Tennis Elbow or Lateral Epicondylitis
- Affects 1-3% of our population.
- Risk Factors include:
- Aged between 45 and 54
- Repetitive movements for at least 2 hours daily
- Managing physical loads over 20 kg
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
- 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.
- 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.