All You Need to Know About Tennis Elbow (Lateral Epicondylitis)

by Mathilde Valade, Osteopathy Practitioner at?THE CLINIC by Medcare ?in DIFC

Let's be clear from the start - tennis elbow (lateral epicondylitis) has very little to do with tennis or racquet sports. That subtle ache on the outside of your elbow that gets worse when you lift or carry things can affect anyone who makes repetitive arm movements. The most up-to-date medical term for this elbow pain is "lateral elbow tendinopathy" which, in layman's terms, means "an issue with the tendons on the outside of the elbow". Today, I will be telling you all you need to know about this uncomfortable condition, including how to prevent it and treat it at home.

Overview of Tennis Elbow

Tendons connect the muscles to the bones. Like most other tendon issues that begin without any trauma that you can remember, lateral elbow tendinopathy or lateral epicondylitis is usually caused by a greater load being placed on the tendon than it can consistently cope with. This load increase may have been caused by a vast range of things from doing DIY around your house, chopping wood for a campfire, or beginning a new gym contract. Tennis elbow, also called?lateral epicondylitis,?is brought about by repetitive motion and overuse of the muscles near the elbow. The tendons become overloaded and inflamed when the extensor muscles are repetitively used. Sometimes microtears develop in the tendon which can be extremely painful.

How Common is Tennis Elbow?

The condition is quite common, affecting about 1 to 3% of the population (4 to 7 cases per 1000) every year. It affects women and men equally. Despite its name, both athletes and non-athletes are likely to develop tennis elbow.

Who is at Risk of Developing Tennis Elbow?

Tennis elbow mainly occurs in people 30 years of age or older, though the risk increases after age 40. Plumbers, painters, tennis players, golfers, butchers, and other people whose jobs require frequent movement of their forearms are very susceptible to developing tennis elbow.

Symptoms of Tennis Elbow

Tennis elbow is a painful condition sometimes eventually leading to tennis elbow surgery. Many sufferers describe the pain as located mainly where the tendons of the forearm muscles attach to the bony lump on the outside of the elbow. However, the pain can also radiate to the forearm and wrist. The ache can range from mild discomfort to excruciating pain.

Other symptoms of tennis elbow include:

• Burning sensation or pain on the outside of the elbow joint often worsening at night
• Pain when gripping small objects
• Pain when twisting the forearm such as when opening a jar
• Pain in the forearm muscles and the back of the hand
• Some people experience stiffness in the elbow joint
• Inflammation of the joint

What Causes Tennis Elbow?

Many activities precipitate tennis elbow in people. It is primarily caused by tears in the tendon due to overusing the forearm in strenuous or repetitive activities or through a direct blow to the elbow.

Other causes of tennis elbow are:

• Not warming up before performing strenuous activities
• Improper use of sports equipment such as incorrect weight lifting
• Recent use of certain medications (fluoroquinolone antibiotics)
• Repetitive arm movements such as using plumbing tools, painting, driving screws, cutting up cooking ingredients, using a computer mouse, swinging a tennis or squash racquet, and weightlifting
• Poor athletic technique while playing tennis, paddling, fencing and other racquet sports like racquetball, and squash

How is Tennis Elbow Diagnosed?

If you feel constant niggling lateral elbow pain, you would do well to pay a visit to your family doctor or osteopathy practitioner. It can often be diagnosed by taking a history and doing a physical exam. Your doctor may order a scan but this is not usually necessary.

How Do I Prevent Tennis Elbow?

It is challenging to prevent the development of tennis elbow when one’s job requires more use of the forearm than the rest of the body. However, once you have become aware of how common it is to develop tennis elbow, there are certain routines you can incorporate into your life to limit its occurrence.

These routines include:

• Performing adequate warm-ups before starting exercises and other strenuous activities:?by doing this, you loosen and prepare your muscles and tendons, making them more pliable and less prone to tear.
• Using light weights with a bigger grip size at the gym:?this helps limit strain on your muscles and tendons.
• Performing progressive strengthening exercises:?these will build and condition the arm muscles
• Limiting the use of your elbow?as often as you can afford
• Osteopathy including muscle stimulating techniques?can help especially for competitive athletes

Treatment of Tennis Elbow

In most cases (about 90% of the time), tennis elbow resolves on its own within a year without having to resort to calling in the orthopedic surgeons. Different kinds of surgical and nonsurgical treatments are available for tennis elbow, and I will discuss them in the following few paragraphs:

1. Home Remedy

Home remedies for tennis elbow are as follows:

1. As it is an overuse injury, resting and avoiding the activities that caused the condition in the first place help get tennis elbow treated quickly.
2. Over-the-counter analgesics like ibuprofen and non-steroidal anti-inflammatory drugs can reduce elbow and arm pain.
3. Application of cold compresses 3 to 4 times daily.

2. Physical Therapy

If home remedies prove to be ineffective, then other nonsurgical treatment methods such as physical therapy are recommended. With this method, the individual is first evaluated by a physical therapist, after which a physical therapy plan is created for the patient. This plan usually includes exercises to help build the muscles and recommends an elbow strap to be worn while the elbow is in use to prevent more stress.

3. TENEX Procedure

This process is also known as?ultrasonic tenotomy, and it involves piercing the damaged parts of a tendon with a needle to promote the body’s healing response. Ultrasonic sound waves vibrate the needle, which immediately liquefies the injured tissue allowing it to be suctioned out.

4. Surgery

If the tennis elbow doesn’t improve after a year of trying the non-surgical methods of treatment, physical therapists or your family doctor may suggest surgery to remove the damaged tissue.

5. Osteopathy for Tennis Elbow

Osteopathy is a form of therapy that utilizes massage for the treatment of this condition. It is used as a preventive measure for tennis elbow to keep the body in optimum condition and reduce the risk of injury. It is used to resolve previous neck, shoulder, or wrist problems, which make a person more susceptible to developing tennis elbow.

Massages and manipulation techniques help ease symptoms and find their cause, thereby preventing tennis elbow from getting worse (or from occurring in the first place).

Osteopathy restores structural balance, ease of movement, and joint mobility using structural and functional techniques as a treatment method. Osteopathy encourages the range of motion in the joints, which in turn reduces pain and stiffness in the muscles and joints because it increases blood flow to the affected area. While the pain will not disappear with only one osteopathic session, regular sessions alongside rest and physiotherapy sessions aid the healing of the tennis elbow.

Final Thoughts

Developing tennis elbow does not mean you will be unable to engage in physical activities you love or need to perform. With the help of experienced medical professionals and your dedication to getting better, you will likely be able to go back to that activity in a matter of months. Always ensure you follow precautions, strive to prevent developing tennis elbow as much as you can, and you will not need to be afraid of this condition.