Tennis Elbow – Do you play tennis?

Tips and tricks for the infamous Tennis Elbow

Tennis elbow is the feeling of pain on the outside of your elbow when gripping and/or lifting something, and gradually builds over time. This injury does not necessarily come from playing tennis! We often see office workers, labourers, weightlifters and racket-sport athletes who develop tennis elbow. In combat sports, we commonly see them in pad holders and commonly boxers as well. Here are a couple of tips and tricks on how to help manage your potential tennis elbow pain.

WHAT IS TENNIS ELBOW?
– An over-use injury that causes your wrist extensor tendons (on the outside of your elbow) to become inflamed and therefore painful when using these muscles.

WHAT CAUSES TENNIS ELBOW?
– Repetitive gripping (e.g. racket sports) or constant hammering type of action (repetitive use of the muscle).
– Potentially a previously injured shoulder of the same arm

WHAT WOULD I FEEL IF I HAD IT?
– Pain on the outer part of your elbow, either when pressing this area or when gripping an object (e.g. swinging a racket, typing on a computer keyboard or trying to open a jam jar)
– More pain and tightness when you wake up in the morning
– Sometimes feels a little better once warmed up
– Some people feel pins and needles in their arm
– Aching sensation in the elbow

HOW DO I MANAGE TENNIS ELBOW?
– I highly recommend booking in with a physiotherapist to begin with, to make sure that what you are feeling is truly tennis elbow. There are a few other diagnoses that present similarly to tennis elbow that we would want to rule out first. Exercises and manual therapy have also been proven to help reduce tennis elbow pain and strengthen the area to help prevent it from re-occurring[1].
– Strengthening exercises!! This is what will help the most long-term. Your physiotherapist will guide you and provide you with an evidence-based strengthening program for your elbow, and potentially your shoulder should it be necessary.
– Studies have shown that using a tennis elbow strap on your forearm helps to provide a significant reduction in pain while you carry out daily activities[2]. You can usually find these at your local pharmacy or your physiotherapist will likely sell them. We recommend using the brace as an adjunct to physiotherapy. If you are unsure about this, you can discuss this with your physiotherapist.

– Avoid any aggravating activity to begin with, so that your pain has the opportunity to reduce.
– Heat application (via a wheat bag or hot bottle) to help reduce muscle tension and improve blood flow to the tendons in the forearm.
– Massage of the forearm muscles to reduce muscle tension.
– Wrist stretch

WHAT ABOUT CORTISONE INJECTIONS?
– A study has found that after 6 weeks, individuals with cortisone injections had poorer outcome that individuals who had physical therapy, or individuals who simply had no physical input but assurances and education [3]! So before rushing off to get your cortisone, make sure you consult someone who can at least provide you with decent advice!

HOW LONG WILL I HAVE TENNIS ELBOW FOR?
This depends on a few things[1].
1. The severity of your pain and any other symptoms.
2. Your environment (e.g. your occupation or home tasks)
3. Compliance: ensuring the rehab program is completed as recommended by your physiotherapist.
Under a guided program, healing time can take 1-2 months, or it may take 6-12 months, depending on the above factors.

References
1. Coombes, B. K., Bisset, L., & Vicenzino, B. (2015). Management of Lateral Elbow Tendinopathy: One Size Does Not Fit All. The Journal of orthopaedic and sports physical therapy, 45(11), 938–949. doi:10.2519/jospt.2015.5841

2. Heales, L. J. (2020). Evaluating the immediate effect of forearm and wrist orthoses on pain and function in individuals with lateral elbow tendinopathy: A Systematic Review. Musculoskeletal Science & Practice , 47, 102-147.

3. Bisset (2006) Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial BMJ 2006; 333

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