What is Tennis Elbow?
Lateral Epicondylalgia, commonly referred to as Tennis Elbow, is an overuse injury of the wrist extensor muscle tendons – the muscles used to bend your wrist back. Depending on the stage of the condition, different changes occur and different symptoms are experienced. In the early stages of Tennis Elbow, an inflammatory process causes pain and dysfunction. If this is allowed to progress, further changes occur within the tendon resulting in disorganisation of collagen fibres and growth of new nerves and blood vessels.
What does it feel like?
The common presentation is pain on the outer (lateral) side of the elbow, which may radiate down the forearm and worsen with gripping, wrist extension (wrist bending backwards) or finger extension (finger straightening).
What causes it?
This pain may start either with a mechanism such as a direct impact to the muscle, a sudden onset after a strain involving the wrist extensors, or most commonly it will build up gradually during unaccustomed tasks that require loading and repetitive gripping and/or repeated wrist extension activities. These tasks include sports such as tennis, squash, and badminton, as well as occupational and leisure activities such as carpentry, bricklaying, sewing, and knitting. Prolonged computer use has also been linked to the development of this condition.
Tennis Elbow affects 1-3% of the western population with equal risk of women and men developing the condition. The typical age range is 35-55 years, with the dominant arm commonly affected.
What can I do about it?
Physiotherapists will assess the affected area to determine the stage of the condition and to rule out other conditions. These tests may involve stretching the muscle, assessing wrist and finger muscle strength and analysing other biomechanical factors. After getting your symptoms properly assessed, an individualised treatment plan is then given depending on the stage of the injury. This is important in recovery and to prevent from re-occurrence.
If this is the first time you have experienced these symptoms, the aim of the first stage of treatment is to deload the area – decreasing the pain, reducing inflammation and allowing the tendon to repair. This may involve advice and education on reducing the inflammation, using therapeutic ultrasound, and deloading the muscle tendons using taping techniques.
Once the pain and inflammation settles the next stage is to gradually reload the tendons – promoting changes within the tendons to increase its strength and flexibility which will prevent the condition from returning. A progressive strengthening and stretching program with modifications of any biomechanical factors for return to work or sport will be used to achieve this.
Some examples of exercises for tennis elbow include: