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Ask the Expert: What is Tennis Elbow?

August 15, 2016 in Articles
Posted by John Fainsan
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By now you're probably well absorbed in the latest happenings of the Summer Olympics. Did you catch Jack Sock and Bethanie Mattek-Sands taking gold in Mixed Doubles?! Tennis has a rich history in the Olympics and is an extremely popular sport around the world. One common injury cited among tennis players is tennis elbow, or lateral epicondylitis. Tennis elbow is pain on the 'outside' of the elbow that can be felt when pressure is placed on the arm, or when a person resists wrist extension {i.e. squeezing, hand shaking, lift, etc.}.

How it happens:

Tennis elbow occurs when the muscles in the arm, forearm, and wrist are overused. The compounding result of the overuse is elbow pain and complaints of decreasing grip-strength {i.e. trouble opening a jar}. Repetitive wrist extension and gripping, a movement common in tennis - hence the name, can cause overloading and overuse of the tendons associated with wrist extension. This can lead to degeneration or failed healing of the extensor tendons. These tendons attach to the outside of the elbow, where the pain is felt.

Who does this affect?
  • Lateral epicondylitis most commonly affects people between the ages of 30 and 60 (1-3% of the general population).
  • Lateral epicondylitis most commonly affects a person’s dominant hand.
  • It affects men and women equally regardless of socioeconomic class.

Although 40-50% of tennis players are diagnosed with tennis elbow, tennis players only account for about 5% of all people affected by lateral epicondylitis.  15% of people who work in industries that require repetitive hand use suffer from lateral epicondylitis.  This condition can vary from a mild irritation to debilitating in which people cannot perform activities of daily living or work tasks.

Things to try on your own:
  1. Resting and activity modification. Try to rest the injured arm or modify tasks. Proper ergonomics in the office or at home can help to minimize irritation to the extensor tendons.
  2. Use ice or a cold pack for 15 minutes over the outside of the elbow after increased activity or at the end of the day.
  3. Use an over-the-counter tennis elbow brace to help decrease the load placed on the extensor tendons during activities. {Virginia Therapy & Fitness Center has this product available for purchase}
  4. Do basic wrist stretches to maintain wrist extensor muscle and tendon mobility.

If your symptoms do not resolve, you should seek treatment from a physical therapist. Your problem may stem from an irritated nerve in the neck. Your elbow pain may also be compensation for a dysfunctional shoulder or wrist. A dysfunctional neck is often implicated when a person has pain in both elbows. Physical therapy can help by using modalities and manual therapy to decrease the inflammation to the tendon and improve healing. It also helps in identifying and correcting dysfunctional movements that could be the underlying cause of the elbow pain. Physical therapy provides guided exercises to improve the flexibility and strength of the wrist extensors and prevent recurrence of the problem.