What is Tennis Elbow?
Tennis elbow, or Lateral Epicondylalgia, is a condition that causes pain on the outside of the elbow. This pain comes from problems with the muscles and tendons that help you extend your wrist and fingers.
Why Does It Happen?
The muscles most often involved are the extensor carpi radialis brevis, extensor digitorum, extensor carpi radialis longus, and extensor carpi ulnaris. These muscles help stabilize your wrist for hand movements and play a minor role in stabilizing your elbow. When these muscles are overused or strained, it can lead to tennis elbow.
What’s Going Wrong?
In tennis elbow, the tendon, which connects the muscle to the bone, doesn't heal properly. There is an increase in cells and a change in the normal structure of the tendon. Blood vessels and nerves grow into the tendon, which can cause pain. These changes usually happen in the deeper part of the tendon, while the rest remains healthy. It's like the tendon tries to heal but fails to do so correctly.
Who Gets Tennis Elbow?
General Population: About 1-3% of people have tennis elbow.
Tennis Players: Up to 40% might get it.
Golfers: More common than golfer's elbow.
Manual Workers: Very common due to repetitive tasks.
Age Group: Most common in people aged 35-65, rare in those under 30.
Causes and Risk Factors
Repetitive Tasks: Activities that involve repetitive hand movements.
Occupational Risks: Jobs requiring repetitive tasks for more than 4 hours a day, lifting over 4.5 kg, using hand tools awkwardly, and overhead work.
Other Factors: Smoking, metabolic syndrome, and history of steroid injections.
Symptoms
Pain on the outside of the elbow, aggravated by gripping, lifting, or handling objects.
In severe cases, writing and gripping a pencil can be painful.
Sleep disturbances due to pain.
Dropping objects due to pain when picking them up.
The pain is usually localized to the elbow and does not radiate down the arm.
Examination
To diagnose tennis elbow, a doctor might:
Test for pain during wrist and middle finger extension.
Palpate (press on) the area where the tendon inserts into the elbow.
Compare grip strength between the affected and unaffected sides.
Check shoulder and elbow range of motion to rule out other conditions.
Management
Exercise:
Exercises should be done without causing pain and should not cause lingering pain beyond 10 minutes after stopping.
Focus on wrist flexion exercises with a band in a bent elbow position, gradually increasing resistance.
Example of exercise:
Pronation and supination with broomstick
Manual Therapy:
Combining exercise with manual therapy, like Mulligan mobilization with movement, can help reduce pain and improve function.
Taping:
Various taping techniques can help, such as spiral and diamond taping for pain relief, especially at night.
Principles of Treatment:
Monitor pain levels and adjust exercises if pain exceeds 3/10 or lasts more than 10 minutes after stopping.
Add manual therapy to increase exercise capacity.
Address any psychosocial factors, posture, and shoulder issues.
Tennis elbow can be a painful condition, but with the right treatment—including exercises, manual therapy, and lifestyle adjustments—it can be effectively managed. If you're experiencing symptoms, it's essential to consult a healthcare professional for a proper diagnosis and treatment plan.
Early intervention is key. Seeking a professional evaluation as soon as symptoms arise not only accelerates recovery but also reduces the risk of the condition becoming chronic.
Take control of your health today and begin your journey toward a pain-free life.
For expert physiotherapy treatment, call us today and take control of your recovery! If you prefer not to call, Joseph—who is passionate about helping those with invisible illnesses—is ready to assist. Reach out to him by email at joseph@movesportsphysio.com.au today!
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