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Tennis Elbow – ‘Lateral Elbow Pain’

484TennisElbowSo firstly let’s clear up a few things……

Myth: You can only get this from playing Tennis (actually only 5% of people suffering from tennis elbow relate the injury to tennis!) Fact: Lateral elbow pain affects not only athletes but also manual workers and office workers, it can respond fantastically to Physiotherapy treatment.

So what is it?

It is the most common overuse syndrome in the elbow, and is an injury involving the ‘extensor’ muscles of the forearm that attach to the outside ‘lateral’ part of the elbow. In a lot of cases these muscles and tendons are affected by the constant overloading from repeated use of your hand such as using a mouse, repetitive lifting or using tools at work such as a hammer.

 

Myth: It is classed as a tendonitis – a pure inflammatory condition. Fact: More accurately it should be classed as a Tendonopathy – where changes occur in the tissue.

 

tennis elbow 2Why do I need to get it treated? Well firstly it can be incredibly painful making simple activities such as lifting a saucepan excruciating! Now for the scientific bit……. nowadays there is better understanding of what the condition is, they used to think it was an inflammatory issue with the tendon however inflammation is present only in the earliest stages of the disease process, which is why taking long term anti-inflammatory medication is of no benefit! Then they realised it was less to do with inflammation and more due to actual changes in the structure of the tendon as result of overload and micro trauma, resulting in the body laying done sub quality ‘scar like’ tissue which has less strength than the original, an increase in water content of the tendon resulting in sometimes visible or possible palpable thickening and new in growth of small blood vessels that have a nerve supply which contribute to an increase in sensitivity and pain at the tendon. If this isn’t dealt with it will become more aggravated and in turn more difficult to settle down. So where do we start with treatment? The skill in physio when diagnosing is to find what other reasons may have contributed to this overload. The old ideas of rest, anti-inflammatory medication, ice, massage and electrotherapy were not dealing with the underlying problem – it’s the role of physio through treatment and exercise to help the body return this tendon as close to the structure it previously was, some of these changes will take weeks! It is always important to get professional advice to confirm a diagnosis, once you have done this you can try these simple steps to ease your symptoms:

  1. Change the position you grip things, i.e. instead of your palm facing down try gripping / lifting with palm facing up wards to change the load on your tendons.
  2. See if these help – Self mobilisations – lateral glide of the Ulnar – Watch Video
  3. Isometric exercise – you can hold up to 30-60 seconds and repeat 1-3 sets per day as long as its pain free: Watch Video. These can be progressed to different wrist positions and resistance added to make them more functional.

Lots of patients come to us telling us that they have been told by friends or other therapists that they should stretch it as much as they can or have deep massage or ultrasound – however the research shows these interventions do not work and in fact some can aggravate the condition!! Contact us today for an expert assessment, diagnosis and to start you on the road to recovery!

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