Tennis Elbow – Why is my elbow hurting?
Lateral epicondylitis (also known as Tennis elbow), is considered an overload injury of the extensor tendons of the forearm where they attach at the lateral epicondyle. It affects up to 3% of the population, and symptoms may persist for up to 1 year in 20% of people. Up to 17% of workers within the highly repetitive hand task industries such as factory workers, admin workers and tradesman, experience lateral epicondylitis.
What does it feel like?
Lateral elbow pain presents as pain and tenderness over the outside of the elbow when doing activities such as:
- Writing or typing on the computer
- Lifting an object (even as light as a sheet of paper)
- Opening the car door or those horrible pasta sauce jars
The pain may build up over a few weeks to become a burning sensation, and cause swelling of the area, stiffness, or weakness in the forearm.
Is it from playing too much tennis?
It can be, but it is categorised as an overload injury. Overload injuries tend to occur after a minor or sometimes unrecognised trauma to the extensor muscles of the forearm. Despite the commonly known title of tennis elbow, tennis is a direct cause in only 5% of people.
How should I manage this injury?
Modify and lower the load going through the extensor tendons. However, make sure not to completely rest the tendon for prolonged time (e.g., resting completely for 10 weeks, and returning to the activity with pain remaining). Throughout the course of the tendon injury, it is essential to continually modify the load because as the tendon heals, it will gradually be able to handle more load and you will be able to do more things with less pain.
Some “handy” tips on how to reduce the load through your elbow include:
- Doing your best to avoid repetitive tasks
- Use the unaffected hand
- Adjusting your work environment (e.g. height of work chair)
- Wearing a brace to disperse load from tendon]
Exercises that specifically load the tendon gradually have been shown to have improved long-term outcomes. The aim is to progressively increase the load as the tendon heals within pain free limits. These exercises are to be best prescribed to you by your Physiotherapist.
Will cortisone injections give me a quick fix?
Cortisone injections have been proven to reduce pain and improve function in the short term, the quick fix of 6 weeks. However, it does have the highest rate of re-occurrence and repeated cortisone injections will increase the risk of surgery. With Physiotherapy intervention where patients are educated about their pathology, given advice on medication, braces and how to deload the tendon, people will get out of pain faster and experience less pain over the duration of their recovery.
Other treatment options you can try including Acupuncture, Extra-corporeal Shock Wave Therapy, orthoses/braces, manipulation and exercise and mobilisation.
Take home message!
- Tennis elbow is an OVERLOAD injury.
- Don’t do nothing. Learn how to modify your daily tasks to avoid overloading the wrist extensor muscles
- Cortisone injections may be good for a quick fix, but think long term
If you are suffering from tennis elbow and would like to learn how to manage this injury appropriately, visit your local Physiotherapist. You can also visit our YouTube channel to view a video I have created to provide a few exercises to get you started.