Tennis elbow is an acute (tendonitis) or chronic (tendonosis) inflammation of a tendon on the outside of the elbow. It usually occurs due to gradual wear and tear associated with overuse, however, the condition may also occur traumatically due to a specific incident. It is common for patients to develop this condition following a sudden increase in activities that place stress on the forearm extensors .
The extensor muscle that is most commonly affected in this condition is known as the extensor carpi radialis brevis. This tendon is involved in extending the wrist joint and is also active when gripping with the wrist extended (as in tennis). Any activity that twists and extends the wrist can lead to tennis elbow. Contrary to what the name suggests, you do not have to play tennis to develop this condition, in fact it has been suggested that only 5% of cases are as a result of playing tennis.
The first sign of tennis elbow is usually tenderness and pain when pressure is applied to the outside of the elbow (lateral epicondyle). If left untreated, a dull constant pain or sharp shooting pain can be felt. Swelling may be present. Other symptoms include: pain when the wrist or hand is straightened (wrist extension), pain felt when lifting a heavy object, pain when making a fist or shaking hands and shooting pains from the elbow down to the forearm or up into the upper arm.
Treatment for Tennis Elbow / Lateral Epicondylitis
Physiotherapy treatment for patients with this condition is vital to hasten the healing process, ensure an optimal outcome and decrease the likelihood of injury recurrence. Treatment may comprise:
- Joint mobilisation/lateral glide mobilisation
- Joint manipulation
- Deep tissue massage/myofascial release
- Dry needling /acupuncture
- Activity modification advice
- Ergonomic and sleeping advice
- Exercise programs to improve flexibility and strength.
- Brace/Splinting advise
- Technique analysis/Biomechanical Assessment
- Injection advise