The majority of people that are diagnosed with tennis elbow, did not get it from playing tennis.
Tennis elbow has a more technical name – (extensor origin tendinopathy or lateral epicondylitis) and it involves pain experienced on the outside of the elbow with activities such as gripping or lifting. Other activities that usually slip under the radar are prolonged keyboard and mouse use, this can often overload the tendon and cause tennis elbow.
Tennis elbow is caused by overload on the extensor muscle group in the forearm. Repeated hand movements, such a gripping and repetitive manual work like gardening usually cause this overload. The small tendon where the muscle attaches to the elbow gets irritated and inflamed. Tennis elbow typically occurs gradually with increased activity that place greater loads on the elbow. Occasionally it can present with a sudden incident, such as a fall or catching a heavy object.
Tennis elbow can be a tricky condition to treat and can often require a balancing act between too much load and not enough load. As we all use our hands frequently throughout the day, it can be difficult to manage load and may often lead to flare-ups.
Tennis elbow – How do you know ?
There are specific clinical tests and assessments an experienced physiotherapists can do in order to diagnose your injury. Tennis elbow typically presents with pain on the outside of the elbow and may radiate down the forearm.
Diagnostic tests will include, activating specific muscles in the foramen that control wrist and finger movement. Applying gentle pressure to different tendons in the forearm may also reproduce pain.
Other conditions that may cause pain in the elbow area include, triceps tendinopathy, osteoarthritis (which is uncommon), muscle strains (settle quickly), or nerve pain referred from the neck. It is important to get your physiotherapist to diagnoses the correct presentation, as treatments often differ between these conditions and what is good for one may cause your tennis elbow to flare-up.
How is tennis elbow treated?
Treatment often includes:
Planning guidelines and education around the activities that cause the overload or overuse. How much pain should you “allow” during and or after activity? Work with your physiotherapist to help guide you though a recovery plan without aggravating the condition further.
Graded strength and activity is essential for treating tennis elbow. This can play a role in improving strength and power in the elbow and wrist and help desensitise the tendons in that area. Once we achieve those goals we can begin with graded return to full activities without pain.
If your tennis elbow has been left untreated or in more severe case, your physiotherapist may work with your treating doctor to discuss medications, cortisone injections and PRP (platelet rich plasma) injections.
Conclusion
Tennis elbow is a common injury, usually due to an increase in load. Increases in load or doing ‘too much, too soon’ –the muscles around the elbow do not have time to build up the strength and cope with the new activity. This is the primary cause of tennis elbow. With treatment, improvement can be seen over a 2-3month period, full recovery or return to high loads like heavy lifting and sports may take longer.
Ultimately, tennis elbow generally responds well with physiotherapy. Obtaining the correct diagnosis and treatment is important. Consulting an experienced physiotherapist is the best approach to getting you back on doing the activities that you love.