Urban Body’s Lead Physiotherapist, Phil Evans, has worked with Loughborough University Physiotherapy, Leicestershire County Cricket Club and Team GB athletes. Phil explains what causes tennis elbow, how to diagnose the condition and overcome it.
“Tennis elbow, or lateral epicondylitis, is a painful condition and is the most common overuse syndrome in the elbow. Several sports and activities, including tennis, can increase the risk of developing problems.
We have been seeing patients who have developed tennis elbow as a result of:
- Going from playing tennis only once a week to playing every day on holiday
- Working from home and perching over their laptop at the kitchen table sitting on a hard chair for 8 hours a day, rather than working in the office with the correct ergonomic set-up
- Doing more gardening, DIY, or housework
Repeating the same motions over and over again can lead to tenderness and inflammation on the outside of the elbow. Tennis elbow is a tendinopathy injury involving the extensor muscles of the forearm. In some cases, micro tearing of the tendons that join the forearm muscles on the outside of the elbow, in particular the extensor carpi radialis brevis (ECRB) muscle which helps stabilise the wrist when the elbow is straight can occur.
The big problem with tennis elbow is that when it starts becoming inflamed, you don’t feel it immediately, and this is the nature of tendinopathies. Pain begins very mildly and slowly worsens over weeks and months.
Diagnosis of tennis elbow
The best way to diagnose tennis elbow is to reproduce the pain. This can be done by palpating the extensor muscles origin on the lateral epicondyle. The pain typically radiates upwards along the upper arm and downwards along the outside of the forearm and, in rare cases, to the third and fourth fingers. Another way to diagnose is to test grip and forearm strength. Pain and weakness during resisted extension of the third digit of the hand or resisted wrist extension while palpating the lateral epicondyle are typical indicators of tennis elbow.
Pain is your body’s way of telling you that you are doing something that it doesn’t like. Total rest from all activities is never needed, but guidance regarding doing the “right” things instead of irritating things will exponentially cut your healing time. Combining exercises with hands-on treatment such as elbow mobilisation and massaging will all aid recovery. Acupuncture and taping have also proven to be very effective. Using elbow orthotics over the back of your forearm may also help relieve symptoms by resting the muscles and tendons, but often only in the short term.
Start with some self-massage into the forearm/lateral aspect of the elbow and tricep area. Find a golf or tennis ball and roll it over your forearm and sensitive areas to break down the tight tissue and tendons of the elbow. Try rolling over the sensitive areas slowly for a maximum of 15 times. Concentrate on one spot at a time and work on it exclusively.
Eccentric strengthening exercises (lengthening a muscle at the same time as being contracted) have also been proven to be very effective for tendon pain and tennis elbow in particular. Start with a basic eccentric wrist extension with a light dumbbell, or add a Theraband Flexbar with some wrist supination.
Perform 10 reps x 2/3 sets, 2-3 times a week with a couple of days rest in between to allow for recovery as it can be quite sore. Try and slow the movement down to last 4-6 seconds per rep.”
About Urban Body: Urban Body’s physiotherapy and rehabilitation clinic is based in Solihull (UK), and the team has more than doubled since the beginning of the pandemic. Urban Body’s team of expert physios are trained at degree level and focus on the underlying cause of the patient’s pain rather than alleviating symptoms, offering step-by-step plans and effective hands-on treatment. Urban Body offers free assessments to new patients. For more information, please visit www.urbanbody.co.uk
This is a Medical Travel Market hosted article with content provided by Urban Body.