Tennis elbow is an inflammation of tendons connecting the forearm ‘s muscles to the elbow ‘s surface. Sometimes it happens due to overuse of the muscles and tendons of the forearm and those around the elbow joint.
Often known as lateral elbow pain or lateral epicondylitis, Tennis elbow is not usually tennis related. Tennis players also develop the disease, however, because it comes from repeated use of muscle. Half of all tennis players in their careers will get the tennis elbow.
Tennis elbow is believed to impact 1 to 3 percent of the U.S. population. It typically happens between the ages of 30 and 50 years.
Important facts about tennis elbow
- Tennis elbow is caused by small tears in the tendons that join the forearm to the outside of the elbow.
- 50 percent of tennis players will experience tennis elbow.
- Overuse of the forearm with incorrect wrist action can lead to tennis elbow.
- Physiotherapy, support devices, and steroid injections can be used to treat the condition.
- Certain exercises that provide strength to the supportive muscles in the arm and shoulder, such as the Tyler Twist, can help symptoms.
- Stretch carefully ahead of racquet sports to prevent tennis elbow.
Symptoms
Recurring pain on the outside of the upper forearm, just below the elbow bend, is the most common symptom of tennis elbow. Pain can be felt further down the arm, towards the wrist as well.
There may be discomfort when the person raises or bends his arm. It is often sensed while carrying out simple acts, such as writing or grabbing small items.
The tennis elbow can cause pain when the forearm is bent. This can be found when a door handle is turned or the forearm completely extended.
Causes
The cause of tennis elbow is due to repetition of incorrect arm movements. This can cause tiny tears in the elbow tendon connection. This in tennis translates into the repetitive movement and impact of hitting a ball with a racquet.
Incorrect technique can cause the power to rotate through and around the wrist in a racquet swing. Instead of the elbow joint or shoulder this produces a movement on the forearm. This can increase tendon pressure, and cause discomfort and inflammation.
The extensor muscles can frequently become uncomfortable because of this deterioration of the tendon. The muscles on the extensor are the ones that straighten the forearm.
Elbow tennis is synonymous with finger extension and wrist extension. This is the kind of movement that allows the person to “snap” or flick the wrist, like when swinging in a racquet.
Other causes
Despite the name tennis elbow refers to any injury caused by overuse to this particular tendon. Tennis elbow can be the result of everyday activities such as:
- using scissors
- cutting tough food
- gardening
- sporting activities that involve high amounts of throwing
- swimming
- manual work that involves repetitive turning or lifting of the wrist, such as plumbing, typing, or bricklaying.
Sometimes, there is no apparent cause.
Diagnosis
There is an simple test a person can do at home to determine if they’ve got tennis elbow.
Stand behind a chair and put your hands on the back of the chair, with palms facing downwards and straight elbows. Try to lift the chair.
If this action causes pain beyond the elbow it is a probable tennis elbow indicator.
Often it takes an X-ray or MRI scan to rule out any more serious problems, such as arthritis or an elbow joint injury. But imaging is rarely required. Before talking about the location and essence of the pain the doctor will test a number of movements with the arm.
Normally this is ample knowledge for diagnosis of tennis elbow.
An MRI provides a more accurate image than an X-ray, as it involves the inside arm’s soft tissues, muscles and tendons. This could be appropriate if after a year, the pain from the outer elbow does not respond to conservative care.
Electromyography (EMG) may be used to determine if the nerves are compressed.
Treatment options
There are some recovery approaches that can be used at home or after a doctor’s appointment.
Rest: It’s important to put your arm down. A break in action in the tendon connection helps the tears to heal. Tennis players take ice, anti-inflammatory medications, soft tissue massages, stretching exercises and ultrasound therapy to treat more severe cases.
Physical therapy: Physical therapists usually advise racquet sports players to improve their muscles in the back, upper arm, and abdomen. This can aid in shoulder and arm movements to will the wrist extensors.
Ice massages and muscle strengthening exercises can help the muscles recover too.
Strapping or rubbing the forearm: Maintaining the area will help to realign the muscle fibers and alleviate the area strain. A physician can suggest taking the elbow out of action using a splint for 2 to 3 weeks.
Steroid injection: If the symptoms are extremely painful and the condition makes movement difficult, a doctor may prescribe an injection of steroids.
The person should rest the arm after a steroid injection, and avoid putting too much pressure on it.
Other conservative treatments: Botulinum toxin injections, also known as Botox, and extra-corporeal shock wave therapy (ESWT) are more alternatives.
ESWT is a technique thought of by sending sound waves to the elbow to cause the healing process. Other treatments include heat therapy, low-level Laser therapy, occupational therapy, and point trigger therapy.
An injection of platelet-rich plasma (PRP), prepared from patient’s blood, is a newly available treatment. PRP contains proteins which stimulate healing. This treatment is identified as promising but still under investigation by the American Academy of Orthopedic Surgeons (AAOS).
Surgery: Surgery could be appropriate to extract the injured portion of the tendon and alleviate discomfort in extreme instances where non-chirurgical therapy does not address symptoms in 6 to 12 months. About 80 and 95 percent of patients recover without procedure.
It may be helpful to wear an arm brace or a wrist splint while using the arm to avoid further damage to the tendons. It can be taken off to rest or to sleep. A doctor or physiotherapist can advise you about the best form of brace or splint.
Exercises
Stretches and incremental weight-reinforcement exercises or elastic bands can be helpful. They will increase the strength of the painless grip and the strength of the forearm.
An article written by the Canadian Family Physicist suggests multiple exercises using dumbbells that have aided muscle strengthening in tennis elbow patients.
Exercising in a tennis elbow case is important to restore muscle strength and to relieve discomfort.
It is possible to ease into an exercise routine by initial stretching through painful sensations. The key part of handling tennis elbow is persisting with a regular stretch and lift regime. Start with lower weights and raise the motions’ complexity until only ten lifts can be completed.
Here is an example of a simple exercise to strengthen symptoms of the tennis elbow.
The Tyler Twist
You can hold a long , thin object with both hands comfortably. Usage of a flexible item which still provides resistance while being twisted is preferable. A rolled up towel can work. People who do the Tyler Twist also use an exercise method known as the FlexBar.
- Hold the object vertically in front of your chest.
- Grip the object with both hands, with your hands facing the same way. Both wrists should be fully extended, or bent back.
- Move the wrist affected with tennis elbow into flexion, or a bent-forward position, around the object.
- Keeping the wrist in flexion, rotate the object into a horizontal position, as if you were holding the handlebars of a bicycle. Hold your arms straight out in front of your body.
- Move the unaffected wrist into flexion, joining the affected wrist.
- Perform three sets of 15 repetitions a day until symptoms improve.
This video shows the requisite motion. But it’s important to complete these steps slowly.
There are other exercises available. Speak to a physiotherapist about the right body routine.
Prevention
To minimize the risk of tennis elbow during exercise or exertion, it is necessary to pay attention to movement techniques.
It is easier to distribute the load to the larger shoulder and upper arm muscles, rather than concentrate exercise on the smaller wrist and elbow muscles.
Warming up: It is important to warm up before playing a sport requiring repetitive arm movements, like tennis or squash. Stretching the arm muscles gently will help prevent injury.
Using lightweight instruments: Lighter sports equipment or racquets with a greater grip size may help to minimize tendon strain. Humid tennis balls and older balls bear undue force on the shoulder.
Growing forearm muscle strength: This will help promote arm movement and prevent tennis elbow.
A physiotherapist may also prescribe suitable exercises to help improve the muscles in question.
