Andy Murray’s breathtaking victory at Wimbledon should inspire a generation to take up tennis, not to mention a few of us older players looking to dust off our racquets to remember former glories!
But talk about amateur tennis and it won’t be long before someone mentions tennis elbow.
Here our physiotherapist, Alison Bugg looks at some of the causes, symptoms and techniques to prevent it.
What is ‘Tennis Elbow’
Tennis elbow is a condition involving the tendons on the outside of the elbow. It is also known as lateral epicondylitis.
Tennis elbow is quite common, affecting 1-3 people in every 100. It is most common in the population amongst people aged between 40 and 60.
The exact cause of tennis elbow is not known, but it does tend to occur after repetitive use of the extensor tendons at the elbow, such as in tennis (hence the name).
These tendons are involved in extending the wrist joint and are also active when gripping with the wrist extended such as turning a door knob, or in gripping and twisting such as shaking hands with someone. Any activity that twists and extends the wrist can lead to tennis elbow. We see patients presenting with lateral elbow pain following gripping a paint brush during prolonged DIY, or using a screw driver for long periods. We also see tennis elbow in people who repetitively use a mouse at work and have poor posture.
People initially report tenderness and pain on the outside of the elbow. If left untreated, a dull constant pain or sharp shooting pain can be felt. Swelling may or may not be present.
Other symptoms include:
Pain when the wrist or hand is straightened (wrist extension)
Pain felt when lifting and gripping heavy objects
Pain when making a fist or shaking hands with someone
Pain when lifting a cup or item with the back of the hand uppermost
Shooting pains can be felt above and below the elbow in longer term cases
Pain when fully lengthening or straightening the arm after a period bent (such as on the phone)
Pain with tennis elbow is typically localised over the bony bump on the outside of the elbow (lateral epicondyle) and may extend down into the forearm. This area is usually tender to touch. Rest quite often relieves the pain but will not resolve.. Other conditions cause pain in the elbow and be mistaken for tennis elbow such as, arthritis in the elbow, an inflamed or trapped nerve in the neck, shoulder problems and wrist problems such as carpal tunnel.
It is IMPORTANT that you always get your pain diagnosed by a qualified doctor or physiotherapist as elbow pain can be an indicator of other problems.
It is imperative to seek treatment early on, treatment in the acute stages is most successful. The type and duration of the treatment will depend on the severity of the condition. The longer the condition has been present the longer it generally takes to reduce the patients’ symptoms. The first step in treating tennis elbow is to manage the activities that cause the pain, and address any factors that could be causing or aggravating this.
Physiotherapy to stretch the tendons and train the muscles is vital.
Soft tissue techniques and massage
Eccentric exercises can prove effective in over 60% of cases
Analgesia (painkillers) relieve the pain during activity and at rest. Anti-inflammatories (NSAIDs) such as ibuprofen can work well if advised they are suitable by your doctor.
A strap designed for tennis elbow can be worn to reduce the aggravation on the tendons
Treating the area with an ice pack or cold treatment can help
Acupuncture can be a useful pain reliever
There are a number of things that can be done to try and ensure tennis elbow doesn’t recur
It is important to strengthen the surrounding muscles under the guidance of a physiotherapist
Using good and correct technique during tennis or when repetitively gripping or lifting heavy objects.
Warm up before activity or sport
After exercising, ice the area and stretch
Reduce aggravating factors
If the patients’ condition does not respond to treatment, an injection can be given by an elbow specialist. More recently Platelet Rich Plasma (PRP) injections have shown to be effective, but tend to be more expensive. These can all be discussed with your physiotherapist and referred onto one of our elbow surgeons if appropriate.