Tennis Elbow can Serve up Real Pain

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Tennis elbow is defined as a type of tendinitis i.e. swelling of the tendons – that causes pain in the elbow and the arm. These tendons are bands made of tough tissue that connect the muscles of the lower arm to the bone. It is also known as Lateral Epicondylitis.

Despite its name, one can still get a tennis elbow even if they have never been near a tennis court. 

Any repetitive gripping activities, especially if someone uses the first two fingers & the thumb, may contribute to the tennis elbow.

It can pop up in people of any age, but it’s most common at about age 40 years.

Causes

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Tennis elbow generally develops over time. Repetitive motions- gripping a racket, or cricket bat during a swing can strain on the muscles, may put stress on the tendons. 

These constant tugging can eventually cause microscopic tears in the tissue.

Tennis elbow might result from the following sports:

 

- Tennis

- Racquetball

- Squash

- Fencing

- Weight lifting

Tennis Elbow can also affect people that have jobs or hobbies which require repetitive arm movements or gripping such as:

- Carpentry

- Typing

- Painting

- Raking

- Knitting

- Racquetball

- Squash

- Fencing

- Weight lifting etc.

Symptoms

The symptoms of lateral epicondylitis include- pain and tenderness in the bony knob, on the outside of the elbow. This knob is present where the injured tendons connect to the bone. 

The pain may also radiate into the upper or the lower arm. Although the damage is in the elbow, someone is likely to feel pain while doing things with his/her hands.

Tennis elbow may cause the most pain when we:

- Lift something

- Make a fist or grip an object, such as a cricket bat, tennis racket. 

- Open a door or shake hands

- Raise hands or straighten the wrist.

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The tennis elbow is quite similar to another condition called the Golfer’s elbow, which affects the tendons on the inside of the elbow.

To diagnose the tennis elbow, the doctor/therapist will do a thorough examination. They will flex the patient's arm, wrist, and elbow to see where it hurts. Other techniques include imaging tests, such as an X-ray or MRI (magnetic resonance imaging) to diagnose tennis elbow or rule out other problems.

Role of Physiotherapy

Tennis elbow can be treat by physiotherapy by following procedures-

* At 6 weeks:

- better than ‘watch and wait’

- worse than a steroid injection.

* Long term:

- better than steroid injection

- same as ‘watch and wait’

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Brace/Elbow Clasp:

* Between 12 and 24 weeks:-

- Pain reduction

- Improved functionality

- Improved pain-free grip strength

  

 * No better at 12 months.

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• Ultrasound

- Limited low-quality evidence

- Used as an adjunct; not independently

• Pulsed ultrasound to break up the scar tissue, promote healing, and increase blood flow in that area.

Manual Techniques

• Deep Transverse Friction Massage:- Have No benefit when combined with concurrent physiotherapy modalities when compared to control group

• Manipulation of the Wrist:- Scaphoid Thrust Manipulation

• Cervicothoracic Spine Manipulation:- 

- Non-thrust manipulation and traction of the cervical spine

- Lateral Cervical Glide Technique.

Steroid injection

• Good short-term relief for 6 weeks

• Poorer outcome in the longer term than

- watch and wait

- physio

* Tennis elbow can also be treated by Surgery.

* Stretch and warm up before any sport or activity that will exercise the elbow or arm.

* Ice your elbow after exercise.

Written by:

- Ms. Anjali Choudhary (Batch- 2017)

References:

https://www.webmd.com/fitness-exercise/tennis-elbow-lateral-epicondylitis