Tennis Elbow

2017 is upon us, and with it comes a swathe of New Year’s resolutions timed perfectly with things like the Tour Down Under and the Australian Open. Been feeling like a pro with the tennis racquet, tennis whites and sweat bands this January? We really hope so! We’ll say it once and we’ll say it again- exercise is one of the best treatment tools in our toolboxes! But… Too much of a good thing can lead to disaster.

At Prevent, we’ve been seeing lots of ‘Tennis Elbow’ presentations in the last few weeks. It’s a very common term describing a pain on the outside of your elbow with gripping and lifting movements. It was cited as being as high as 40% prevalence in a tennis population and 15% in a non-tennis population in one study.

It can be caused by many things- and obviously tennis is one of them. The most aggravating activities we see at Prevent are gripping and twisting movements of the forearm; ironing, lifting heavy pans and pouring out contents, tennis- especially when applying spin, carrying heavy bags, opening stuck jars etc.

But why is it really caused? Most commonly, it is caused by doing too much (or too many) of the things that overload the muscles on the outside of your elbow (listed above), doing them with poor technique or rushing back into being a tennis pro after a long winter off!

Fair warning though: ‘Tennis Elbow’ is not always a true ‘Tennis Elbow’ (or lateral epicondylitis, to get technical). Very often there is some contribution of pain attributed to the nerves in the area, or more specifically, the radial nerve. Arm pain, neck pain, shoulder pain, numbness and pins and needles can all be signs that maybe the pain is being radiated to your elbow from somewhere else. Or, the old chicken or the egg scenario- the dysfunction caused by the muscles on the outside of your elbow could be causing some nerve irritation. Either way, Google Doctor isn’t always the best course of action.

Our top tips:

1.      If you’re looking to increase your tennis regime, aim for a 10% progression each week, no more. That will bring you inline with your body’s tissues ability to adapt.

2.      Exercise and rehab are a much better option than a cortisone injection- all of the best current evidence shows no difference in pain after 6-8 weeks between cortisone and active rehab, and an actual increase in pain for cortisone groups after 12 weeks in some studies.

3.      Don’t put up with elbow pain! It can be the kind of thing to resolve quickly and completely (within 5-6 weeks) or it can drag out for months. Because of the close proximity of your nerves to the typically-affected muscles, the area can become sensitised and more complicated to treat. 

     By Suzannah Michell 

    Physiotherapist