What is it? How does it happen?
The technical term for tennis elbow is “lateral epicondylitis.” This term is just fancy for swelling/irritation of the muscles and their tendons that attach on the outside of the elbow. The muscles that attach there are those which control wrist extension or bringing the back of the hand upwards like when you wave hello or goodbye.
The cause of tennis elbow is not just tennis as the name would suggest, although it is very common among tennis players and those who play other racquet sports. Despite the name, any activity in which repetitive twisting of the wrist or up and down motions are frequently used can lead to tennis elbow. This can also include excessive computer use. Tennis elbow is an overuse injury where small tears to the muscle and tendon occur over time. These tears produce scar tissue that binds down the muscle tissue causing it to become less elastic. This decrease in the elastic properties of the muscle creates more tension throughout the tissue and causes irritation where the tendon meets the bone causing pain and sometimes swelling. The main motions that cause this irritation and pain are the backhand motion that includes extending the wrist, as well as any twisting, gripping, or squeezing motions of the hand.
Another problem that can cause tennis elbow is shoulder weakness. When we lift up and object, our body normally fires in sequence with the muscles of the shoulder firing first then moving down the chain. The shoulder therefore takes the brunt of the tension as it stabilizes the rest of the arm. If it is weak, the tension shifts lower which means the main stress is now placed on the elbow joint causing irritation. A main point of weakness will be in rotating the arm inward towards the body against resistance.
Some signs and symptoms to look out for that occur with tennis elbow:
- Pain on the outside of the upper part of the elbow. This pain can gradually get worse with continued use of the affected arm.
- Weakness. You may notice weakness in the hand when trying to grasp or grip onto something.
- Pain when the palm of the hand is passively bent downward or the back of the hand is actively bent upward.
- Point tenderness. This means there will be pain when touched in very specific points around the elbow joint. This mainly occurs on the muscles and tendons that are connected to the outside of the elbow.
If you feel pain on the outside of the elbow for greater than 1-2 weeks, you should make an appointment to see your doctor of physical therapy. To determine a diagnosis of tennis elbow a social and medical history will be taken and special tests will be used, some of which may reproduce your symptoms. After the diagnosis has been made, your doctor of physical therapy will prescribe an exercise program that will be appropriate for you and your degree of injury. Physical therapy can help you improve muscle strength and endurance, improve your ability to move your arm with less pain, and retrain your muscles to fire in the correct sequences. It is important to know that treatment times will vary depending on severity of the injury. That is why it is necessary to make an appointment with your doctor of physical therapy as soon as possible.
If you suspect that you may have tennis elbow and cannot make an appointment to see your doctor of physical therapy, here are a couple of basic things you can do:
- Rest. Stop doing the activities that are causing pain. This may be difficult in some situations but attention must be paid to the amount that you are using the affected arm.
- Ice. Although extremely cold, and sometimes uncomfortable, ice can be your best friend. Ice does a great deal to calm down pain and inflammation if present. You can ice down your elbow as many times as needed throughout the day as long as you don’t exceed 10-15 min per application.
- Bracing. Tennis elbow braces or straps can be used to help decrease pain with activity. Braces can help take off some tension from the attachment site by moving the tension a little farther down the arm. This is a pretty simple yet effective concept. This allows the tendons to relax a little bit and hopefully calm down the amount of irritation.
These are not replacements for making an appointment at Total Performance Physical Therapy. The symptoms may go away but they will come back, more than likely worse the next time, if the problem at hand is not resolved. If the muscular imbalances are not corrected and the muscles are not retrained, the process of continued tearing and production of scar tissue will persist which will cause greater difficulty throughout the healing process in both effort and length of treatment.