What is Tennis Elbow?
Tennis elbow is a common term for lateral epicondylitis. It refers to pain on the outside of the elbow where the muscles of the forearm attach to the bone.
What Causes Tennis?
Overuse of the muscles that move the wrist is the most common cause for tennis elbow. Small tears appear in the tendon at its attachment to the bone. It tends to occur in people that do manual repetitive jobs using the wrist such as using a hammer, screwdriver or in people who do racquet sports, hence the term tennis elbow. People who do a bout of DIY or gardening whose muscles are not used to that level of exertion are also prone.
What are the symptoms?
Usually the symptoms are very well localised to the lateral epicondyle of the elbow (boney point on the outside of your elbow), but occasionally they can spread further down the forearm towards the wrist. Initially this will present as pain during activities involving the wrist extensor muscles, but if left to become chronic can cause pain even at rest.
First line treatment involves rest from the aggravating activity. This can be difficult as it usually affects the dominant arm and activities that are part of work. A tennis elbow clasp can help lessen the forces through the tendon allowing activities to continue. Most cases will settle over 12 weeks but some can persist for a couple of years. Steroid injections can give excellent results in the short term but don’t address the cause so pain normally returns once the effects wear off. Physiotherapy has much better long term outcomes.
Specific exercises and stretching
Prescription of specific exercises to strengthen the affected muscles and stimulate collagen synthesis to rebuild the tiny tears in the tendon.
To offload tension and ease pain from the painful area.
Soft tissue massage
To release tight muscles that will place longitudinal tension on the area.
Sound wave therapy to improve the quality of the inflammatory process (Acute problems only).
For pain relief and healing stimulation
Your tissue heals at a rate that cannot be accelerated, only optimised, so expect resolution for chronic cases to take at least 3 months. More recalcitrant cases may require attention from an Orthopaedic surgeon but surgery is rare only a last resort.
It is difficult to prevent tennis elbow however the stronger your forearm muscles are the less likely you are to suffer from it.
Golfers elbow, or medial epicondylitis refers to pain on the inside of the elbow where the muscles of the forearm attach to the bone. It’s pathology is essentially the same as Tennis elbow and is not exclusive to people who play golf. The symptoms and treatment advice is also the same.