Nose Creek Physical Therapy Information on Tennis Elbow
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No discussion of the elbow region would be complete without some mention of the condition 'tennis elbow'. The condition has been recognized for over a century. It was first distinguished as 'writer's cramp' by Runge in 1873. Later Morris named it 'lawn tennis arm'. Over the last century research has implicated numerous anatomical structures as the major problem in tennis elbow. Even today some of the details of the condition are still controversial. However, with 20 million tennis players in North America and the numbers growing, physiotherapists know from experience that at least half of these people will suffer from elbow problems. This is particularly true for those over the age of 35. While this alone represents a significant number, we can add at least as many sufferers from outside of the tennis community.
Physiotherapists frequently see Tennis elbow in individuals carrying out forceful forearm rotation motions, heavy lifting, and repetitive hammering. Therefore tennis elbow is definitely not limited to tennis and other racquet sports.
Nose Creek Physical Therapist Definition of Tennis Elbow:
Tennis elbow (also Lateral Epicondylitis) is a condition affecting the origin of the tendon of the muscles that extend/straighten the wrist. There is local tenderness on the outside of the elbow at the Common Extensor Tendon Origin (where the tendon attaches to the bone). Also present is an aching and pain in the back of the forearm. The condition is aggravated with:
Physical Therapist Defined Stage 1 of Tennis Elbow:
- Immediate swelling.
- Pain during activity.
- Minor aching, usually after activity.
Physical Therapist Defined Stage 2 of Tennis Elbow:
- Constant swelling and scar development initiated pain during activity and at rest.
Physical Therapist Defined Stage 3 of Tennis Elbow:
- Extensive scar tissue present.
- Small tears in the tendon, sometimes leading to a large tear of the tendon.
- Pain at rest, sometimes night pain.
- Pain reproduced with numerous activities of daily living.
Tennis elbow is a preventable condition if you:
- Stretch the tight forearm muscles.
- Modify your technique at play and at work.
- Identify lateral elbow pain early and initiate the home-stretching program.
- Seek help sooner rather than later.
Early Identification
If tennis elbow is treated in the early stages, the tendonitis will respond well in physical therapy. Unfortunately physical therapists frequently see patients when they are in the chronic phase Ð often three months after the initial signs were noticed. When this is the case patience and perseverance throughout the physical therapy and healing process must prevail because often the recovery is a slow process.
But how can something as simple as swinging a tennis racquet injure my elbow?
Tennis elbow is an anatomical flaw in that the majority of muscles that extend the wrist, come up the forearm and attach to the same common tendon. This creates a lot of stress on the tendon and with repetitive use, it slowly breaks down. Studies show that after the age of 35 the circulation to this tendon is not as good, therefore if injured it takes longer to recover.
The two most common sites for a tear to occur are where the tendon attaches to the bone, and where the muscle attaches to the tendon.
Stretching doesn't seem like enough. What else can I do?
If you are a racquet sport enthusiast experiencing these tennis elbow symptoms, physiotherapists will recommend that you review and correct your technique with your coach or local professional. If you are a laborer, physiotherapists will recommend that you consult with a senior fellow employee about your workstation. Or, request a temporary change in the workstation if you cannot modify your technique.
Can I be sure it's tennis elbow?
If you have pain in your elbow but it doesn't quite feel like the symptoms described here, or the discomfort is causing you concern, consult your physician. There could be something other than tennis elbow causing you pain and the wrong self-diagnosis could lead to the wrong treatment and further complications. Other structures which could be involved in lateral elbow pain are:
- Joint cartilage on the end of the radius bone in elbow.
- Bursas - sacs of fluid between the tendon and the bone which swells up from overuse.
- Capsular lining around the joint, which gets pinched in the radiohumeral joint where the rotation takes place in the forearm.
- Annular and Radial collateral ligaments.
- Posterior branch of the Radial nerve, that passes by the ECRB muscle and tendon.
Note: Another way to reduce tension generated at the CETO is the application of a tennis elbow strap. The strap limits the expansion of the forearm muscles when you contract and therefore limits the amount of tension that can be generated at the CETO. Your physical therapist or doctor should prescribe the application of this strap.
