The medical term for Tennis Elbow is lateral epicondylitis: meaning pain and inflammation (itis) at the attachment of the wrist extensor muscles (lateral epicondyle). It's caused by the tightening and shortening of the wrist extensor muscles, usually as a result of over-use.
Playing racket sports, tamping coffee, typing on a laptop, carrying heavy boxes, using a screwdriver are all example of the kind of over-use that will lead to Tennis Elbow.
Although the cause of Tennis Elbow is muscular - the injury is actually in the common extensor tendon - the origin for all eight of the wrist extensors. For that reason Tennis Elbow can take a long time to resolve - muscles are superficial, full of blood, and relatively easy to manipulate, but tendons are deeper, devoid of blood and very difficult to fix.
In this quick guide, I'll briefly outline the things you can do before developing Tennis Elbow to prevent it; after development to treat it; and after resolution to keep it from coming back.
Prevention of Tennis Elbow is easy in theory, but harder in practice. What you need to do is avoid repetitive movements of the forearm. You'll find it impossible to avoid entirely, but there are always some things you can do to rest your forearms. You can use 2 hands instead of 1 when using a screwdriver or thumb-screw; you can lift your elbows when you type to keep a straight wrist, you can curve your wrist when doing a pulling set at the gym to keep from over-training your wrists. The list is endless, but only you will know your daily life well enough to know what needs changing.
Even after making those changes, you should release your forearms with stretching, self-massage, or with treatment from a professional on a fortnightly basis to prevent even the small amount of use from shortening the wrist extensors.
The goal for Tennis Elbow intervention is 2-fold: release the forearm muscles to stop them from pulling on the tendon, and minimise the inflammation in and around the tendon.
Massage is an excellent way to relieve the muscle tightness, but it will make the inflammation worse. For that reason, I suggest stretching and needling as the best cause of action for active Tennis Elbow.
To supplement that, you should be exercising RICER - rest, ice, compress, elevate, refer. Rest the forearm until the elbow is pain-free, ice the elbow for 20min every 2 hours, compress and elevate the elbow above the heart as much as is practical.
If the pain is terrible, it's worth speaking to a doctor about the different anti-inflammatory drugs that are available to you - they won't repair any of the damage, but they will make you more comfortable while you do repair the damage with stretching, needling, and resting.
Where there is a tight muscle, there will be a weak muscle 100% of the time. After you release the wrist extensors and resolve the tennis elbow, it will keep coming back until you strengthen the weak muscles around the elbow and shoulder and correct the movement pattern that got you there.
The rehab for Tennis Elbow is best carried out by a physiotherapist or exercise physiologist and will involve a 6-week + program of exercises for you to do at a gym and home.
Tennis Elbow is common, but it's not simple. It involves a multi-disciplinary approach to correct and prevent.
For more information on Tennis Elbow, email me directly via the contact page. For specific information on an injury you have, or for treatment, contact one of my clinics directly. You can find that information here. I work with industry-leading Physiotherapists and Exercise Physiologists. If you want a referral to one of my colleagues for a Tennis Elbow rehab program, contact me.
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Dr Mitch Clark