Tennis elbow can be a debilitating pain felt over the outside of the elbow that worsens having played racquet sports. With the tennis season and full flow and Wimbledon underway we thought we’d share some information about tennis elbow or lateral epidocndylitis.
The elbow joint is composed of the humerus (upper arm bone) the radius and ulna (forearm bones).
These three bones form three joints; the ulnohumeral, radiohumeral and radioulnar. Each joint permits a different motion that allows us to bend and straighten our arm to feed ourselves and reach overhead as well as rotate through the wrist to open door handles and turn a key. The elbow joint is strengthened by ligaments that are much stronger on the inside than outside which can be one of the reasons the tendons on the outside of the elbow become injured.
What causes tennis elbow?
A tendon can become overloaded by exercising, working more than normal or due to poor biomechanics. The body is designed to heal itself when this happens but when the rate of damage is greater than the rate of repair the tendon becomes injured. If we catch this early during the ‘reactive’ phase the tendon will settle quickly with the correct management. If left to it’s own devices the tendon goes into a period of ‘dysrepair’ which can make it harder to repair. If left untreated the tendon goes into a degenerated state which could result in rupture and this stage is much harder to treat.
We don’t solely see tennis elbow in our tennis players but often in those people who do repetitive one-sided movements in their jobs such as electricians, carpenters and gardeners.
Only 5% of people with ‘tennis elbow’ relate the injury to tennis.
Pain is often felt strongest on the outside of the elbow but can radiate into the forearm and sometimes into the upper arm. There is often reduced strength in the wrist including gripping and lifting and there can be a previous shoulder injury or some weakness in the shoulder.
Often there is no specific injury associated with the start of symptoms and more commonly the symptoms creep up gradually. The dominant arm is most commonly affected though both arms can be affected in rarer cases.
- Activity modification; avoiding aggravating activities can be challenging especially when your symptoms are exacerbated by working.
- Anti-inflammatories if medically safe can be useful to ease pain and swelling if in the acute phase of injury
- Bracing or taping can offoad the tendon allowing you to function
- Gentle range-of-motion stretching exercises for the forearm muscles may help to reduce symptoms and preserve function
- Manual therapy including massage and acupuncture may be beneficial
- Shockwave therapy can aid healing by reducing muscle trigger points and increasing energy into the tendon which kick starts the healing cycle. Whilst it can be painful during treatment the benefits for pain are vast.
Are you struggling with tennis elbow? Let us know if we can help!