Tennis Elbow

Tennis elbow (Lateral Epicondilitis) is a repetitive strain injury that is the most common complaint presented for elbow pain.

Cause

• Repetitive contraction of the muscles running on the top of the arm that insert into the outside of the elbow. Commonly bringing the wrist backwards and rotating it outwards (this action is common in tennis players, repetitive gripping of hand tools, picking up buckets/shopping bags, gardening etc.).
• Repetitive strain leads to micro tears in the tendon close to where it inserts into the bone which leads to acute inflammation and pain.
• Tennis elbow can also be be caused by poor posture/biomechanics of the whole arm, shoulder and neck.

Symptoms

• Pain is often moderate to severe commonly comes on gradually and is felt on the outside of the arm (can radiate down the arm).
• Pain is often worse with elbow use and can be irritated with simple activities like picking up a coffee cup.
• Some people experience pain at night (especially early on).
• You may become weak in certain movements (e.g. such as gripping)

Treatment

This condition commonly benefits from early management and manual therapy.

Your chiropractor will take a full past medical history and physical examination to create a therapy and management plan for the tennis elbow (not all causes are the same so they require different approaches). Generally the initial aim of the chiropractor will be to settle the inflammation and pain. This will involve direct and indirect techniques to the elbow area to assist with reduction in muscular tension that may be as a result of the tennis elbow. A deep tissue friction technique may be applied.

Your chiropractor will also look globally at the rest of the arm, shoulder, neck, back and rest of body to ensure that the related areas are functioning well to enhance recovery and restore normal function.

You will be prescribed self help stretching and strengthening exercises as pain subsides and function is restored (this may be implemented immediately if indicated).

Management

• Ice in the initial 24-48hrs.
• A short course of anti-inflammatory and pain reliever medication may assist (as prescribed by your doctor or pharmacist)
• Stretching and strengthening exercises are slowly introduced as pain reduces and function returns.
• Your chiropractor will aim to identify factors that may have caused the tennis elbow and will provide you advice on areas such as posture/biomechanics and lifestyle/work ergonomics.
• In some cases a wrist splint may be prescribed if indicated.
• Imaging studies are usually not necessary for tennis elbow but can be visualised with a MRI.
• False Insertion Brace: this brace is a strap that wraps around the upper arm and acts like a false insertion for the muscles which effectively takes the pressure off the inflamed tendons. These braces should only be used over a short course and alongside treatment and rehabilitation.
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