Tennis Elbow
Tennis Elbow, also known as the lateral epicondylitis, is a painful condition of the elbow joint that occurs when the tendons connecting the forearm muscles and bones are weakened. These tendons are weakened due to overload or repetitive movements of the wrist and elbow.
The pain may occur due to inflammation of the tendons on the outside (lateral side) of the elbow. It may also cause the pain to radiate over the back of the forearm. Despite its name, 95% of tennis elbow occurs in non-tennis players.
The tendon is the fibrous connective tissue band that connects the muscle to the bones. The forearm tendon connecting the forearm muscles to bones undergoes microtears and fibrosis due to overuse, which causes pain. One of the muscles which are commonly damaged in tennis elbow is- Extensor Carpi Radialis Brevis (ECRB). The ECRB helps in extension (raising) of the wrist.
Causes of Tennis Elbow
The repetitive activities involving the use of forearm muscles can cause tennis elbow. Some of the activities include:
- Racquet sports
- Gardening
- Cutting tough meat and food
- Continuous swimming
- Golfing
- Using tools that require fine motor skills
- Frequent use of computer, screwdrivers, and other tools
- Plumbing
- Using a paintbrush or roller while painting or decorating
Symptoms of Tennis Elbow
You may experience the following symptoms:
- Pain- The microtears in forearm tendons cause immense pain in the outer bump (lateral epicondyle) of the elbow. Initially, the pain may be less, but with time it gets worse if not treated.
- Weak grip- Holding a cup or a glass becomes difficult.
- Difficulty in opening the door.
- Pain radiating from elbow to the back of the forearm and wrist.
- Writing, lifting objects, and using small objects is painful.
- Shaking hands or squeezing objects is difficult and painful.
Diagnosis of Tennis Elbow
You may need to visit your doctor to let him/her examine your elbow. Your doctor may perform certain manual tests and palpate your elbow to determine the severity of the condition.
Manual examination:
- Palpation- The doctor will palpate your elbow to determine the rate of pain.
- Movement- The doctor might ask you to move your elbow in different ranges to determine your pain during each movement.
- Special tests- The doctor might also perform some manual special tests like Mill’s test to confirm.
You can also perform a simple test at home to know if you have tennis elbow.
Chair-lift Test
- Stand behind a chair.
- Place your hands on the back of the chair over the top.
- Your palms should face downward and elbows should b straight.
- Now try to lift the chair.
- If this action generates the same pain on the outside of the elbow, then it is an indicator of a tennis elbow.
Imaging tests:
The doctor might ask you to perform any of the following imaging tests to rule out any severe conditions like arthritis or fracture.
- X-rays
- MRI (Magnetic Resonance Imaging)
Treatment of Tennis Elbow
- Rest- Your doctor might ask you to stop doing activities that cause overuse of the elbow. You might also have to stop playing sports for a while. Resting the elbow to reduce pain is helpful.
- Splint or brace- A splint or brace may be recommended to avoid further damage to the tendons.
- Ice- Icing over the elbow for 10-15 minutes can help in reducing the inflammation. The cold therapy works wonders in reducing the pain.
- Massage- Trans-friction massage over the forearm can help in soothing the pain. Your physiotherapist can do this for you then they may teach you self-massage techniques.
- Ultrasound- The ultrasound has a probe that is placed over the elbow and it emits ultrasonic waves. These waves can increase blood flow and promote healing.
- Pain medication- The doctor might give you some painkillers to reduce the pain like Non-Steroidal Anti-inflammatory Drugs(NSAIDs) or ibuprofen.
- Steroid injections- In severe cases where the pain is unbearable, the doctor might suggest you take a steroid injection. The corticosteroid is directly injected into the affected muscle which can help in reducing the inflammation.
- Long-term treatment- The physical therapist might start with a certain range of motion and strengthening exercises to increase the strength. A combination of stretching and strengthening exercises will be recommended as a home program for long-term treatment.
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