Tennis Elbow / Lateral epicondylitis
What is tennis elbow or lateral epicondylitis?
Tennis elbow is a common injury and got its' name because tennis players tended to get it. Tennis elbow is inflammation or degeneration of the tendon of the that attaches to the bony bit (lateral epicondyle) on the outside of the arm or elbow. The main tendon involved is that of the extensor carpi radialis brevis muscle. Although the injury is called tendinitis (inflammation of the tendon) a more common occurance is thought to be tendinosis (degeneration of the tendon).
What are the causes tennis elbow?
A common cause in tennis is poor backhand technique or a grip that is too small. A small grip will mean the muscles in the elbow must work harder and become inflamed. The majority of people getting tennis elbow are between 40 and 50 yrs but it can affect athletes of any age. (Is this because 40 - 50 yr olds are the ones with more time to play?)
Hitting tennis backhands with a 'wrist' action will put far too much strain on the elbow. The wrist should be firm and not bent when the ball is struck so the forces can be spread over the arm, shoulder and the rest of the body. If you imagine a ball travelling at 70mph and over hitting the end of a long lever made up of your arm and the tennis racket then all that force is focussed on the tiny insertion of the tendon of the lateral epicondylitis.
It is not just tennis players who suffer with tennis elbow. Repetitive tasks such using a screwdriver or hammer or opening heavy doors can also cause lateral epicondylitis.
Chronic tennis elbow can be a difficult injury to treat so it is important you do the correct thing as early as possible.
Signs and symptoms of tennis eblow / lateral epicondylitis include:
- Pain on the bony bit (lateral epicondyle) on the outside of the elbow, or 1-2cm forward of it on the tendon.
- Weakness in the wrist with difficulty doing simple tasks such as opening a door handle or shaking hands with someone.
- Pain in the outside of the elbow when the hand is bent back (extended) at the wrist against resistance.
- Pain on the outside of the elbow when trying to straighten the fingers against resistance.
- Pain when pressing in (palpating) the bony bit on the outside of the elbow.
- Symptoms can often be recreated by lifting a heavy object such as a chair with the forearm promated (palm downwards).
Other injuries and conditions with symptoms similar to tennis elbow:
- The symptoms for this injury are very similar to Entrapment of the radial nerve which I recommend you also have a look at.
- It is important to have the neck examined as well as elbow pain can be referred from problems in the neck.
Treatment for tennis elbow - what can the athlete do?
- Apply ice or cold therapy the elbow (20 min's on up to six times a day). This will help reduce pain and inflammation.
- Rest - a very important component in the healing of this injury
- Wear a brace or support to protect the tendon whilst healing and strengthening, particularly when returning to playing / equivalent.
Treatment for tennis elbow - what can a sports injury specialist or doctor do?
- Apply ultrasound or laser treatment to help reduce pain and inflammation and stimulate healing.
- Use massage therapy.
- Advise on rehabilitation to return the athlete to full fitness.
- Prescribe anti-inflammatory medication.
- Give a steroid injection.
- Operate - if the usual treatments have failed for about a year then this might be considered.
How long with tennis eblow take to get better?
Tennis elbow may heal quickly within two weeks but you could suffer with this problem for up to two years. When the symptoms have settled down it is essential full rehabilitation and strengthening the elbow takes place.
Preventing tennis elbow:
- Correct technique - play the backhand with the arm not the wrist!
- Use a forearm brace or heat retainer if you have a weak wrist or elbow.
- Do not play with wet, heavy balls.
- Use a light racket if you do not play very often.
- Make sure your strings are not too tight.
