As the days get shorter you may be feeling the wear and tear of an active summer. After a season full of home projects, tennis matches, golf, and gardening you may find yourself with lingering elbow pain. That twinge of pain may be tennis elbow. Most people with this diagnosis don’t even play tennis.
Tennis elbow (lateral epicondylosis) effects the tendons on the outside of the elbow that work to bend the wrist back.
These tendons straighten the fingers and therefore help provide strength to the hand during gripping and carrying. 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 reaching out to grab the morning cup of French Roast may be uncomfortable. Shaking hands can be extremely painful. A tennis player may feel pain after ball contact with a forehand swing as the racquet decelerates.
In addition to the 50% of tennis players that have 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. Activities that require repeated forceful gripping, such as pruning, can cause of tennis elbow. Working at a desk that’s too low forces the tendons around the elbow have to work extra hard. Also, a sudden increase in lifting tasks, such as picking-up a newborn baby, can also cause this trauma to the tendons.
Using a racquet that is too stiff will place a heavy load on the tendons of the elbow. Overreaching for the ball, as often happens as leg speed and agility decrease make the tendons absorb much more 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 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 decreases the pull of the 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. Modify racquet handles, time on the court, and intensity of play to keep playing during the healing process. For the non-athlete, core, lower body, and select upper body exercises should be utilized to maintain or improve overall fitness and also decrease risk for re-injury.
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