Tennis Elbow
What Is Tennis Elbow?
Tennis elbow, or lateral epicondylitis, is a tendon injury that occurs on the outside of the elbow. There is a bony prominence there on which the wrist extensor muscle group all attach. These muscles run along the top of the forearm and are involved in movements such as bending the wrist back, making a fist, and twisting the forearm. Tennis elbow occurs if the tendon of these muscles becomes overloaded and damaged, causing elbow pain and stiffness on the outer aspect. Tennis elbow and Golfers elbow are similar in nature and are the two most common elbow problems we treat at The Physiotherapy Place.
What Causes Lateral Epicondylitis?
Tennis elbow is so called because it can be caused by poor technique in a tennis shot. However, this is only one of the many ways that tennis elbow can happen. Any activity that creates excessive load to the muscles on the top of the forearm can cause the repetitive strain known as tennis elbow. Some common examples are:
gripping e.g. a paintbrush
twisting e.g. a screwdriver when doing DIY
pinching e.g. when weeding in the springtime
typing and using the mouse with poor posture
It typically is a condition that builds up over time and by the time that you feel pain in the elbow, the problem has likely been developing for weeks or months prior to that without you necessarily knowing it.
What Does Tennis Elbow Feel Like?
If you have tennis elbow, you will likely feel symptoms such as:
pain on the outside of the elbow, and sometimes into the forearm
increase in pain when gripping tightly or shaking hands, using a screwdriver or twisting a jar, or any activity that requires wrist and hand use
the outside of the elbow can be very sensitive to touch, especially if bumped accidentally
it may get very stiff, especially first thing in the morning.
How Long Does It Take For Lateral Epicondylitis To Heal?
Left untreated, tennis elbow can take several months or even years to heal if the aggravating factor continues to irritate the tendon. With the correct treatment and optimal healing conditions, the tendon should heal in 2-3 months.
What Is The Best Treatment For Tennis Elbow?
Treatment is 2-fold.
Firstly any biomechanical factors that are causing the tendon damage must be corrected. This might mean postural correction or altering technique with certain activities.
Then the tendon itself is treated with a combination of friction massage, soft tissue massage, dry needling, ultrasound, shockwave and taping to support the tendon. All of these treatment techniques can help at different stages of tissue healing and an exercise program will be prescribed to strengthen the muscles accordingly.
Shockwave And Tennis Elbow
A relatively new treatment for Tennis Elbow that has a substantial body of evidence to back it up is Shockwave therapy. Shockwave is a machine that delivers an acoustic wave directly to the injured tendon, increasing blood flow and metabolic activity in order to optimise healing. We are seeing great results with Shockwave therapy at The Physiotherapy Place, with patients noticing a huge improvement after only a few sessions.
What To Avoid When You Have Lateral Epicondylitis?
The most important thing is to avoid aggravating activities. This usually means any repetitive twisting, gripping, screwing or even typing with the affected arm. Anytime the muscles on the top of the forearm are under strain means that the tennis elbow will be under strain too. Too much of this will delay the healing process.
How Do You Treat Tennis Elbow At Home?
Rest from aggravating activities and stretching the muscles on the top of the forearm are the first ports of call. You can do this stretch by having the affected elbow straight and using the other hand to pull the fingers and palm down towards the wrist. You should feel the stretch along the top of the forearm. In addition you can use heat and do some gentle self-massage to the forearm to get blood flow to the tendons to aid healing.
What Will A Physio Do?
A physiotherapist will diagnose the problem and the underlying issues that have lead to the tennis elbow in the first place. This might lead to treatment being done in the neck or shoulder on the affected side if an issue has been found here. Correcting any imbalances is important to take pressure off the elbow and then treatment directly to the tendon will be more effective. Some treatment techniques that I like to use for tennis elbow include friction massage, Gunn IMS, ultrasound, and a progressive program to strengthen the tendons.