Tennis Elbow

Tennis elbow is a painful condition over the lateral (outer) part of elbow due to inflammation of tendons of the forearm and hand muscles. Tennis elbow can occur in anyone who overuses the forearm and not just restricted to tennis players. Likewise, a painful inflammatory condition of the medial (inner) condyle of elbow is called Golfer’s elbow.

Causes

Certain repetitive movements of the wrist can strain the forearm and wrist muscles resulting in swelling and inflammation of  the tendons (origin of muscles) at the elbow joint. Tennis elbow occurs in people who are engaged in activities that demand excessive and frequent gripping, squeezing and screwing.

It is commonly seen in plumbers, lumber workers, and tennis players. In a game of tennis, certain strokes and actions that lead to tennis elbow (lateral condylitis) are one- handed backhand stroke, late forehand swing and full power serving.

Symptoms

The symptoms of tennis elbow develop gradually. There is usually no specific injury associated with the start of symptoms. Common signs and symptoms of tennis elbow are:

• Pain over the outer side of elbow. Pain may extend to the muscle bulk of forearm.
• Weak and painful grip.
• Certain activities like holding a coffee cup, turning a door knob, wringing clothes, etc. become difficult.

Diagnosis

• Physical examination – Generally, medical history and physical exam provide enough clues to diagnose tennis elbow. There is a tenderness on applying pressure on lateral condyle. Manual tests like Mills and Cozens test are done by the physiotherapist to confirm the tennis elbow.
• X rays – This is done to rule out arthritis of elbow joint.
• Magnetic Resonance Imaging (MRI) – If the doctor feels that the symptoms are related to the cervical spine, then they may suggest an MRI of the cervical spine to rule out a herniated intervertebral cervical disc.
• Electromyography (EMG) – Doctor may order an EMG to rule out nerve compression. Many nerves pass around the elbow joint and symptoms of nerve compression are similar to tennis elbow.

Treatment

• Rest- Avoid all activities that put forearm muscles under stress and strain. A supportive elbow brace is prescribed to control swelling and protect the forearm muscles.
• Non-steroidal anti-inflammatory medicines like ibuprofen and aspirin are prescribed to relive pain and swelling. These drugs are generally taken when required depending on symptoms.
• Physiotherapy – Physiotherapy has a vital role in treating tennis elbow. Ice, massage and ultra sound helps in healing the injured tendons. Once pain subsides, stretching and strengthening exercises are started to prevent recurrence.
• Steroid injections – Injections of steroid like cortisol is given locally over the elbow to relieve the symptoms.
• Surgery- If none of the above conservative and non- surgical methods are effective in terminating the symptoms, surgery is recommended. Surgery involves removing the damaged tendons/muscles and reattaching the healthier ones back to bone.

If you are suffering from tennis elbow or have any questions regarding this condition please don’t hesitate to contact one of the health professionals at P&C Rehabilitation Services. The physiotherapist and chiropractor are well trained in treating this condition. Call today to book your free consultation.