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Tennis Elbow

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow (lateral epicondylitis is a condition that affects the forearm around the outside of the elbow usually limiting movement of the wrist and forearm due to pain. The muscles in our forearm are known as extensors and are responsible for lifting the hand up in the air/backwards. These muscles and tendons all attach to what is called the lateral epicondyle. The main muscle/tendon that is normally involved with tennis elbow is Extensor carpi radialis brevis (ECRB)

Causes

Tennis elbow is thought to occur because of small changes to the tendon that are most commonly due to overload being placed through the tendons after heavy or repetitive activities. Common pain complaints begin with pain when gripping, writing and twisting, as well as other movements of the forearm, especially with the palm facing down.

Tennis elbow can occur at any age, commonly it occurs in people aged 35-55 and the majority of people who develop this problem do not play tennis. Its most often found in workers or athletes who have to complete a movement multiple times gripping/other repeated wrist action.

Signs and symptoms

  • Tenderness on the outside of the elbow.
  • Morning stiffness of the elbow with a persistent dull ache.
  • Soreness of the forearm muscles.
  • Elbow pain is worse when grasping or holding an object (a sign that active inflammation is present because of changes to the tendons)

The most common symptom of tennis elbow is recurring pain on the outside of the upper forearm, just below the bend of the elbow, although radiated pain may also be felt further down the arm towards the wrist. Pain can occur when the individual lifts or bends the arm. This can be noticeable when turning a door handle or extending the forearm fully.

Self-Managing Tennis elbow

Steps for reducing your symptoms if you are struggling with tennis elbow.

  • Look at what activates you complete day to day (workstation, desk, tools) try to modify or adjust them so they are easier e.g. soft support under wrist/hand when using a desk mouse. You will not cause further damage to the tendon if you continue to use them, although this may result in an increase of the symptoms you are already having.
  • Try to avoid gripping too hard when possible. Having a loose grip will help reduce symptoms further as it relaxes the muscle which relieves stress on the tendon.
  • Gripping, carrying, lifting and grasping activities should be completed with thumbs facing upwards. This position will limit the amount of stretch placed on the forearm muscles and in particular limits the stretch caused in the common tendon area.
  • Massage the area with a small ice back (fifteen minute maximum at any one time)
  • Use anti-inflammatory, non-steroidal gels or creams, which can be rubbed into the painful area to help relieve symptoms.
  • Take painkillers NSAID’s (you may need to speak to your GP or pharmacist about which painkillers are suitable).
  • You can also use a tennis elbow brace. You may find this is helpful to offload the area  by moving the particular point of stress on the tendon and allow you to continue with normal activities.
  • REST – rest will allow the tendon to begin its natural recovery process. So, you may find that three to five days rest from the aggravating activities may decrease your pain levels.

What to do next?

If these steps of managing tennis elbow do not change the nature or intensity of your pain you should visit a physiotherapist, who will recommend an exercise programme involving changes to activities and stretches which can reduce pain levels.

A full assessment and treatment from a physiotherapist will allow the recovery process to be faster and more specific to fit your individual needs.

Strand House, 169 Richmond Rd, Kingston upon Thames KT2 5DA 020 8546 6464