Tennis Elbow

What is it?

Tennis elbow (also called lateral epicondylitis) is an overuse injury of the wrist/elbow muscles that attach near the outside of the elbow. The group of muscles that attach here are called the “extensors” as many of them function to extend the wrist. Specifically, it is the tendon portion of the muscles that are affected by tennis elbow; tendons being cord-like structures that connect muscles to bone. The most common tendon affected in tennis elbow is from the extensor carpi radialis brevis muscle, however others may also be involved. While it can occur in Tennis players, any repetitive task using the elbow and wrist can cause this injury whether that be competitive sports or desk work!

What does it feel like?

• Pain on the outer side of the elbow (and down into forearm) 
• Worsened pain with gripping, twisting, and extending the wrist
• Reduced ability to grip objects with your hand without pain
• Possible elbow pain at night 

What causes it?

• A change in elbow load (e.g., a new sport, increased intensity of sport, or a new repetitive task at work)
• The new repetitive motion causes minor damage to the tendon (called microtrauma), and the body struggles to heal the tendon properly as the repetitive task continues. 

What prevents/reduces the likelihood of it?

• Ensuring adequate warm-ups (with dynamic movements) before sports or activities with repetitive elbow or wrist motions. 
• Building strength and flexibility in elbow and forearm muscles
• Ensuring proper grip and form when using equipment that requires a repetitive forearm movement (e.g., tennis racket or computer mouse). 

What can be done to treat it?

• Ice application in 15-minute bouts and rest for the first 48-72 hours, after 72 hours switch to heat use
• Once the initial soreness is relieved:
• Stretching the forearm muscles to increase flexibility and tolerance to stretch
• Exercises to strengthen the forearm muscles first with minimal movement, then with more movement and resistance as tendon strength improves (a physiotherapist can help find the right exercises for you)
• Manual therapy to increase movement in the elbow joint
• Soft tissue massage over the affected muscles
• Shock-wave therapy over the forearm
• Wearing a brace below the elbow joint (around the forearm) to help control forces during repetitive tasks