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WHAT IS “TENNIS ELBOW”?

“Tennis elbow” or Lateral Epicondylalgia causes pain around the outside of the elbow. Activities of excessive wrist extension or gripping can overload the extensor muscles’ origin at the elbow. This causes small tears in the tendon that often tear again, leading to degenerative changes in the tendon and the surrounding tissues. Pain can be aggravated by simple activities of daily life such as holding a pan or opening a door.

WHAT ARE THE CAUSES?

Elbow pain can be divided into 3 categories:

  • Acute : a single traumatic event
  • Chronic : multiple / repetitive overuse
  • Acute-on-chronic : single traumatic event to tissue predisposed to injury due to overuse

Only 5% of all patients seen with “tennis elbow” are recreational tennis players. If tennis is the cause it can be due to:

  • An altered pattern or posture
  • A change in grip / racquet
  • Improper technique
  • A increased level of play
  • Irregular practice/play
  • Different racquet string tension

HOW TO TREAT TENNIS ELBOW?

Physiotherapy entails a detailed history and a thorough assessment of the possible causes (multi-structural approach) and biomechanical analysis of neck, shoulder, elbow and wrist. Techniques include :

  • Mobilization of the elbow and cervical spinal joints to improve mobility
  • Myofascial release and neural stretches
  • Deep Transverse Friction Massage techniques to improve collagen formation in the tendon.
  • Electrotherapy: ultrasound-interferential -Biofeedback
  • Taping or elbow “cuffs” to offload/ realign the tendon and muscle at the elbow insertion.
  • Dry needling to minimize trigger points and improve collagen formation.
  • Acupuncture for pain relief.

Progressive Exercise Programs , including eccentric drills and strengthening of forearm and wrist extensors, stretches and neural sliders.

Initial treatment may involve relative rest from the causative action and application of ice .

HOW TO PREVENT RECURRENCE?

This type of injury typically takes 2 weeks to alleviate acute symptoms and a further 6-8 weeks for rehabilitation of muscle flexibility, strength and control.

Some cases can become chronic (tendinosis) with recurrences if not treated with a specific rehabilitation exercise program .

Physiotherapists can analyse your movement patterns / techniques and advise on corrective mechanics, appropriate eccentric strengthening program for the extensor muscles and progressive return to sport and function.

You should also work with your tennis coach to look at your grip, racket size, strokes and string tension and try to keep to a regular level of play.

Identifying possible hazards in your occupation that leads to over-usage or strain would also be beneficial.

Physiotherapy should always be the first treatment option , before both steroid injections and surgery is considered. If an injection or surgery is performed, it should always be followed with a course of physiotherapy sessions and a specific exercise program.

For more information or to book an appointment with one of our specialist physios please call:

Physio for all
Battersea: 020 7228 2141
Chelsea: 020 7373 0050