If you are told you have tennis elbow you may feel baffled if you have never picked up a tennis racket in your life! However, this common condition is basically an over use injury and can occur with unaccustomed or prolonged daily activity.
To clarify, you don’t have to be a tennis player to suffer from tennis elbow! It is caused by the repetitive movements and the gripping actions common in tennis hence the term ‘tennis’ elbow. However, it may also occur in other activities requiring repetitive gripping actions. Tennis elbow can therefore stem from daily activities such as using scissors, cutting meat, carrying grocery bags, gardening, manual work that involves repetitive turning or lifting of the wrist, such as plumbing, or bricklaying, and typing.
If you have tennis elbow you can experience pain when performing gripping tasks or resisted wrist/finger extension. Pain can also be present when your forearm muscles are stretched. There
is probably tenderness directly over the lateral epicondyle, the bony bump on the outside of the elbow, and tender points (trigger points) in the forearm muscles. In some cases you may also
experience neck stiffness and tenderness, and possibly also signs of nerve irritation like numbness and tingling. Most elbow movements are pain-free despite the surrounding area being painful.
The pain is felt on the outside of the elbow, unlike ‘golfer’s elbow’ where the pain is felt on the inside of the elbow.
ACUTE VS CHRONIC
Acute tennis elbow, also known as lateral epicondylitis, is an injury to structures involved in extending (straightening) the wrist and fingers at the site where the forearm muscles attach to the bone via the extensor tendon. It occurs when more force is applied to that area than the normal healthy tissue can handle.
WHAT CAUSES IT?
Sometimes just a weekend of home DIY may trigger it! But if you are a tennis player these may be some of the reasons you develop tennis elbow:
Unaccustomed hand use such as starting the tennis season, or increasing the frequency or amount of time playing tennis too quickly.
Excessive gripping or wringing activities, possibly a new racket or different grip size
Poor forearm muscle strength or tight muscles Poor technique (this may be a poor tennis shot).
Chronic (ie. longer term) tennis elbow is associated with degenerative changes in the tendon. While a sudden acute flare up of tennis elbow may have some inflammation or swelling, chronic tennis elbow generally doesn’t involve inflammation and is instead associated with changes in the nerves and blood supply to the tendon.
Unfortunately, rest as a treatment is rarely helpful. If left untreated, tennis elbow can last anywhere from 6 months to 2 years and can have a serious affect on your sport, daily activities and work. Physical therapy is effective both in acute and chronic tennis elbow, and there are several things you can do to help in recovery and prevention.
No tennis racket in sight!
TREATMENT
Tennis elbow should be diagnosed by a physical therapist or doctor. A history is taken and tests performed. Referred pain from the neck and reduced nerve mobility can mimic tennis elbow. The physical therapist must check your neck and clear it from any involvement in your elbow pain. An ultrasound scan or MRI are the best tests to identify tendon damage, but are often not necessary.
Physical or manual therapy treatments than can help include:
Massage therapy to relieve pain and stretch tight muscles and
structures
Manual therapy can mobilise joints in the elbow and around the neck
to ensure normal function.
Taping and braces are beneficial in reducing pain in the elbow and supporting the muscles when you return to sport
Ice and ultrasound therapy may be used to reduce inflammation.
Dry needling can also be effective for pain relief, releasing trigger points in the muscle and promoting tissue healing.
Exercise therapy should be prescribed to strengthen and balance the muscles of the forearm, while stretches help to lengthen tight muscles.
Other treatment options may include injections, which should only be considered if the exercises have not helped. At Blackberry Clinic our MSK doctors offer various injection treatments for chronic tennis elbow including PRP injections, steroid injections and prolotherapy. Very rarely, for stubborn cases when all treatment has been exhausted, surgery can be carried out under local injection (subcutaneous tenotomy) with a 95% success rate and no reduction in grip strength.
You need to try and prevent tennis elbow from occurring or recurring,which unfortunately it has a tendency to do, which means finding out what caused the injury and addressing these issues with the help of your therapist.
WHAT CAN I DO TO HELP?
Try the following modifications to the equipment causing your tennis elbow:
These changes refer to tennis but some changes are relevant to tools/ work equipment too.
Always increase your work load or tennis time gradually, allowing your muscles time to adapt to the new demand.
Conditioning your muscles and arm with specific exercises will go a long way to playing pain-free tennis!
Use a lighter racket or one with a more flexible shaft
Increase the racket grip size
Use string vibration dampeners
Reduce string tension
Increase the racket head size
Play with newer balls
Don’t play with wet balls
Use softer grip material
EXERCISE HANDOUT
For exercises to help with your tennis elbow click on the link below:
[download id=”15819″ template=”Exercises for Tennis Elbow”]
The information contained in this article and the exercise handout is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical
care or as a substitute for specialist medical advice in each individual case. All exercises are done at your own risk. (Blackberry Clinic Group Ltd)
