Tennis Elbow

What is it?

Tennis elbow is also referred to as lateral epicondylalgia and is typically an overuse injury of the muscles of the forearm, specifically the extensors responsible for bending your wrist backwards. It is most prevalent amongst individuals performing repetitive movements frequently within a work environment and with some leisure activities e.g. tennis, hence the name.

Anatomy and Biomechanics

The extensor muscles of the forearm attach to the lateral epicondyle (outside) of the elbow via a common tendon. They then run along the forearm toward the wrist and attach into various places as seen in Figure 1.

A complex network of muscles all run side to side and work together to perform the many various movements that the wrist and hand are capable of doing. The extensor tendon acts as a common anchor for most of the muscles to attach on to, making it susceptible to overuse injury.

The role of the extensor muscles become most important with activities which involve movements of the wrist and fingers of the hand, such as with typing and repeated gripping. Tendons are made to withstand a lot of repeated force and trauma but excessive activity can injure this faster than the body’s ability to repair itself.

Long-standing tendon injuries are predisposed to degeneration which can lead to an increased risk of injury and worst case scenario may tear. Proper management of this injury is vital to reduce the risk of longstanding symptoms and weakness.

What are the signs and symptoms?

  • Pain around the outside of the elbow
  • Pain with gripping and bending your wrist backwards
  • Typically, gradual onset made worse with activity

Contributing Factors

Tennis elbow may develo9p more readily with poor upper limb posture and biomechanics, especially within work environments. Tightness of the extensor muscles of the forearm can also predispose yourself to this injury. Assessing workplace posture at both the shoulder and elbow can play an important role in reducing the risk and help manage individuals suffering from tennis elbow.

Tennis elbow can also be caused by repeated forces being placed upon the muscles of the forearm. This is seen within sports mainly involving racquets or activities that are heavily hand dependent.

Diagnosis

The Physiotherapists at Pro Physio SA are able to accurately diagnose and treat tennis elbow based on your daily activities and a physical examination.

Other imaging such as an ultrasound and MRI are also able to diagnose tennis elbow and can be used at times to confirm diagnosis.

Treatment

Early stage management by our Physiotherapists will aim to reduce pain and promote healing of the tendon and musculature. This can also be facilitated with ice and heat, strapping, dry needling, electrotherapy and shockwave therapy.

Our Physiotherapists will then address the relevant contributing factors related to your injury and work to strengthen the area to bring it back to optimal strength. If you feel you may be suffering from tennis elbow, arrange an appointment with one of our experienced Sports & Musculo-Skeletal Physiotherapists at you local Pro Health Care clinic.

Dwain Pinfold, Physiotherapist