With Wimbledon 2012 upon us let’s look at the condition Tennis Elbow.
Tennis elbow, or lateral epicondylitis to give it it’s medical name (meaning inflammation of the outer bony part of the elbow), is a fairly common condition affecting about four adults per thousand annually.
What causes tennis elbow?
Tennis elbow occurs when there is damage to the muscles, tendons and ligaments around the elbow joint and forearm. Small tears, called micro tears, form in the tendons and muscles which control the movement of the forearm. They cause a restriction of movement, inflammation and pain. These micro tears eventually lead to the formation of scar tissue and calcium deposits.
If untreated, this scar tissue and calcium deposits can put so much pressure on the muscles and nerves that they can cut off the blood flow and pinch the nerves responsible for controlling the muscles in the forearm. Often this happens during a backhand stroke in racket sports, especially if the stroke technique is poor. Another cause is overuse of the muscles in a repetitive way. Examples of this are prolonged use of a screwdriver or typing.
What are the symptoms of tennis elbow?
Individuals experiencing tennis elbow may complain of pain and tenderness over either of the two epicondyles. This pain increases with gripping or rotation of the wrist and forearm. If the condition becomes long-standing and chronic, a decrease in grip strength can develop.
However, pain is the most common and obvious symptom associated with tennis elbow, and is most often experienced on the outside of the upper forearm, but can also be experienced anywhere from the elbow joint to the wrist.
Weakness, stiffness and a general restriction of movement are also quite common in sufferers of tennis elbow. Even tingling and numbness can be experienced.
How to avoid getting tennis elbow:
Obviously prevention is better than cure so I will first discuss a few prevention options:
A thorough warm up will help to prepare the muscles and tendons for any activity to come. Without a proper warm up the muscles and tendons will be tight and stiff. There will be limited blood flow to the forearm area, which will result in a lack of oxygen and nutrients for the muscles. This is a definite recipe for a muscle/ tendon injury.
Having flexible muscles and tendons is extremely important in the prevention of most strain or sprain injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement. When this happens strains, sprains, and pulled muscles occur.
Changing your racquet, grip size, weight etc can bring on the symptoms due to the grip force altering. Also pro-longed backhand training can result in overuse syndromes which in time can bring about Tennis elbow.
How to treat tennis elbow:
Treatment may include stopping or limiting activities that cause the pain, such as heavy lifting with the palm facing down. Sometimes a band wrapped around the forearm near the elbow is used to protect the injured muscles as they are healing. In some cases, the wearing of a wrist splint may be recommended for the same purpose.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen may be given for pain. Injections of cortisone may also be used to relieve the pain. A tennis elbow band may be advised.
In severe or long-lasting episodes, an injection of medication into the area may relieve the discomfort. Your hand surgeon may recommend exercises that stretch and strengthen the muscles to help prevent the condition from returning. Some patients respond to additional treatment through therapy. As the condition improves, there is usually a slow return to normal activities. Recurrence of this condition is common.
Joint mobilisations such as “Mulligans” distraction techniques I find bring virtually instant reduction in symptoms.
Get in touch if you would like more information on tennis elbow or any other condition.