Tennis elbow (also known as lateral epicondylitis) is a common overuse injury causing pain into the outer (lateral) side of the elbow.
Although the name suggests the cause of this pain to be as a result of playing tennis, less than 5% of cases are as a result of this. More common causes include repetitive activities like computer use, heavy lifting and activities requiring repeated twisting at the wrist (common for electricians, carpenters and gardeners). These repetitive activities result in an excessive amount of strain through the tendons and muscles of the outer forearm. This overuse causes degenerative changes to occur at a cellular level in the tendon leading to a reduction in the tendon’s ability to tolerate load.
Common symptoms are tenderness over the bony prominence of the lateral elbow (lateral epicondyle), and pain that radiates up the arm or down the outside of the forearm. Individuals may also experience pain and reduced strength with activities such as lifting or carrying in the affected arm, and with gripping activities, for example, opening jars and opening doors. Pain may also be provoked with activities involving twisting at the wrist or positions where the palm is turned face down, such as using a screwdriver or typing at a computer.
A common indicator of tennis elbow is that, initially, pain will begin after the provoking activity, and then slowly progress to pain during the aggravating activity, to then having pain constantly (in the later stages of the injury) which will limit you from being able to complete other activities beside the initially aggravating one.
Physiotherapy treatment usually involves an initial focus on reducing pain and irritation with a combination of manual therapy techniques such as soft tissue massage, ultrasound and exercises to gently stretch the muscles of the forearm.
The focus of treatment in the management of tennis elbow is to reduce the excessive loading through the tendon and progressively rebuild the tendon’s tolerance to load. This is achieved through a graduated loading program which your physiotherapist will prescribe for you.
Use of a tennis elbow brace can sometimes be extremely effective in managing the load through the tendons of the lateral elbow, especially in individuals who are unable or have difficulty reducing aggravating activities. Our physiotherapists are experienced in fitting these and will advise you as to whether a brace would be beneficial, and if so, how and when to wear it.
Physiotherapy management for tennis elbow is successful in most cases. Certain cases that do not respond to initial treatment may require further investigation, and possibly medical intervention if it is indicated.
All our physiotherapists are skilled in the diagnosis and management of tennis elbow. Should you need some help in this area, don’t hesitate to contact either our Berwick or Pakenham Lakeside Physiotherapy clinic to book in your appointment.
