Tennis Elbow – What you need to know.
Tennis elbow is a very common injury that we, as physiotherapists, see in clinic. The name, however, is misleading, as it is mostly non-tennis playing people that it affects!
What is tennis elbow?
Tennis elbow is caused by overuse or strain to the tendons in the forearm. Tendons are tissues that connect the muscles to the bones. In tennis elbow, it is the tendons that connect the forearm muscles to the bony prominence on the outside of the elbow that become inflamed and painful. Repeated activities that involve gripping, extending the wrist, or twisting of the forearm can cause this type of strain on the tendons.
Common causes of tennis elbow include:
- Prolonged desk work – resting the arms on the desk with the wrists in an extended position whilst you type causes over use of the forearm muscles.
- Activities that involve fine, repetitive hand and wrist movements – such as using scissors
- Using a paintbrush or roller whilst decorating
- Manual work – such as bricklaying
- Using secateurs or shears when gardening
- As well as throwing and racket sports.
What are the symptoms?
You may start to notice a mild pain around the out side of the elbow. This can become progressively worse with some people suffering with pain radiating down the forearm as well. You will normally experience tenderness on the outside of your elbow and there may be swelling. Repetitive movements of the wrist will make symptoms worse, gripping and lifting heavy objects will also aggravate symptoms.
Ways to help your tennis elbow:
- Ensure that you have the optimum desk set up.
- Wrists shoulder be straight – you may need a small support under the wrists by the keyboard or mouse.
- Rest your arms on your desk when typing – ensure that your chair is at a height that allows this.
- Stretch your forearms out 1-2 times a day in you predominantly do deskwork. Try the following stretch, holding for 30 seconds:
- Wearing an elbow clasp:
Wearing the elbow clasp can off-load the tendons that are inflamed and allow you to continue with activities.
Massaging the forearm muscles can ease the tightness in the muscles contributing to the pain and pressure on the outside of the elbow.
- Strengthening of the forearm muscles. With tendon problems it is really important to optimally load the affected area with exercise. A physiotherapist would be able to guide you through this process – as the type of exercise required depends on you stage in the healing process and the severity of the injury.
Other things to consider….
Painkillers such as Paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen, may help ease mild pain and inflammation caused by tennis elbow.
Topical NSAIDs, such as Voltarol, applied over the area can also help, with the advantage of not having the side effects associated with oral medications.
If the pain persists and does not respond to conservative treatment, then it may be recommended to have a corticosteroid injection. The injection requires relative rest for 2-3 weeks afterwards, and can temporarily increase symptoms. There is also no guarantee that it will be effective – there is limited clinical evidence to support their use as an effective treatment for tennis elbow.
AUTHOR: Laura Lewis