Tennis Elbow – It’s not always tennis that causes the problem!

Tennis Elbow is a common condition that can in some cases lead to other conditions and extended pain in the arm, shoulder and neck. People who experience tennis elbow often report a “putting up with it” phase and then an “Oh I really think I should get some help now” phase. As with many painful conditions, the sooner you act the higher the likelihood of a faster and successful recovery.

What is tennis elbow?
Tennis elbow is a condition that affects the tendons (connections between muscle and bone) on the outer aspect of the elbow. The tendons themselves can become inflamed (swollen), and in some cases, micro tears within the tendon can occur.

Tennis elbow can also be referred to by a doctor on a referral letter as Lateral Epicondylitis.



What causes tennis elbow / lateral epicondylitis?
Although the name suggests, it is not always tennis that causes tennis elbow!

The cause of tennis elbow is always multifactorial and is influenced by:
– Capacity (strength) – your ability to perform a certain task.
– Biomechanics (the way you move) – how you moved to complete the task.
– Load (the amount of challenge required) – was the task an easy or a tough challenge for you?

If the tendons in the forearm, and the surrounding aspect of muscle and where the tendon attaches into the bone cannot tolerate the “load” an injury is likely to occur.

For this reason, tennis elbow is often referred to as an “overuse injury” as the area has been injured by a certain “load” / task that is above the capability of the body’s “biomechanics” and “capacity”.

What are the symptoms of tennis elbow?
People who are experiencing tennis elbow will notice a feeling of soreness on the outside of the elbow. Tennis elbow is the kind of injury that can sneak up on you and take you by surprise as the feeling of soreness can slowly increase over time and once the injury is established, the pain will remain ongoing.

People who have tennis elbow will experience pain on the outside of the elbow. It is characterised by weak grip strength, trouble holding things or performing occupational tasks. As the condition escalates, the pain can be bothersome even at rest or when trying to sleep.

How is tennis elbow diagnosed?
It is common for people to be diagnosed with tennis elbow after seeking a medical image such as a MRI or ultrasound from their doctor. This is often the trigger that requires the doctor to make a referral to a movement focussed therapist such as a physiotherapist for treatment.

Although this is the common pathway for diagnosis in Australia, it is helpful to know that imaging, such as MRI and ultrasound is not required to diagnose and begin treatment. A good therapist who has experience working with tennis elbow can apply a wide range of physical tests within the first consultation to diagnose, understand more about the causes of the tennis elbow and begin treatment within the first session.

When we speak to a new client who thinks they might have tennis elbow, we always encourage the person to book in with a physiotherapist and seek a physical assessment first as in many cases, further doctors appointments and cost of medical imaging can be avoided and this saves the client time, finances and gets them back to doing what they love faster.

Who gets tennis elbow?
As the name suggests, playing tennis and other hitting and racquet activities can cause tennis elbow. However, several other activities with repeated hand/ arm actions can also cause the condition. These activities include typing, knitting, using a hammer, pulling a rope and using a nozzle, for example when watering the garden.

What are the treatment options for tennis elbow?
Successful long term management of tennis elbow begins with a thorough assessment and understanding of the influencing factors that have caused the problem (see causes above).

As every case of tennis elbow has multiple influencing factors, a successful management plan will usually involve addressing multiple factors such as:

– Load/ activity management (this changes with healing)

– Fitting of sling/ brace consideration

– Strength and conditioning exercises to reduce pain and increase resilience of the tissue

People with different physical requirements and different levels of ability should always be offered an individualised treatment.

If you are experiencing tennis elbow, the most important thing to consider is what you want to be able to do again (whether it be playing sports, increasing your work activities or simply using your arms again confidently) because it’s the things that we want to do in life, that make us feel fulfilled and what can bring us joy

Helpful links
Please feel welcome to book an appointment here, or call us on (03) 52981147

Understand and learn more with the following resources:
The 3 biggest causes of neck pain
Pulled a muscle in your back? What does this mean and what to do about it?

Written by:
Ryan Michell,

Physiotherapist

Proactive Health & Movement

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