Tennis Elbow is the common name for a condition characterized by pain on the outer side of the elbow, felt especially on gripping activities. But you don’t need to be a tennis player to suffer Tennis Elbow, indeed less than 5% of people with this condition will attribute it to playing tennis, but amongst tennis players approximately 50% of players will experience lateral elbow pain. It occurs equally in males and females and is most commonly seen between the ages of 30 & 60.
Most Tennis Elbow cases are caused by repetitive strong use of the forearm or wrist extensor muscles. Activities such as hammering, clippers, shears, secatuers, gripping a knife, axe or shovel, lifting or carrying are typical causes.
When such activities are performed repeatedly or to excess the muscles that grip and cock the wrist up become strained at their attachment to the humerus bone on the outer side of the elbow (the Lateral Epicondyle). This strain causes small micro tears in the tendon that anchor the muscle to the bone. This muscle-tendon-bone junction has a relatively poor blood supply, so after the initial strain, it often fails to heal fully. As we age, the central part of the tendon may become weaker and less able to withstand loading with subsequent pain and weakness. This results in the typical Tennis Elbow symptom of pain on gripping, even light objects like a toothbrush or coffee mug.
In the early stages of the condition painful activities should be avoided, but gentle movement of the elbow and forearm should be continued. Early management of the condition will help aid recovery.
Physiotherapy treatment may include a strapping to protect the damaged tissue while it heals, specialized massage to encourage the formation of collagen fibres, acupuncture for pain and to promote healing, strengthening and stretching exercises.
Your Physiotherapist may also be able to help with an assessment of your work activity and work station set up to minimize the stress on the affected muscles.
In a small number of cases the condition does not resolve with Physiotherapy and your Doctor may consider a Cortisone injection or referral on to an Orthopedic Surgeon.
In the long term prevention is best. If your work involves repeated strong gripping, punctuate your activity with frequent Micro-Pauses. –between sets of activity, say each 10-15 minutes, relax your grip, let your hand hang down and totally relax the muscles for just a few seconds. This allows the blood to flow through the muscles, helping to prevent tissue damage.
Regular stretching of the muscles being used also helps to maintain their pliability and help prevent problems. Try these before work, during meal breaks and after work. Holding each stretch for 15-20sec and repeating three times.
Jeannie Brown is a Physiotherapist at the Oamaru Physiotherapy Clinic. She has a wealth of physiotherapy experience in the management of orthopaedic and musculoskeletal conditions.
“Source: Oamaru Physiotherapy Clinic written by Mike Stewart and Michelle Sintmaartensdyk”