13/10/2024
Less Pain and More Power to Your Elbow
Lateral Epicondylitis or Tennis Elbow
Here is an overview of this common condition that leads to micro-trauma in the wrist extensor tendons at the elbow, plus a number of contributing factors that should be checked.
For those who suffer from tennis elbow, more than 2/3 will be affected on their dominant arm although there are probably far more people where the condition has little to do with tennis, particularly with the advent of lighter racquets, and the two-handed backhand. Whatever the cause, the discomfort starts with tenderness to the area just below the elbow on the back of the forearm, close to where the common wrist extensor muscles attach to the bone and is often troublesome to get rid of.
The problem arises from excessive repetitive action involving gripping, coupled with any movements extending the wrist, such as backhand in tennis, rowing, or using a screwdriver, to highlight just a few more common ones. The onset may be further exacerbated by jarring of the upper limb during the same activity, so when the racquet strikes the ball in tennis causing vibration through the racquet and arm, this may lead to micro-trauma and an inflammatory response within and around the tendons. The accompanying pain may also radiate towards the wrist.
Although the condition may start with too much of a particular activity, frustration will usually be heightened as it will be aggravated by many other simpler movements such as opening doors and jars, picking up kettles and cups, and even shaking hands. Strong indications to confirm you have tennis elbow will be localised tenderness just below the elbow in the extensor muscles, and discomfort or pain with any form of gripping.
Assessment of your condition should extend to checking the neck and shoulder region for any possible causative or contributory factors, as well as muscle tension and biomechanical imbalances resulting from the injury. These are important to correct during rehabilitation to ensure a full recovery and an unhindered return to sport or activity. Other checks must include racquet size, grip size, string tension, technique, and of course doing too much. You will almost certainly be advised to rest, but this is ‘easier said than done’ because you will find it difficult not to use your dominant arm for all regular daily activities.
Treatment should include alleviating the tension in both the forearm extensors and flexors as both will almost certainly be tight. Soft tissue massage and stretching of these muscles should then extend to other upper limb groups to release tension and facilitate normal movement patterns through the whole upper limb.
Although rest is essential in the early stages of injury, the key to a successful return to action must focus on returning normal flexibility and strength to the muscles and their tendons so that the affected area is well prepared for typical loading of the tissues.
Return to sport must be gradual, controlled, and carefully monitored. Normal upper limb biomechanics must be checked and integrated into any sport or daily activity to help prevent other problems or deficiencies in performance development.
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