Tennis Elbow and I don’t even play!


What is “Tennis Elbow”?

Tennis elbow, or the medical term “lateral epicondylitis” is a painful condition effecting the common tendon origin of the extensor muscles of the wrist and hand, causing pain where these muscles connect to the outer edge of the elbow joint. The issue usually arises when there is repeated overload of these muscles through repetitive gripping and motions of the elbow, wrist or hand. We see more office workers and gym goers than tennis players for this condition, so the name doesn’t really accurately describe this painful condition. 

So why is it sore?

The tendons of the forearm extensor compartment arise from a common tendon from the outer side of the elbow. The muscles then branch from this tendon and go to various places in the distal wrist and hand. Low-grade inflammation within this common tendon is a common problem which usually arises due to repetitive actions such as typing, but also in excessive gripping actions through manual work or gym exercise. This low-grade inflammation causes minor changes in collagen structure and overtime may lead to the development of pain. Patients usually describe a pain with gripping and squeezing and those who are really had have trouble holding household items such as kettles, pots and pans. 

I have elbow pain, but how do I know it is lateral epicondylitis?

Lateral epicondylitis is a condition that usually arises over weeks to months and for no known reason to the patient. The condition usually starts as a mild pain and then worsens to the point that it happens with every grip or pinching action of the fingers. Trauma to the elbow or forearm, such as a fall onto the outstretched hand may cause a sudden pain development at the elbow, which is more likely to be a ligamentous sprain or a muscle tear. If you are having pains around your elbow from either method of injury, why not give us a call and we can help you deal with it. 

Ok, I have rested myself for weeks and tried to go back to gripping activity or weights and it still hurts? What gives?

Lateral epicondylitis is an inflammatory condition where the structure in the collagen has changed, Unfortunately, like other muscle injuries, rest doesn’t change the structure of the collagen back to what it was and therefore the pain will persist due to the irritation of local nerves. The way to treat this condition is to load up the tendon and try and strengthen the collagen. This can be achieved with a progressive resistance programme that a physiotherapist is trained in providing and monitoring. Typically we do these exercise programmes with resistance bands or weights and instruct with a view of increasing the difficulty of the programme as the condition improves.  

So what other treatments are available. 

Shockwave therapy is a relatively new form of treatment that we currently offer in our clinic. The treatment is aimed at locally irritating the offending tissue in a bid to kick-start a healing effect. Shockwave is usually combined with a strengthening programme which we mentioned above. The treatment “gun” has a mini bullet that an air-compressor fires into the treatment cap which creates a strong vibration, which is sent into the tissue. You can expect a mild-to-moderate discomfort during the treatment which usually reduces with tolerance during a single session. The shock pulses are directly targeted to penetrate deep into the tissue and directly on the source of the pain. Shockwave is particularly effective when there are calcium deposits within the tissue and it is believed that the shock pulses can help the body re-absorb some of these deposits and help alleviate discomfort. Shockwave is an irritant type treatment, so the body needs to rest for 24 hours following the treatment and then it is usually performed over at least 3-5 sessions spaced no more than 10 days apart for the treatment to be effective. 

So to round up

Lateral epicondylitis is a common presentation into our clinic and it occurs most often in office workers and gym goers. The condition is typically characterised as a pain that arose out of the blue and gradually worsened with time to the point that any gripping or holding of a moderate weight causes pain to the other side of the elbow. To treat this condition, we typically aim to put the patients on a progressive weight training programme to strengthen the tissue and this can be performed with shockwave therapy to help aid for faster tissue repair.

If you are struggling with similar elbow pain, why not give us a call and we can help you to rid yourself of this unnecessary burden.