Commonly referred to as “tennis elbow”, this condition refers to degeneration and inflammation within the tendons on the outside of the elbow and forearm. These tendons connect the forearm muscles to the elbow and function to lift the wrist, hand and fingers.
This is a common injury associated with activities requiring repetitive use of the wrist and hand, and results from overuse of the tendons on the outside of the forearm. Repetitive use of these forearm muscles and tendons can lead to microscopic tears within the tendons and degeneration or breakdown of the tendons called tendinopathy. To repair this degeneration, the body commences an inflammatory response.
The primary problem is pain and tenderness felt on the outside of the elbow and forearm. Initially it may be felt only following exercise, but as the tendinopathy worsens the pain within the tendon becomes more intense and more frequent. In the earlier stages, this pain during exercise may initially disappear as you warm
up, only to return as you cool down. However, as you continue to exercise, the tendinopathy worsens and your pain may begin to be present for longer periods during exercise until you are constantly aware of it. Weakness of grip may follow, even an inability to pick up a coffee cup.
An easy at-home test can be performed: Stand behind a chair, place your hands on top of the chair back with your palms down, and try to lift the chair up. If this causes pain on the outside of your elbow, the culprit is most likely tennis elbow. Tenderness should be present over the origin of the forearm muscle on the outside of the elbow joint and there should also be pain when bending the wrist down with the other hand as well as bending the wrist back against resistance.
Physiotherapy is the most important part of conservative treatment. It includes various treatment modalities including manual therapy, mobilisation techniques, electrotherapy modalities, dry needling, exercise/technique modification, ergonomic modification, exercise and stretching etc.
Other treatments include:
- Anti-inflammatory medication
- Heat or ice
- A counter-force brace or strap to reduce strain, to limit pain provocation and to protect against further damage.