TENNIS ELBOW - ELBOW PAIN

Despite its name, tennis elbow often has nothing to do with tennis

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What is Tennis Elbow

Tennis elbow or lateral epicondylitis is an injury to the tendons at the outer side of your forearm close to your elbow. They are connected to the muscles called extensor carpi radials longus and brevis, and they function to help extend or abduct our wrist.

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Fun facts about Tennis Elbow:

• < 1/10 people experiencing tennis elbow actually play the game
• ~ 5% of people whose jobs involve repetitive arm motions/vibrating tools may develop tennis elbow (eg.) painters, assembly workers, musicians, nail technicians, dentists, just to name a few)
• Once thought of as an inflammatory condition, tennis elbow is actually a degenerative process of the ECRB (extensor carpi radialis brevis) tendon at the elbow

You're probably wondering, "Ok, so how did I get tennis elbow and what do I do about it?!" Let's get to it.

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Tennis elbow is typically due to an overuse injury

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How does Tennis Elbow Occur?

Tennis elbow is typically due to an overuse injury to the tendons from weights that are too heavy, repetitive motions, or sudden change in frequency and equipment, or all of the above. The overuse of the muscles and tendons will put strain on the tendons which over time, causes maladaptations to the tendon structure leading to pain over the outer elbow. Jill Cook proposed a 3 stage model for tendons: reactive tendinopathy, tendon disrepair, and degenerative tendinopathy.

There are other types of injuries with a similar presentation to tennis elbow such as radiculopathy or radial tunnel syndrome. Radiculopathy is when a nerve root is pinched at the spinal column and is then referred to an area farther away. Whereas, radial tunnel syndrome is when the radial nerve is pinched or compressed as it enters the radial tunnel in the forearm. For this reason, it is important to get a proper assessment from a physiotherapist in order to accurately diagnose your elbow pain condition.

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Early intervention is key!

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Symptoms of Tennis Elbow with Increasing Severity

• Tight and sore at the outer elbow in the morning which tends to improve within 30 minutes
• Symptoms typically appear during the repetitive activity that caused the injury in the first place and/or lifting heavy weights (eg.) Picking up a jug of milk or a pot of coffee)
• Symptoms can flare up during or sometimes after an activity that originally caused the strain on the muscle and tendon
• During exercising or an activity, the first few movements will cause discomfort and sometimes pain which typically feels better shortly after as people describe it as "warmed up." However, after the exercise or activity has ended, people will report the elbow pain to have returned.
• If symptoms are ignored, and the activity which originally caused the injury continues at the same intensity and frequency, this is when people will report their pain has increased to a point where it bothers them at night
• When the injury is left longer, there will be referral pain down to the wrist

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Getting an accurate diagnosis will allow for the quickest recovery

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Diagnosis and Treatment

As previously mentioned, an accurate and thorough history taking and physical assessment is important to sufficiently rule in tennis elbow and rule out other injuries with similar presentations. Getting an accurate diagnosis and proper treatment plan is key to optimal recovery and return to activity as quick as possible.

Once diagnosed with tennis elbow, treatment will include education on pain control and modification of activities. Manual therapy and IMS (intramuscular stimulation) are effective techniques to help reduce tension on the tendon from the muscles. Taping is also effective for pain management and helps increase grip strength and functional movements. Lastly, home exercise from stretching to strengthening exercises will be prescribed to properly load the tendons to resolve the pain. These exercises with be specifically tailored to your activity needs.

If you think you may have Tennis Elbow or have any questions about Tennis Elbow, Come in for an assessment and treatment with one of our experienced physiotherapists at our Vancouver location. We look forward to meeting you!

With care,

Therapy X Collective

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