As we head into late fall and winter, you may find yourself with lingering elbow pain, maybe from working from home for months without an ergonomic setup or maybe from too much gardening while you’ve been staying socially distant. That twinge of pain may be tennis elbow. But don’t let the name fool you – most people with this diagnosis don’t even play tennis!
Tennis elbow (lateral epicondylosis) affects the tendons on the outside of the elbow that work to bend the wrist back.
These tendons straighten the fingers and therefore help with your grip strength, ability to lift, push, and pull, and more. If left untreated, tennis elbow can become debilitating and impair daily activities. This is related to overuse and repetitive stress on the tissue, which leads to tears of the tendon over time. This is a condition that can become chronic if not cared for promptly and properly.
Individuals with tennis elbow will typically feel pain and tenderness on the outside of the elbow.
Holding up a newspaper or pouring your morning cup of French Roast may be uncomfortable. Scrolling on your phone or working on your computer can be extremely painful. A tennis player may feel pain after a forehand swing as the racquet decelerates. Climbers might not be able to stick the moves that used to be easy.
In addition to the 50% of tennis players that experience tennis elbow at some point in their career, 1-3% of the general population between 30 and 50 years of age also suffer from this.
Gardeners can develop it when they have to use a repeated forceful grip, such as when pruning. Been working at your kitchen table as part of your pandemic office setup? If it’s too low, it can force the tendons around the elbow to work extra hard. We frequently see mothers of newborns dealing with tennis elbow, as they suddenly increased the number of times they are lifting and putting something down in the course of a day, in this case, their baby.
When are tennis players likely to develop it? If they’re using a racquet that is too stiff, that will place a heavy load on the tendons of the elbow. Or if they are overreaching for the ball to compensate for decreased leg speed and agility, their tendons have to absorb the extra force.
Tennis elbow treatment:
The first line of treatment is to modify or decrease the frequency of the activities that cause pain. This gives your body a chance to start the healing process.
Rest, icing 2-3 times a day for 5-10 minutes, and wearing a compressive sleeve (or tennis elbow brace) may help relieve pain.
Your physician may refer to you an Occupational Therapist and Certified Hand Therapist (need one? You’ve come to the right place!) who specializes in rehabilitation of the arm. The therapist will assess symptoms and develop a program of exercises to regain pain-free arm use. Your Occupational Therapist will assess shoulder strength and mobility. Weaknesses and imbalances in the upper arm can lead to over-stressing the muscles around the elbow. Therapy will include education on activity modification, safe lifting techniques, and specific exercises that speed healing.
Treatments used for pain relief include therapeutic massage, ultrasound, and therapeutic laser.
A removable custom wrist support brace is often made to support the injured tendons in the initial phase of healing. The splint can be transitioned to kinesiology tape to facilitate supported motion and function as healing progresses. A snug strap worn around the top of the forearm will decrease the pull of the muscles on the elbow and may lessen pain. Forearm straps and wrist support splints are found in rehabilitation clinics, drug stores, and sporting good stores. As healing progresses, stretching and strengthening exercises advance to “real world” activity.
For the athlete, a therapist can issue agility and sport-specific training exercises that improve performance without stressing the elbow. Modifying racquet handles, time on the court, and intensity of play can all help you to keep playing during the healing process. For the non-athlete, focus on strengthening your core, lower body, and doing select upper body exercises to help you maintain or improve overall fitness and also decrease the risk for re-injury.
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