Author: James Clayton MCSP BSc(Hons) Physiotherapy
Introduction (1,2,3)
Tennis elbow, also known as lateral epicondylitis, is an overuse injury that affects the lateral wrist extensor muscles that attach at the elbow.And despite the term, tennis is only a direct cause in 5% of people with tennis elbow. And if left untreated, symptoms may persist for greater than one year. Approximately 1-3% of the population will have this condition at some point in their life, with it being most common in people aged between 40 and 50.
This means that people experiencing this condition often have pain on the outside of the elbow that is commonly made worse by gripping or trying to lift their wrist up.
Causes(3,4)
Tennis elbow is what we call an ‘overuse’ injury. This is where a muscle or joint in the body undergoes too much repetitive work too quickly, and as the joint or surrounding muscles aren’t strong enough, it sustains repetitive trauma and becomes injured and painful.
Common Causes are-
🔨🔧Doing a lot of DIY at home in a short space of time. This is due to the repetitive use of tools that require lots of gripping, twisting and hammering.
🧑🏼💻👩🏾💻Working at home from a desk for long periods. Typing on a computer, or writing for large parts of the working day can lead to tennis elbow as the wrist muscles are over worked for several hours a day at a time.
⛳️Playing more golf or changing swing technique. The wrist extensor muscles often work overtime during golf swings in order to keep the wrist stiff, and if they aren’t given enough time to recover, they may suffer trauma.
🧣Sewing may also lead to pain at the elbow because of the amount of fine, repetitive finger movement.
🏸🎾Racket sports also put you at risk of tennis elbow as the wrist muscles work hard to maintain stability and generate power.
What can we do to help you? (5,6)
Over the years there has been an abundance of research that supports physiotherapeutic interventions for the treatment of tennis elbow, all of which we can offer here at Bradley Physio.
Advice and education
Professional advice regarding activity modification, rest and the avoidance of certain triggers can be instrumental in the treatment of tennis elbow.
A home exercise programme
Exercises are key in strengthening and loading the tendons that are often inflamed and damaged in this condition. It is important that the exercises you do are individualised to yourself as everyone is different.
Manual therapy
A hands on approach combining massage with advice and exercise has been shown to reduce pain, restore movement and improve the functionality of the wrist and elbow in those suffering with tennis elbow.
Taping
Research has proven that taping of the elbow can improve grip strength and reduce pain in people with tennis elbow, and is therefore an adjunct to hands on treatment and exercise for this condition.
Acupuncture
If tennis elbow is not responding to any of the treatments above, acupuncture has been found to be a safe, alternative treatment technique which can induce pain relief.
Corticosteroid injection
If physiotherapeutic interventions have failed then the next step would be a corticosteroid injection which has a significant effect at reducing pain, particular in the short term
Shockwave Therapy
Shockwave therapy is a non-surgical treatment, and works by delivering impulses of energy, targeted to specific damaged tissues within the abnormal tendon. This increases the blood flow within the affected area, stimulating cell regeneration and healing, and decreasing local factors which can cause pain. It is used when conservative physiotherapy treatments have failed to resolve the issue.
References
1- Winston, J. and Wolf, J., 2015. Tennis Elbow: Definition, Causes, Epidemiology. Tennis Elbow, pp.1-6.
2- Buchbinder, R., Green, S. and Struijs, P., 2008. Tennis elbow. BMJ,.
3- Bisset, L., Coombes, B. and Vicenzino, B., 2011. Tennis Elbow. British Medical Journal,.
4- nhs.uk. 2021. Tennis elbow – Causes. [online] Available at: <https://www.nhs.uk/conditions/tennis-elbow/causes/> [Accessed 1 February 2021].
5- Shamsoddini, A. and Hollisaz, M., 2013. Effects of Taping on Pain, Grip Strength and Wrist Extension Force in Patients with Tennis Elbow. Trauma Monthly, 18(2), pp.71-74.
6- Mallen, C., Chesterton and Hay, 2011. Management of tennis elbow. Open Access Journal of Sports Medicine, p.53.
