What is Tennis Elbow?

Tennis Elbow or Lateral Epicondylitis is an extremely common injury that originally got its name as it appeared in a high proportion of tennis players. Nevertheless it commonly manifests in a vast proportion of people who do not play tennis at all. Tennis elbow occurs most commonly in the tendon of the extensor carpi brevis muscle at approximately 2cm below the outer edge of the elbow joint or lateral epicondyle of the humerus bone.

Specific inflammation is rarely present in the tendon but there is an increase in pain receptors in the area making the region extremely tender.

Symptoms of Tennis Elbow / Lateral Epicondylitis

• Pain about 1-2 cm down from bony area at the outside of the elbow (lateral epicondyle)
• Weakness in the wrist with difficulty doing simple tasks such as opening a door handle or shaking hands with someone.
• Pain on the outside of the elbow when the hand is bent back (extended) at the wrist against resistance.
• Pain on the outside of the elbow when trying to straighten the fingers against resistance.
• Pain when pressing (palpating) just below the lateral epicondyle on the outside of the elbow.

Causes of Tennis Elbow

Tennis Elbow is often caused by overuse or repetitive strain caused by repeated extension (bending back) of the wrist against resistance. This may be from activities such as tennis, badminton or squash but equally from activities such as bricklaying, excessive use of a screwdriver and computer typing.

Sudden Onset of tennis elbow occurs in a single instance of exertion such as a late back hand where the extensors of the wrist become strained. This is thought to correspond to micro-tearing of the tendon.

Late Onset normally takes place within 24-72 hours after an intensive term of unaccustomed wrist extension.

Prevention / Treatment of Tennis Elbow

The following guidelines are for information purposes only. Seeking professional advice before beginning rehabilitation is recommended.

Tennis Elbow / Lateral Epicondylitis may heal quickly within two weeks but it could last for up to two years. When the symptoms have settled down it is essential that full rehabilitation and strengthening of the elbow takes place. Use the following guidelines as prevention.

• Correct technique - play the backhand with the whole body not just the wrist!
• Use a light racket if you do not play very often.
• Make sure your strings are not too tight.
• Be aware of too much strain on the elbow for example when performing Data Entry for extended periods of time.
• Apply ice after use to reduce any inflammation early.

The therapist at Advanced Alternatives Massage Therapy are skilled at providing effective Neuromuscular Therapy (NMT) for this syndrome.

Doctors Janet Travell and David Simons are widely acclaimed for their medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual. Extensive research by Travell and Simons has shown that myofascial trigger points (tiny contraction knots) in overworked or traumatized forearm muscles, are the primary cause of pain in the elbow.

Tennis Elbow / Lateral Epicondylitis is effectively helped with massage therapy. Even in conditions where the problem has become chronic, massage may be one of the best approaches.

Sources:

1. Lateral Epicondylitis copyright Peter Gardner
2. Massage Magazine article by Whitney Lowe