Tennis Elbow

Tennis Elbow is one of those well-known diagnosis’s that everyone seems to have heard of. If you have ever experienced elbow pain its more than likely someone said to you “oh yeah that’s tennis elbow.”

So what is exactly tennis elbow? Strangely enough it’s often not related to tennis at all. Most of the cases of tennis elbow we treat are people who don’t even own a tennis racquet.

Clinically it’s known as Lateral Epicondylitis or Lateral Tendinopathy and is an irritation/inflammation and/or a degeneration of the common extensor tendon of the elbow. This common tendon is formed by all the muscles in the forearm that act to extend your wrist and hand.

Common Signs and Symptoms

  • Pain on the outside of the elbow
  • Tenderness to touch the outside of elbow
  • Pain with gripping, reaching, using keys, shaking hands
  • Stiffness and increased irritation in the morning
  • Pain can refer down into the forearm

What causes it Tennis Elbow

The simple answer is Overload. There can be a number of issues that contribute but often it comes down to overloading the tendon. This overload can come from repetitive movements of the wrist, excessive squeezing or gripping activities. It can also come from beginning a new activity or a sudden increase in current activity e.g. someone who just started weight training or started doing increase in manual labour etc.

Often people don’t realise how many day to day activities use the muscles of the forearm, in fact as you sit there right now, scrolling on your phone or computer, texting, typing, holding a knife and fork. It’s all gripping which all accumulates as load.

What should you do?

  1. Stop irritating the elbow

This can be hard if the irritating movements are work related. This is where some short term ‘unloading strategies’ can come in handy. Ask your physiotherapist about taping techniques for the elbow or you can also look into a tennis elbow brace which can offload the are in the short term and provide relief.

Additional aggravating movements activities that can be avoided should be put aside where possible to allow reduction in overall load.

  1. Stop poking & prodding at it!

Quite often people will come in and say they have tried to self-massage the sore point of the elbow. They have stuck in their trigger ball, knuckles, tried to aggressively stretch it.

Great you are trying to self-manage BUT in this case we need to stay away from the hot spot that’s sore and inflamed.  The massage needs to be directed down the forearm away from the sore spot. There are also some mobilising techniques around the elbow that your physio should be able to apply to assist with reducing irritation and pain.

  1. Slowly Reintroduce Load

This will involve some specific strengthening exercises to slowly build back the strength and take away the pain. These tendons actually respond well to load, it’s just about finding the right amount to assist with healing without irritating it further. Isometric holds along with light gripping activities will most likely be the start of your rehab exercises, but again you should be guided by your physiotherapist.

The take home message…..

Don’t let that niggle on your elbow get worse and worse and worse…. Ultimately the longer you leave it and greater the level of irritation and the longer the recovery process.