Article prepared by Philip Ting
Tennis elbow is a common condition affecting many people. It isassociated with repetitive activity involving repeated wrist gripping, twisting, or extension against resistance that is needed in sports such as tennis and squash as well as some leisure and occupational activities like sewing, knitting, bricklaying, painting and computer/mouse work. It was previously thought that there was an inflammatory component to tennis elbow but it is actually an extensor tendinopathy. This means that there is a degenerative breakdown of the tendon causing pain and a reduction in strength. There is a poor blood supply to the extensor tendon involved and this combined with excessive load, may lead to degenerative changes weakening the tendon.
Factors which may predispose to this condition include:
- Overuse e.g. work, sport, leisure activities
- Poor technique
Symptoms may include:
- Pain associated with gripping, twisting or wrist extension i.e. lifting heavy objects, backhand at tennis
- Gradual/acute onset of pain on the outside of the elbow
- Aching after activity or during the night
As this is a degenerative condition, treatment may last 3 months or longer. Treatment will involve correcting the predisposing factors in addition to:
- Activity modification
- Tendon strengthening program combined with icing
- Deep tissue massage and self massage techniques
- Gentle Stretches
- Taping and/or bracing
If your tennis elbow doesn’t progress as expected, then other treatment options may be considered. Research recently supports the use of glycerol trinitrate patches as an adjunct to physiotherapy treatment for elbows that do not respond to physiotherapy treatment alone. These patches have different side effects that need to be discussed with your doctor.