Tennis elbow, also known as lateral epicondylitis, describes pain on the outside of the elbow. It is generally considered to be an overuse injury due to repetitive use of the muscles of the arm and forearm, particularly the muscles that extend the wrist and fingers (extensors). This leads to small tears in the tendons that attach to the outside of the elbow (lateral epicondyle) and can result in degeneration. This can then result in pain and inflammation.
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Tennis elbow can occur as a result of any activity that involves repetitive use of the forearm muscles. As the name, suggests, it is also common in tennis players. Several factors can increase a person’s risk of developing tennis elbow, including:
- Activities involving prolonged gripping as with racquet sports, gardening or power tools, knitting or sewing, and painting.
- Prolonged and repetitive use of hand tools, particularly hammering.
- Repetitive heavy lifting (bricklaying, weight lifting).
- Excessive computer or keyboard use.
- Recent increases in work or sports training intensity, frequency or duration or a change in equipment.
Patients presenting with Tennis Elbow will have a very typical presentation including one or multiple of:
- Pain and tenderness on the outside of the elbow, which may spread down the arm to the fingers.
- Pain is aggravated by activities such as gripping objects, twisting tops off jars or doorknobs and carrying heavy objects.
- Pain initially relieved with rest.
- Weakness of wrist and finger extensor muscles.
Our Physiotherapists are skilled at performing a range of orthopaedic tests to confirm the diagnosis of a Tennis Elbow.
The initial aim of treatment is to reduce associated pain and inflammation. Rest from aggravating activities is important. Treatment and management options include:
- Avoidance of aggravating activities.
- Anti-inflammatory medication as recommended by a doctor or pharmacist.
- Taping, braces or supports as indicated.
- Physiotherapy- massage and mobilisations, ultrasound, shockwave therapy, taping/bracing and dry needling acupuncture.
- Development of a pain-free exercise program aimed at stretching and strengthening specific muscles around the elbow.
- Education and advice regarding technique correction for the aggravating activity.
A period of three to six weeks (at least) of physiotherapy should be allowed before considering other options. If symptoms persist, a corticosteroid injection into the painful area may be considered to assist in reducing pain and inflammation. In this case, continuing the exercise program provided is still important. Surgery is a last resort treatment and is rarely required.