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Tennis Elbow or Lateral Epicondylitis
Background Information
- Affects 1-3% of our population.
- Risk Factors include:
- Smoking
- Obesity
- 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
Tennis Elbow 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.
Interesting facts
- Tennis elbow is not always caused by playing tennis.
- Any activity, which involves repetitive use of the muscles on the top of the forearm, can result in tennis elbow symptoms.
- The term tendonitis has now been replaced with tendonosis as there are no inflammatory cells present.
Nerve root irritation in the neck can often contribute to the pain presentation in the forearm.
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