What is tennis elbow?

What is tennis elbow or lateral epicondylitis?

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Tennis elbow, medically known as lateral epicondylitis, is a common condition that affects the tendons in the outer part of the elbow. Despite its name, it is not limited to tennis players and can occur in anyone who engages in repetitive wrist, hand and forearm motions  Activities requiring firm wrist stability such as; backhand stroke in tennis, or repetitive work tasks that require repeated wrist extension, such as computer keyboarding or pulling weeds in the garden, can stress the forearm muscles and cause symptoms. The condition is characterized by pain and tenderness around the bony bump on the outer side of the elbow (lateral epicondyle). 

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Treatment for tennis elbow usually involves a combination of rest, icing the affected area, and over-the-counter pain medications to reduce inflammation and manage pain. Physical therapy exercises are often prescribed to strengthen the forearm muscles and improve flexibility. In more severe cases, a doctor may recommend corticosteroid injections to reduce inflammation. Rarely, if conservative measures fail, surgery might be considered.

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Common symptoms of tennis elbow

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The symptoms of tennis elbow may include:

1. Pain  and tenderness on the outer part of the elbow that increases after excessive activity of the wrist and hand or when the involved muscles are stretched.
2. Decreased strength and endurance of the muscles surrounding the outer part of the elbow. 
3. Decreased grip strength, limited by pain.

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To diagnose tennis elbow, a healthcare professional will typically perform a physical examination and may order imaging tests such as X-rays or MRI to rule out other possible causes of the pain.

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What causes tennis elbow?

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The most common cause of tennis elbow or lateral epicondylitis is excessive repetitive use or eccentric (lengthening) strain of the wrist or forearm muscles which are attached to the lateral epicondyle (bony bump on the outer side of the elbow). The result is microdamage and partial tears on the affected area, when the strain exceeds the strength of the tissues and when the demand exceeds the repair process. This can result from activities such as playing tennis (hence the name),  and any other activities that involve repetitive wrist, hand and forearm movements.

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Preventive measures include using proper techniques and equipment during activities, taking breaks to avoid overuse, and performing stretching and strengthening exercises to keep the forearm muscles in good condition. If you suspect you have tennis elbow or experience persistent elbow pain, it's essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.

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How can physical therapy help? 

Physical therapy can be highly beneficial in the treatment of tennis elbow (lateral epicondylitis) by addressing the underlying causes of the condition and helping to reduce pain, inflammation, and improve the overall function of the affected arm. A physical therapist will tailor the treatment plan based on the individual's specific needs and symptoms. Here are some ways physical therapy can help with tennis elbow:

1. Immobilization: The physical therapists may require the patients to rest the muscles affected by immobilizing the wrist in a splint and will instruct them to avoid all activities that may aggravate the symptoms.
2. Pain and Inflammation Management: Physical therapists may use various techniques and modalities such as ice or cold packs, ultrasound, or electrical stimulation to reduce pain and inflammation in the affected area.
3. Manual Therapy: Hands-on techniques, like cross-fiber massage and manual manipulation, can help improve blood flow, reduce muscle tension, and promote healing in the affected tendons.
4. Strengthening  Exercises: Specific exercises are prescribed to strengthen the forearm muscles and tendons gradually such as dynamic exercise with the use of resistance band or free weights, and eccentric (lengthening) resistance training. Initially, low intensity resistance is prescribed to the patient and will progress to more intense resistance to strengthen and improve the endurance and overall performance of the affected muscles.
5. Stretching: Gentle stretching exercises are employed to increase flexibility in the forearm muscles and improve the range of motion in the elbow joint.
6. Activity and Ergonomic Modification: Physical therapists can guide patients in modifying their daily activities or sports techniques and teach proper ergonomics before they return to repetitive or stressful activity to avoid excessive stress on the affected tendons and prevent recurrence of tennis elbow.
7. Functional Training: As flexibility and strength improve, and the pain is under control, physical therapists will incorporate functional training that utilize functional patterns into the exercise to help individuals return to their regular activities with proper techniques and reduced risk of reinjury.
8. Patient Education: Physical therapists provide education which includes advice and techniques on prevention, recognition of provoking factors and identification of symptoms. They also teach the patients how to reduce overload forces that caused the problem. 
9. Home Exercise Program: To facilitate the recovery process, physical therapists often prescribe a home exercise program tailored to the individual's needs, which includes a combination of self-stretching and strengthening exercises.

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Physical therapy for tennis elbow is typically a conservative approach and can yield excellent results when followed diligently. It is crucial to work closely with a qualified physical therapist to ensure proper assessment, personalized treatment, and guidance throughout the rehabilitation process.

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