Going by name alone, you wouldn’t expect to see Tennis Elbow too far from centre court. But the reality is that lateral epicondylitis is currently causing thousands of painters, plumbers, carpenters and computer programmers alike plenty of pain and discomfort around the country. In fact, only 5% of tennis elbow cases are actually linked directly to tennis, most new cases are due to heavy computer use. Talk about false advertising! Maybe it should be renamed for the 21st Century – Computer Elbow. Tennis elbow is one of the most common overuse injuries seen by musculoskeletal and sports physiotherapists. With many cases leading to joint compression, nerve inflammation, increased stress on the arm and pain when gripping and lifting things … due only to not getting it treated earlier!
Tennis Elbow pain is commonly focused where the forearm meets the elbow joint on the outside of the arm (not to be confused with Golfer’s Elbow which normally affects the inside of the arm). Excessive use of wrist extensors (those muscles that work all day when you have your hand on your mouse or raised keyboard) and forearm supinators can cause small tears to develop on the elbow end of the extensor carpi radialis brevis (ECRB) muscle. When this pain first starts to occur is when your local physio should hear about it, but the reality is that many people just grin and bear the pain, only causing more problems in the long run. With these tips you will be able to help stave off tennis elbow or cut down the length and intensity of your pain considerably.
Stop and recover
If you are currently experiencing pain, holding an ice pack (please wrap it in a chux or a towel… ice burns are awkward to explain!) against your sore elbow for a few minutes several times a day can help ease it. Tendons calm down slowly. Tennis elbow can last from anywhere between weeks and years, depending on how you manage it. The simplest way to recover from tennis elbow is to cut back on the movement/s causing it. This can be hard for those of you who perform this movement every day for work. You may need to modify your movements, focusing on using other muscle groups effectively. Tennis elbow CAN (though rarely) get better without treatment. Rarely! If you are at the point where your elbow has been experiencing ongoing pain, in the long term you statistically have a longer recovery period and more chance of recurrence than someone who undergoes a physiotherapy rehabilitation program[1]. A musculoskeletal physiotherapist has expert knowledge on recovery and prevention methods.
Have a coach or physio check out your form
For the 5% who do get their tennis elbow on the court, having your coach or a local sports physiotherapist with a tennis background observe and critique your technique and movements could help reduce the strain on your tendons. Incorrect technique can unequally distribute the power in the swing of a racquet to rotate through and around your wrist; creating a movement through the wrist instead of the elbow joint or shoulder. This can increase pressure on the tendon and cause irritation and inflammation, leading to tennis elbow. A sports physio will be able to observe these movements and offer advice on how to make adjustments to minimise this strain. Another simple thing to check is the size of your grip. Those playing with a fat overgrip are at a higher likelihood of developing elbow pain!
Make ergonomic adjustments to your workspace
If you are a heavy computer user, making some adjustments to your computer workstation may be all you need to kick the dreaded “computer elbow”. Keyboards are a large contributor to these issues, with many people raising the back of the keyboard so that it slopes downwards. Doing so cocks your wrists into an extension; causing the extensor muscles of your forearm to contract, extra pressure on your wrists and fast-tracking your way to pain. A gel pad is a good defender against this problem for both the keyboard and mouse, as is a comfortable chair with an ergonomic design.
Stretching and strengthening exercises
Musculoskeletal physiotherapists recommend and will take you through a number of stretches and strengthening exercises designed to help prevent a recurrence of pain. An effective stretch involves simply extending the painful arm with your palm down, bending your wrist so your fingers point toward the floor, with the other hand pull your fingers back toward your body. You will feel the stretch along the outside of your forearm. 30 seconds on. Rinse and repeat. Strengthening the wrist with a simple home exercise known as the ‘towel twist’ is also an effective preventative measure. Hold a loosely rolled-up towel with one hand at each end, twist the towel by moving your hands in opposite directions like you’re wringing out water. Give it 10 good twists holding for a few seconds in one direction and then 10 in the other.
Your Dee Why physio will ask you a number of questions on your first visit, try to note:
- When your symptoms began
- If any motion or activity makes the pain better or worse
- Any recent direct injuries
- What medications or supplements you take
This allows us to help build a profile of the injury and lets us get stuck into creating your personalised recovery program. If any of the above sounded like you, click the buttons above to book an appointment or just give us a call!
[1] Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Nynke Smidt, Daniëlle A W M van der Windt, Willem J J Assendelft, Walter L J M Devillé, Ingeborg B C Korthals-de Bos, Lex M Bouter – “At longterm follow-up, our findings suggest that physiotherapy becomes the best option, followed by a wait-and-see policy.”
