Tennis Elbow

What is Tennis Elbow?

Tennis elbow is a tendinopathy of the wrist extensor tendons, which attach at the lateral epicondyle of the elbow.

Tendinopathies follow a continuum of three stages – ‘reactive tendinopathy’, ‘tendon disrepair’ and ‘degenerative tendinopathy’. The state of the tendon can move along this continuum through managing the amount of load on the tendon.

If you have tennis elbow, you may notice the outer aspect of the elbow just below the joint is particularly tender. You may notice some redness and thickening around the area. It can often feel quite stiff in the morning or after rest until it is ‘warmed up’. It is often worse with increased repetitive use of the wrist and forearm and gripping – you may find it painful for example lifting the kettle – symptoms might be aggravated at the time of the activity, worsening with prolonged use, and a couple of hours after the activity.

What causes Tennis Elbow?

Tennis elbow primarily occurs when the tendons attaching onto the lateral epicondyle are repetitively overused, causing an overload on the tendons. This commonly results from activities involving repetitive use of the upper arm including computer/keyboard use, lifting, gripping and rotational movements such as using a screwdriver. It can also be common in sports requiring repetitive upper arm movements such as swimming and throwing, and is very rarely associated with tennis! It could develop as a result of a weakness elsewhere in the body, for example a weakness in the rotator cuff muscles of the shoulder could lead to overcompensating with the elbow, therefore leading to overuse and increased strain.

How can physiotherapy help?

At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm the diagnosis, help you manage pain and return to normal activity.

Treatments which can help Tennis Elbow include:

  • Home exercises – your physiotherapist will devise an exercise programme based around progressive loading of the tendon. This improves the strength of the tendons and the ability to tolerate load, meaning you can better manage the activities that are currently aggravating your symptoms. The assessment will also help to identify any contributing factors to developing tennis elbow, for example a weakness in the rotator cuff muscles of the shoulder. Exercises can then be specifically tailored based on the assessment.
  • Soft tissue massage – this can help to increase blood flow and reduce any muscle tension in the forearm.
  • Tennis elbow support strap – this can help to offload the tendon by changing the site of load absorption and reducing the tension on the tendon attachment site.
  • Shockwave therapy – this has been shown to be an effective treatment for chronic tendinopathy. See our page on ‘shockwave therapy’ for more information on this.

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