Tennis Elbow: Not Just for Tennis Players

Tennis Elbow, or Lateral Epicondylitis, is a common overuse injury that we see in the clinic. While it can be seen in sports that have repetitive movement of the elbow (such as tennis), the majority of people who get tennis elbow have never even stepped foot on a tennis court. According the American Physical Therapy Association, less than 5% of tennis elbow cases are tennis players.

So what is tennis elbow? Tennis elbow occurs when the extensor tendon, that attaches to the outside of your elbow and connects down to the forearm, becomes inflamed. Anyone who repeatedly uses their elbow, wrist, or hand, either for work or play, can get tennis elbow. This painful condition can make gripping, twisting the arm, or carrying objects quite painful. While it can affect people of all ages, it is more common in men than women, and most common in those ages 30-50.

What are the symptoms? Symptoms can be brought on suddenly by excessive use, or forceful activities such as a sudden pull of the lawnmower cord, but more often occur in a gradual onset of pain anywhere from a few weeks to a few months. Symptoms occur when there is repetitive motion of the hand, wrist or elbow. Symptoms may include:

• Pain radiating from elbow into forearm/wrist
• Difficulty or pain with gripping, such as opening the door, or shaking someone’s hand
• Increased pain with lifting objects
• Stiffness in the elbow
• Arm/wrist weakness

How is it treated? Treatment can vary from person to person depending on the root cause of the pain. Tennis elbow can be caused from damage to the muscles or tendons of the elbow, repetitive movements, a pinched radial nerve (which runs the length of your arm and can become pinched at various locations), or even stress.Uncovering the true source of the pain is crucial to receiving proper treatment. Treatment can include:

• In the first 24-48 hours of pain onset, you can follow the old adage of R.I.C.E. (rest, ice, compression, elevation). All of this will help to reduce swelling in the area:
  • Resting the arm and/or modifying activities that exacerbate the pain
  • Ice in 10-20 minute intervals
  • An elastic bandage can sometimes be helpful to help provide support and take pressure off other muscles, but in some cases it can actually aggravate the problem, so should only be used if deemed appropriate by your healthcare provider
  • Anti-inflammatory medications such as Ibuprofen can also help with inflammation and pain management (check with your doctor before taking any medication)
• Manual therapy, including joint mobilization and soft tissue mobilization, to loosen tight muscles and restore lost mobility.
• Strengthening program. Tennis elbow can be caused by weak muscles in the wrist and arm, or, surprisingly, by weak postural muscles in the core and along the spine. A Physical Therapist will do testing to find out where your areas of weakness are and target them with specific exercises.  Therapy will start out with more gentle exercise/stretching, progressing you as your pain reduces and strength increases to help give you lasting relief and avoid re-injury.
• Re-establishing proper movement patterns, and modifying activities that may exacerbate the pain. Simple modifications to your work station, or the technique you use to lift heavy objects for example, can make a big difference in reducing re-injury.

An Ounce of Prevention. Tennis elbow can be prevented, and the best way to do that is through fitness, proper ergonomics on the job and around the house, and if you’re on the court, having the proper equipment and a good warm up. A Physical Therapist can give you all the tools you need to stay on track and prevent injury in the future.