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Tennis elbow

With the warmer season we mainly want to enjoy outdoor activities like tennis, climbing or simply painting the garden fence.

Unfortunately sometimes a combination of poor physical preparation, over zealous repetitive movements or overload can spoil the fun and we end up with annoying and sometimes debilitating pain in the outside of or elbow: could it be a case of “tennis elbow”?

We might just wait till it gets better but that can take up to several months to improve. Here some more information and what swissphysio can do for you.

1. Tennis elbow: what is it
2. Tennis elbow symptoms
3. Causes
4. Treatment
5. Prevention
6. Medication

1. Tennis elbow: what is it

Lateral epicondylitis or lateral epicondylalgia, known colloquially as tennis elbow, shooter’s elbow, and archer’s elbow or simply lateral elbow pain, is a condition where the outer part of the elbow becomes sore and tender.
Since the pathogenesis of this condition is still unknown, there is no single agreed name.

While the common name “tennis elbow” suggests a strong link to racquet sports, this condition is most commonly seen in two groups of people:

Manual Laborers

People who work with their hands are at greater risk of developing tennis elbow. Jobs that may lead to tennis elbow include plumbers, painters, gardeners, waiters, carpenters and even musicians like guitar players.

Sports Participants

Sports participants, especially racquet sport players, are prone to developing tennis elbow. In addition to racquet sports, tennis elbow is seen in golfers, fencers, swimmers and climbers to mention

2. Tennis elbow symptoms

Pain over the outside of the elbow (lateral epicondyle)
Pain when lifting objects and cocking back the wrist.
Pain from gripping and grasping objects and movements of the wrist
Pain from activities that use the muscles that extend the wrist (back hand shot, pouring a container of liquid, lifting with the palm down as well as activities of daily living)
Painful grip while shaking hands or turning a door knob
Pain radiating down the forearm
Weakness of the forearm
Point tenderness over the lateral epicondyle
Morning stiffness.

3. Causes

Tennis elbow is an overuse injury. The pain associated with this condition usually has a gradual onset but it may also come on suddenly as a consequence of a trauma such as a direct blow to the epicondyle, a sudden forceful pull, or forceful extension. The acute pain that a person might feel occurs when they fully extend their arm.

Disorders such as calcification of the rotator cuff, bicipital tendinitis, or carpal tunnel syndrome may increase chances of tennis elbow and Kaplan also stated that the radial nerve was significantly involved in tennis elbow problems.

That means that the onset of a “tennis elbow” can be the result of a combination of various factors like:
– repetitive movements with either high intensity or poor technique, poor equipment or a combination of those
– poor shoulder stability/ control often resulting from poor posture at work and/ or during activities. This also includes restrictions of movement resulting from old scar tissue and adhesions in other part of the body.
– irritation off the Radial nerve do to problems at the cervical spine (often posture related)

4. Treatment

Treatments given at swissphysio always aim to solve the problems from the root. For this reason an experienced chartered physiotherapist or/and qualified TCM acupuncturist will first thoroughly assess you focusing not only on your elbow but also the whole body and the biomechanics of neck, trunk and arm in relation to your daily activities and your actual and past medical history.

Treatment  usually include mobilisation and manipulation of soft tissue and joints, electrotherapy, kinesio taping, stretching and strengthening exercises for the arm, shoulder, neck and core.

We create an exercise program specific to the need of the patient and if requested we can assess the workstation or the position of the car seat. A parallel treatment with a fully qualified acupuncturist can be suggested to support the healing of chronic conditions.

In some cases, the severity of tennis elbow symptoms mend without any treatment within six to twenty-four months. However, Tennis elbow left untreated can lead to chronic pain that degrades quality of daily living.

5. Prevention

Decrease the amount of playing time if already injured or feeling pain in outside part of the elbow.
Stay in overall good physical shape.
Strengthen the muscles of the forearm: (Pronator quadratus, Pronator teres, and Supinator muscle) — the upper arm: (biceps, triceps, Deltoid muscle) — and the shoulder and upper back (lower trapezius). Increased muscular strength increases stability of joints such as the elbow.
Like other sports, use equipment appropriate to your ability, body size, and muscular strength.

It is rarely an overnight cure.

6. Medication

Typical non-steroidal anti-inflammatory drugs (NSAIDs) relieve lateral elbow pain in the short term, however they provide no improvements in functional outcome. Injected NSAIDs may be better than oral NSAIDs. There is insufficient evidence to recommend or discourage the use of oral NSAIDs.