What is tennis elbow?
Tennis elbow is caused by a strain to tendons in the forearm.
Any activity, including playing tennis, that involves repetitive use of the extensor muscles of the forearm can cause acute or chronic tendonitis of the tendinous insertion of these muscles at the lateral epicondyle of the elbow.
The condition is common in carpenters and laborers who swing a hammer or other tool with the forearm, and is similar to golfer’s elbow, which affects the medial epicondyle the inside of the elbow.
Continuing activity after onset of the condition and avoiding mandatory rest may lead to permanent onset of pain and only treatable via surgery.
The tendons become inflamed where they join the bony part on the outside of your elbow joint.
Any activity that involves gripping and twisting of the forearm can cause this type of strain – most cases aren’t actually related to tennis or any kind of exercise.
What are the symptoms?
Symptoms vary – you may have mild discomfort when you move your arm, or the pain may be bad enough to disturb your sleep.
Symptoms of tennis elbow / lateral epicondylitis
- Pain about 1-2 cm down from bony area at the outside of the elbow (lateral epicondyle)
- Weakness in the wrist with difficulty doing simple tasks such as opening a door handle or shaking hands with someone.
- Pain on the outside of the elbow when the hand is bent back (extended) at the wrist against resistance.
- Pain on the outside of the elbow when trying to straighten the fingers against resistance.
- Pain when pressing (palpating) just below the lateral epicondyle on the outside of the elbow.
Two types of onset are commonly seen:
Sudden Onset: Sudden onset of tennis elbow occurs in a single instance of exertion such as a late back hand where the extensors of the wrist become strained. This is thought to correspond to micro-tearing of the tendon.
Late Onset: This normally takes place within 24-72 hours after an intensive term of unaccustomed wrist extension. Examples may be a tennis player using a new racket.
What can the athlete do?
- Apply ice or cold therapy to the elbow (20 min’s on up to six times a day). This will help reduce pain and inflammation if present.
- Rest – an extremely important component in the healing of this injury
- Wear a brace or support to protect the tendon whilst healing and strengthening, particularly when returning to playing / equivalent. The brace should not be put on the painful area but rather approximately 10cm down the forearm.
- As with all soft tissue injuries a comprehensive exercise program should be carried out. This is particularly the case with tennis elbow.
What can be done to help?
Simple self-help treatments are probably all you’ll need to clear up your tennis elbow.
Most cases will ease within about 2 weeks and you probably won’t need to see a doctor.
The first thing you can do to help is to adapt any movements that may be causing your symptoms.
For example, lift objects with your palms facing upwards and elbows bent.
Painkillers may help you.
It’s important that you take them regularly and at the recommended dose to help you control the pain and allow you to continue exercising.
Don’t wait until your pain is severe before taking painkillers.
You can also rub anti-inflammatory cream directly onto the painful area.
If your elbow pain is affecting your activity and is persisting, ask your doctor about referral to a physiotherapist.
Physiotherapy can help you to manage pain and improve your strength and flexibility.
A physiotherapist can provide a variety of treatments, help you understand your problem and get you back to your normal activities.
They may recommend an epicondylitis clasp, which can help reduce the strain on your elbow if you need to make repetitive hand and elbow movements, for example while you’re working.
Your pain should ease within 2 weeks and you should recover over approximately a 4–6 week period.
You should carry on with the exercises overleaf for at least 6–8 weeks after the pain disappears to help prevent symptom returning.
– Dr.Chandra Shekar