in most tendons doesn’t occur in this instance.

So patients may experience pain for a long, long time before, alternately, that scar is absorbed and the full healing process occurs. Most patients who have this are in their third, fourth decade of life, although it can happen in younger patients as well as in the older patients. It can happen in any elbow, and often patients may get it first in one elbow followed by the other elbow subsequently.

Some people can make modifications in their sporting activities from an ergonomic perspective if they can’t get rid of this entity – making changes in the size of their racket, their grip, the string if it’s due to tennis.

It may be due to golf, it may be due to other activities or sports that people do that they can make changes that will help accommodate this pain during that healing process.

Presenter: Dr. Bertrand Perey, Orthopaedic Surgeon, New Westminster, BC

Local Practitioners: Orthopaedic Surgeon

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