What is Tennis Elbow?
One of the most common causes of elbow pain is a condition called Tennis Elbow. It’s a condition that causes pain on the outside of the elbow and it usually occurs during activities that require heavy or repetitive gripping motions or motions of the wrist that place stress on the muscles and tendons that extend the wrist.
While the condition is relatively common amongst tennis players, tennis elbow doesn’t just happen in tennis players. It can happen to anyone who enjoys racquet sports or bat and ball sports (cricket, baseball), people who require strong gripping motions as part of their occupation (tradespeople) or even keen gardeners, especially during the pruning season.
Wrist Extensor Tendons
Tennis elbow usually develops when the tendons of the muscles that extend the fingers and wrist become irritated through overuse. These muscles attach via a common tendon to the outside of the elbow. Even though the tendon attaches to the outside of the elbow, it’s the use (or overuse) of the hand and wrist that usually brings about this irritation and usually not the bending and straightening of the elbow.
Cervical spine, shoulder and peripheral nerves
Any time pain develops anywhere in the upper limb it is important to consider if the neck may be a contributing factor and providing a referral of pain that mimics tennis elbow pain. Similarly, it is quite often the case that nerve tissue may be irritated somewhere in the upper limb, for example the upper arm or the shoulder, and this may be producing symptoms similar to tennis elbow.
What can I expect from a Physiotherapy appointment for my tennis elbow?
Firstly you can expect a thorough assessment to help identify the cause or causes of your elbow pain. This will involve;
- an interview where questions are asked to determine what factors may have lead to the onset of your elbow pain
- a movement assessment where your Physiotherapist will work to determine which movements of your upper limb and neck, not just your elbow, may be contributing to your pain. The movement assessment will be used to identify if there are aspects of muscular strength and coordination that may be contributing to your pain.
- a functional assessment where it is determined what tasks you are able to complete with no or little risk as well as the ones that you should avoid.
- a hands on assessment which is used to try and find the origin of your pain. Patients are often surprised to learn that with tennis elbow there can be soreness in areas other than the elbow.
How is tennis elbow treated?
Treatment for tennis elbow will vary depending on the severity of the pain, the location of the pain and also the functional needs of the individual.
Each individual’s experience with pain will be unique and it is no different when it comes to shoulder pain. As such, you should expect an individualised treatment plan for your episode of tennis elbow.
Education and advice is an essential part of any treatment plan. I think that it is important to take the time to explain fully what may be causing your tennis elbow and what factors may be contributing to it so that we can focus our attention on what needs to be done to change it.
Ergonomic and postural advice may be an important consideration if your injury is affecting your ability to work. For athletes such as tennis players or cricketers it may be necessary to perform a biomechanical analysis of their technique. It may be possible to reduce load on the elbow by making technique adjustments. Sometimes, especially in cricketers, the bat is simply too heavy and is placing too much pressure on the elbow.
Exercise rehabilitation is a key component of any recovery from tennis elbow. The prescribed exercises will focus on the aspects of muscular strength, tightness or coordination that may be holding you back.
Symptom & pain management
Manual therapy and massage can be used to relieve muscular pain and tightness and any referred pain that may be contributing to the tennis elbow symptoms. Mobilisation techniques of the cervical spine can be very useful in helping to reduce symptoms that may be coming from the neck.
Taping or bracing can also be a simple yet very effective means of reducing pain quickly and may allow the individual to continue with their work or their sport while they work with me towards full recovery.