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Tennis elbow

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Tennis Elbow is the inflammation and degeneration of the common extensor tendon of the forearm that attaches to the outside part (lateral epicondyle) of the humerus bone at the elbow. Tennis elbow is common amongst sports people and manual workers. Tennis elbow is not a diagnostic term, it is no more specific than back pain as a diagnosis. In fact this condition is more common in non tennis players then tennis players.

What Causes Tennis Elbow?

Tennis Elbow is the most common injury in patients seeking medical attention with the complaint of elbow pain. The inflammation in the extensor tendon of the forearm muscles is caused by prolonged gripping such as driving, racket sports or even using a hammer. The inflammation and pain associated with tennis elbow is due to tiny tears in a part of the tendon and in muscle coverings. After the initial injury heals, these areas often tear again, which leads to haemorrhaging and the formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Collagen, a protein, leaks out from around the injured areas, causing inflammation. The resulting pressure can cut off the blood flow and pinch the radial nerve, one of the major nerves controlling muscles in the arm and hand.

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Symptoms Of Tennis Elbow

Generally the symptoms arise from a degenerative process relating to a strength deficit in one of the extensor tendons of the forearm just below where it originates from the elbow. This is most commonly a result of an overuse syndrome related to excessive use of the wrist.

Symptoms include pain associated with wrist and gripping activities on the outside of the upper forearm just below the bend of the elbow and occasionally this pain radiates down the arm toward the wrist. There is difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments). Pain typically lasts for 6 to 12 weeks and the discomfort can continue for as little as 3 weeks or as long as several years.

If you feel pain directly on the back of your elbow joint, rather than down the outside of your arm, you may have bursitis, which is caused when lubricating sacs in the joint become inflamed. If you see swelling, which is almost never a symptom of tennis elbow, you may want to investigate other possible conditions, such as arthritis, infection, gout or a tumour.

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Physiotherapy Treatment

Tennis elbow is the most common elbow condition Manchester Physio treat. Treatments commonly used involve:
  • Massage to relieve stress and tension in the muscles.
  • Exercise programmes including; neural and extensor muscle stretches, and progressive conditioning exercises to strengthen the area and prevent re-injury.
  • Tapping a band around your forearm to take pressure off the extensor tendons.
  • Myofascial release of the forearm extensors, especially extensor carpi radialus brevis.
  • Deep Transverse frictions to the extensor tendon.
  • Acupuncture
  • Electrotherapy
  • Advise on Corticosteroid injections for stubborn cases of tennis elbow. These dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects

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If rest, anti-inflammatory medications, and a stretching routine fail to cure your tennis elbow, you may have to consider surgery, though this form of treatment is rare (fewer than 3 percent of patients). Physiotherapy should always be the first treatment option, before both steroid injections and surgery. If injections or surgery are performed they should always be followed with a program of physiotherapy or the problem with undoubtedly reoccur.

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