What Is Tennis Elbow?
Tennis elbow is pain or irritation on the outside bone of your elbow joint which can be caused by overuse of the muscles in the forearm, or may follow an injury.
The muscles that run from your fingers and hand up along your forearm come together to attach at one point at the side of your elbow called your lateral epicondyle. The muscles attach at this point via a tendon.
All of these muscles allow your wrist and fingers to bend back.
When these muscles are overused i.e. when the wrist is repetitively bent back in activities, for example tennis, painting, plumbing, gardening, typing and many other repetitive jobs. The tendon that attaches these muscles to the bone can become irritated and even partially torn giving pain on the outer aspect of the elbow.
What can I do to help this?
- Rest from aggravating activities
- Adapt activities to prevent too much extension at the wrist (bending back) which irritates the pain
- Change your desk position if you are working at a computer to ensure your wrists are in a good position
- Alter your activities so you do not continue to perform the same motion for a long period of time
- Altering your technique in sport
- Wrist or elbow splints to help take the pressure of the tendon
How can physiotherapy help?
Physiotherapy helps by analyzing and evaluating your work, sport and other daily activities to assess what are the aggravating factors. It proceeds to work on adapting these activities to take the pressure off the muscles and tendons to help ease the pain.
Physiotherapy also helps with hands on techniques to help loosen and stretch out the muscles of the forearm, again helping take the pressure of the tendon at the elbow. This is achieved through massage and different release techniques along with stretching exercises. Splints or strapping can also be provided to help ease the pain.
Steroids reduce inflammation, and injection around the most inflamed area can reduce the pain. Often a single injection will settle the symptoms; however 2 or more injections may be required. Repeated injections are unwise as tissue damage can occur.
If a course of physiotherapy and injections do not settle the symptoms surgery may be indicated. Frequently investigations such as MRI scanning may be performed to confirm the diagnosis. Surgery can be performed through a open wound 3 to 5cm in length over the outer aspect of the elbow, or through a key hole (arthroscopic) method. Surgery removes the affected area, allowing the body to heal this as a surgical scar and not an area of inflammation. Following surgery the arm is placed in a sling. This period of rest is vital for healing and is usually 4 to 6 weeks. Following this the arm is allowed to move freely, physiotherapy can help to strengthen the muscles.
Surgical results can be variable and is usually quoted as being 70% successful.