Tennis elbow is a broad term often used to describe pain or discomfort on the outside of the elbow that has occurred from overuse of the hand, wrist and forearm musculature. Tennis elbow tends to occur either acutely, or gradually over time.
The bony part on the outside of the elbow (the lateral epicondyle) is where the muscles and tendons converge to form a common tendon that attach to this bony prominence and they permit movement of the hand and wrist (figure 1).
Health professionals refer to tennis elbow as lateral epicondylalgia. Studies of tissue samples have shown us that the tissues show a degenerative component as a result of micro trauma.
Tennis elbow most commonly affects people on their dominant side, or the side that is used for repeated gripping, high levels of resistance and movement at the wrist. Though it is possible for the condition to occur in both arms.
Symptoms vary from person to person, but common presentations include:
Aching or pain that is worsened by forcefully moving the wrist. Some activities may include handling kitchen utensils like using a knife to cut firm vegetables, opening a jar or a door, turning on the taps, using carpentry tools or gardening tools that require you to grip or twist and cleaning tables and windows.
An ache or pain that is experienced during or after gripping or squeezing objects.
Aching or pain around the area of the lateral epicondyle that may slowly develop over time. The onset of pain can also occur quickly, but less commonly.
Most literature suggests that tennis elbow can affect up to 50% of tennis players throughout their careers. It’s important to know that this condition can be just as common with non tennis players. Tennis elbow more commonly occurs in men more than women and is most commonly present between the ages of 30 and 50 years. However, tennis elbow can affect people of any age.
Despite being highly prevalent among tennis players, tennis elbow may affect anyone who participates in work or leisure activities that involves repetitive use of the elbow, hand and wrist, especially if there is a lot of force during gripping as part of the action.
Tennis elbow can be diagnosed by your physiotherapist. During the consultation, your physiotherapist should ask you a number of questions about you symptoms before they take you through a series of tests to determine the source of pain.
Only a small proportion of people require other imaging such as an ultrasound or CT. This will typically be because the symptoms may not fit the expected diagnosis, other structures may be involved, or a person may not be responding to the usual management of the condition.
Tennis elbow is successfully managed with physiotherapy treatment and a rehabilitation program. Other possible treatment includes cortisone injections, and in severe cases, surgery if there is no improvement with conservative means.
Some modalities to reduce pain would include:
Regular application of ice to the area
Taping the elbow, or using a brace, as per your Physiotherapist’s instructions
Avoiding movements that cause unnecessary pressure or stress through the forearm muscles and elbow
When the pain and discomfort have begun to subside, your physiotherapist will take you through some specific exercises to stretch and strengthen the muscles and tendons surrounding the elbow. There will be specific movements that you will be advised to avoid, including any activity that causes pain to the elbow either during or afterwards.
Your recovery may also be assisted with taping of the elbow / forearm or the use of a specific brace fitted by your physiotherapist.
Generally, a high percentage of people will make a full recovery with physiotherapy treatment and management. Around 5% of people require surgical intervention to repair the muscle and tendon around the elbow. In the 5% who undergo surgery, 80-90% experience pain relief and restoration of function.
By guest blogger Sophie Halsall-McLennan
Sophie Halsall-McLennan is the owner of Fresh Start Physiotherapy in Curlewis, Victoria and has a special interest in hand therapy, tennis elbow and back pain.
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