<b>Prevalence of Lateral Epicondylitis and Associated Risk Factors Among Racket Sports Players in Lahore, Pakistan: A Cross-Sectional Study</b>

Background: Lateral elbow pain related to repetitive wrist extensor loading is common in racket sports, but local evidence among Pakistani athletes remains limited. Racket sport players may be exposed to sport-specific mechanical demands, gripping loads, equipment-related factors, and inconsistent warm-up routines that contribute to symptom and functional burden. Objective: To estimate the frequency and severity of lateral elbow symptoms and PRTEE-measured functional impairment among active racket sport players in Lahore, Pakistan, and examine associations with demographic and sport-related factors. Methods: This cross-sectional observational study included 265 badminton, tennis, and squash players aged 18–35 years recruited from sports clubs, universities, and academies in Lahore. Data were collected using a structured questionnaire, the Patient-Rated Tennis Elbow Evaluation, and the Numeric Rating Scale. Descriptive statistics, Pearson correlation, and chi-square tests were used for analysis. Results: Participants had a mean age of 23.65 ± 5.38 years, and 161 (60.8%) were male. Badminton players constituted 236 (89.1%) of the sample. Only 11 participants (4.2%) had a PRTEE score of zero, while 254 (95.8%) reported some degree of PRTEE-measured pain or functional limitation. NRS pain was mild in 118 (44.5%), moderate in 50 (18.9%), and severe in 35 (13.2%) participants. Age was positively correlated with PRTEE total score (r = 0.31, p < 0.001). PRTEE severity categories were significantly associated with gender (χ² = 21.50, p < 0.001), racket grip size (χ² = 44.48, p < 0.001), sport type (χ² = 39.22, p < 0.001), and warm-up routine (χ² = 27.00, p < 0.001). Conclusion: Lateral elbow symptoms and PRTEE-measured pain and functional limitation were frequent among sampled racket sport players in Lahore. Age, gender, self-reported racket grip size, sport type, and warm-up behavior showed significant unadjusted associations with symptom severity. Findings support routine symptom screening, structured warm-up education, and ergonomic equipment guidance, while future studies should include clinical diagnostic confirmation and adjusted longitudinal analysis