Tennis Elbow: What it really is and how to treat it



What Is Tennis Elbow?

Tennis elbow or Lateral Epicondylitis is one of the most common work-related musculoskeletal injury. It is most often seen in individuals 35-55 years of age, with presentation in their dominant arm, but can sometimes present in both arms. Tennis elbow is an overuse injury involving the wrist extensor muscles, specifically extensor carpi radialis brevis. The extensor muscles of the forearm are important in extending our wrist and straightening our fingers. Extensor carpi radialis brevis is responsible for extending the wrist with your palm facing down.


Tennis Elbow Symptoms

Tennis elbow will present with point tenderness pain or burning sensation on the outside of the elbow. It can sometimes radiate upwards toward the shoulder or down towards the wrist. The pain most commonly occurs with sustained grip (i.e. gripping a tool, coffee cup, racquet) especially with the elbow extended. Tennis elbow pain can also be experienced with wrist rotation (turning a door handle) or straightening the wrist and/or fingers. Those who experience tennis elbow often have a weak grip and tend to find they drop objects due to the pain felt on the outside part of the elbow.

Tennis elbow is often caused by forceful grip, repetitive activities, or poor posture. This can be seen in professions such as assembly line workers and laborers. Tennis elbow is also seen with tendon overload which can occur when a specific object or position is held over a length of time, causing prolonged contraction of the muscle. With the muscle being placed under tension small micro tears occur to the tendon leading to degeneration of the extensor muscle. This is commonly seen in rock climbers and individuals who play racquet sports such as tennis, squash and pickleball.


Tennis Elbow Treatment

Conservative treatment by one of our therapists is key to managing the symptoms of tennis elbow. Treatment options might include dry needling, soft tissue mobilization, ultrasound, activity modification, strapping, k- tape, stretching and strengthening. Depending on the type of activities, strengthening the core and shoulder can prevent further stress at the elbow which often leads to tennis elbow flare. Tennis elbow is best treated very early, as degeneration of the muscle can lead to a chronically painful elbow.


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References

  • Fedorczyk, J.M. (2006). Tennis Elbow: Blending Basic Science with Clinical Practice. Journal of Hand Therapy, 19(2), 145-153.

  • Fedorczyk, J.M, Day, J.M, Lucado, A.M, Vincent, J. (2021). Therapy Management of Lateral Elbow Tendinopathy. Rehabilitation of the Hand and Upper extremity (7th edition, Volume 1, pages 518-531). Philadelphia: Elsevier, Inc.

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