Tennis Elbow, or Lateral Epicondylitis/Epicondylosis is a condition that can happen to anyone, although it gets its name from tennis, it is more commonly from repetitive manual use. It happens when the tendons that attach to the outside of the elbow (something called the common extensor tendon attachment) are overloaded with intense or repetitive actions and micro tissue tears occur. Pain and sometimes swelling can be felt around the bony prominence on the outside of your elbow and can spread into the forearm and even the wrist. This might come on suddenly but often builds up gradually.
What Causes It?
We used to see this a lot more in weekend DIY warriors before power tools took the strain – gripping and twisting motions can often be a cause.
- Jobs involving a lot of heavy lifting or heavy tools, or blunt tools eg secateurs in gardening
- Repeated movements with gripping and squeezing or twisting – especially gripping a small pen or even typing and gripping the mouse
- Taking up a new hobby or sport where you try to play too much or progress too quickly
- Deciding to pain the whole house one weekend, or chopping wood, or hammering or other DIY that you are not used to doing
- Poor sports technique, not holding a tennis racquet properly, weak wrist in hitting sports, not fit enough for the amount you’re playing – you may benefit from a coaching session to look at technique (the coaches at Marlborough tennis club are excellent)
- Age is a factor – tennis elbow commonly presents at about 40-50 years of age with between 1-3 people in every 100 experiencing it
Self Management
In the first instance is to rest from aggravating activities if you can and try ice (mostly to desensitise the pain) and simple over the counter pain killers.
Rest: You don’t have to stop sports and activity completely, but taking a step back and reducing the number of sessions per week can help.
Ice: Wrap some ice in a cloth and cover the painful area as much as possible for 15-20 mins at a time.
Exercises: Stretching exercises and gentle forearm exercises are great, to prevent the injury in the first place and to help ease any pain and discomfort.
Extensor Stretching
Place the back of each hand against each other, pushing the elbows down so that they are aligned.Hold for 30 secs. Try 3 or 4 reps or do one every so often throughout the day
Extensor Stretch (Elbow Bent)
With the elbow bent and locked into your side, use the opposite hand to push the back of the hand towards the floor.Hold for 30 secs. Try 3 or 4 reps or do one every so often throughout the day
Extensor Stretch (Elbow Extended)
Perform the same movement as the exercise above but keep the elbow extended with the hand further in front of you. Hold for 30 secs. Try 3 or 4 reps or do one every so often throughout the day
Eccentric Wrist Extension
Holding a light dumbbell or can of food, place most of your forearm on a table with the wrist over the edge.
Keep this hand relaxed.
Use the opposite hand to assist to lift the dumbbell and your relaxed hand upwards, before letting go and slowly lowering the dumbbell towards the floor.Perform 3 sets of 5 repetitions. Build to 3 sets of 15 reps when comfort allows
In Sports …
- Warm up and give your muscles a stretch before and after play
- Use your full arm when possible instead of just wrist and elbow eg in a forehand hit give yourself plenty of room to swing
- Make motions smooth not jerky
- Use a looser grip on the racquet or make the grip larger
- Increase the strength of the muscles around your shoulder, elbow, forearm and wrist
Listening to yourself: Most importantly, you understand yourself better than anyone. If you feel like playing more tennis would probably do more harm than good, just rest. Don’t return until you are comfortable to do so.
How can Physiotherapy / Sports therapy help?
If you’re fed up with putting up with tennis elbow pain or want more assessment and advice to confirm your diagnosis and plan options for treatment, come and see us.
We can answer any questions, help you modify activities, offer pain relief (laser therapy, massage techniques and acupuncture can all help) – we may try taping techniques or suggest you try a clasp or brace, known as an epicondylitis brace which you wear during aggravating activities to reduce pain and help you continue with your work or sport.
We assess the WHOLE PERSON to see if there are any other areas that need help, neck, shoulder, wrist – it’s a whole chain….remember the song ‘the hip bone’s connected to the thigh bone….!’
