What is Tennis Elbow?
Tennis elbow is a painful elbow disorder. This term is misleading because does it arise only from playing tennis. The technical name for tennis elbow is “lateral epicondylitis”. This term indicates an inflammation occurring near a small point or projection of the upper arm bone (humerus) just above the elbow joint on the outer side of the arm. However, pain can also occur in other areas of the forearm and elbow. Some experts suggest that “lateral elbow pain syndrome” is a more accurate name, but this term is not yet commonly used.
The pain from tennis elbow comes mainly from injured or damaged “extensor” tendons near the outside of the elbow called the “common extensor tendon”. Tendons are strong bands of tissue that connect muscles to bones. When repeatedly stressed or overused, tendons can become inflamed. This results in a painful condition called tendonitis, the medical term for inflammation of a tendon. Tennis elbow is simply a specific type of tendonitis that occurs in a particular part of the elbow known as the lateral epicondyle.
Playing tennis three times in a week when you haven’t played for some time is the sort of overuse that can cause tennis elbow. It is especially likely if you have a poor backhand technique or use a grip that is too large. However, there is a range of different activities not related to tennis that involve repeated hand, wrist or forearm movements that may cause lateral epicondylitis. These include using scissors or shears, gardening, ball sports, using tools (i.e. hammer), manual occupations that involve repetitive turning of lifting the wrist such as plumbing or brick laying.
The development of tennis elbow often relates to the way that activities such as gripping, twisting, reaching, and moving are carried out. These activities can become hazardous when they are done;
- In fixed or awkward position
- With constant repetition
- With excessive force
- Without allowing the body to recover from the wear and tear
- Weakness and inflexibility in the muscles of the forearm will also predispose you to developing the condition
- Signs and symptoms
Lateral epicondylitis usually affects your dominant arm. The main symptom is a gradual onset of pain and tenderness on the outside of the elbow, and sometimes in the muscles on the top of the forearm. Pain may go away after a day or so, but if the aggravating activity is repeated soon after the pain is likely to return and worsen as damage to the tendon progresses.
As the body compensates for the weakness you may also get pain and stiffness in other parts of the arm, shoulder or neck. Pain may become constant and interrupt sleep Other symptoms include morning stiffness, pain on turning door handles and shaking hands.
Tennis elbow requires attention as soon as the symptoms appear. Early intervention usually prevents the development of a serious disorder.
Rest from the activities that cause elbow pain is the most important treatment for tennis elbow. This kind of disorder is often called “self-limiting” because it eventually disappears when people change or avoid activities that cause elbow pain. It is important allow proper rest and not perform activities that cause pain, or continue the activity despite pain.
Physiotherapy intervention will aim to reduce pain, swelling and inflammation of the affected tendon, and then improve strength and endurance of the forearm before recommencing full activities. Treatment may involve ultrasound, icing, taping, muscles releases, interferential therapy, and specific exercises rehab programs, with the intent of gradual and structured return to full activity. Physiotherapy treatment can best be complimented with ongoing home treatment. The priority is resting the injured tendon and avoidance of the stressful activities, use of ice-packs and anti-inflammatories (i.e. ibroprufen, aspirin), and possible use of an arm brace/taping if the activity cannot be avoided.
For tennis elbow that is failing to heal, your doctor may prescribe a course of corticosteroid injections to reduce inflammation and speed healing. This treatment usually is effective in the short term, but cannot be used repeatedly.
Prevention of tennis elbow requires general awareness of the disorder and how it can relate to activities at work and prompt action to deal with the risk factors and eliminate them before the disorder develops.
Tasks associated with tennis elbow should be identified and modified to reduce the risk of serious or repeated injury. Of greatest concern is the use of fingers, wrists, and forearms in repetitive work involving forceful movement, awkward postures, and lack of rest. Avoid tasks that place excessive force, stress, or strain on muscles of the forearm. Effective prevention must deal with all disorders caused by repetitive work and the inappropriate demands on muscles and tendons.