Tennis Elbow

Tennis Elbow or Lateral Epicondylitis

Background Information

What is Lateral Epicondylitis?

Your Lateral Epicondyle is a bony point on the outside of your elbow.
Your wrist extensor muscles attach at this point. These muscles enable you to lift your wrist and assist with grip.
Lateral Epicondylitis is inflammation of this area when these muscles are repetitively overused.

What can cause lateral Epicondylitis?

Repetitive or explosive demand on the muscle-tendon is the main cause of lateral epicondylitis.
Performing strenuous or exaggerated movements with a known degenerative tendon.
Repetitive motions in which the wrist frequently deviates from a neutral position (ie not held straight).
The regular handling of loads over 20 kg.
Non conditioning or weakness of the muscles/tendons to be able to perform all of the above tasks

Treatment

Initially relative rest and avoidance of all aggravating activities with guided graded return of these activities when appropriate.
Use of Taping/support brace to offload the tendon.
Physiotherapy led specific strengthening exercises.
Use of Non-steroidal anti-inflammatories or Gels if not contraindicated
Using ice wrapped in a light cloth over the painful area – 10 minutes on, 5 minutes off, 10minutes on.
Soft tissue release and friction massage of the wrist extensor muscles and tendon.
Dry needling or western medical acupuncture to aid muscle release and pain relief.
Joint mobilisation
If your symptoms persist or are significantly impeding your function/ability to work a corticosteroid injection or PRP treatment may be beneficial.
Very occasionally a surgical referral may be required if severe pain/functional restrictions continue for six months or longer despite compliance with physiotherapy.

Prognosis

Over 90 % of cases of epicondylitis can be managed non-operatively.
On average if left untreated, symptoms associated with Epicondylitis persist between 6 months and 2 years
With treatment symptoms usually improve within 6-12 weeks.
In some cases rehabilitation may take 3-6 months.
Longer rehabilitation is more likely with high physical strain at work, dominant side involvement, concurrent neck pain, duration of symptoms for greater than 3 months, and severe pain.