What is Tennis Elbow?
Tennis elbow, also known as lateral epicondylitis, is a condition that occurs when the tendons that attach to the outer part of the elbow become inflamed or damaged. This can cause pain and tenderness in the outer part of the elbow and forearm, and can sometimes radiate down towards the wrist. This overuse can cause small tears in the tendons, leading to pain and inflammation.
Tennis elbow can affect anyone who performs repetitive motions with their wrist and arm. It is a common condition among athletes who play racquet sports, such as tennis, but it can also affect people who perform repetitive manual labour tasks, such as carpenters, painters, and plumbers.
What causes Tennis Elbow?
1. Muscle Overuse
Any repetitive task that requires gripping can increase the demand on forearm muscles and tendons.
This can lead to overuse of the outer forearm muscles and tendons that attach to the lateral epicondyle (bony bump on the outer part of the elbow), which can cause small tears in the tendons, leading to pain and inflammation.
2. Direct Trauma
A direct blow to the outer aspect of the elbow, such as sustaining contact in sport or via car accident can injure the muscles and tendons. However, it is important to note that repetitive stress is more likely to be the cause of tennis elbow.
3. Improper Gripping Mechanics
Certain gripping techniques such as overextension in the wrist and excessively tight grips require more outer forearm muscle use, which can cause strains and tears to the muscles on the outer elbow.
4. Suboptimal Shoulder Mechanics
In some cases, shoulder dysfunction relating to weakness or decreased mobility can be compensated for via excessive forearm recruitment, which can cause strain and small tears to the outer forearm muscles.
How does physiotherapy Treat Tennis Elbow?
Resolves the root cause
During the assessment, your therapist will determine why your tennis elbow is occurring. Your therapist will then provide treatments, prescribe exercises, and educate you on how to reverse your tennis elbow symptoms.
1. Manual Therapy
Myofascial release: to reduce pain, tightness, and inflammation of the muscles, joints, nerves, and fascia of the affected areas.
Joint mobilization: to promote smooth joint movement and mobility of the elbow, wrist, and other affected areas.
2. Biomechanical Optimization
Movement pattern conditioning: optimizing gripping mechanics and appropriate forearm muscle recruitment, while also incorporating shoulder recruitment to reduce load on the forearm and elbow.
3. Exercise Therapy
Stretching: to improve flexibility and reduce muscle tension in the upper arms and forearms.
Strengthening: to improve the activation and stability of the muscles around the elbow, shoulder, and wrist to prevent compensations, reduce future injuries, and restore optimal nerve function.
Home exercise program: individualized exercise prescription to restore optimal and balanced movement.
Shockwave therapy: use of high-energy sound waves to improve blood flow, break down scar tissue, regrow new tissue, reduce pain, and stimulate healing processes.
Taping: to support the lateral forearm musculature and reduce stress.
Acupuncture: use of thin needles to improve local and systemic function, regulate the nervous system, and promote the body’s natural healing processes.
Heat and cold therapy: to manage reduce pain and tension or control inflammation.
Electrostimulation: use of electrical currents to stimulate muscles and reduce pain.
Ultrasound: use of high-frequency sound waves to produce deep tissue heating to reduce muscle tension, fascial tension, and inflammation.
Laser therapy: to improve blood flow, reduce pain and inflammation, and promote tissue healing.
Recommendations regarding lifestyle and activity modifications, posture, and sleeping position to help reduce load, risk of recurrence, and further injury.