What is Tennis Elbow?

1-3% of the population will suffer with tennis elbow each year [1][2][3] and most people will have heard of tennis elbow or heard of somebody else suffering with it. But what is it?

The clinical term for the condition is lateral epicondylitis, which just describes inflammation over the outer part of the elbow. Typically there will be pain over the outside of the elbow in an area known as the common extensor origin. This is simply where a few tendons attach to the bone. These tendons are connected to the forearm extensor muscles, which are responsible for extending the wrist and fingers backwards.

Therefore, the usual causes for tennis elbow are the activities that use these muscles or put strain through them[4]. A backhand shot in tennis involves some of these muscles being on tension when gripping the racquet and then being strained as the wrist is jolted when the ball hits the racquet. A similar movement can happen in golf too, especially when taking a divot. Lateral epicondylitis does not just affect club and racquet swingers though and other repetitive activity like using a computer mouse or prolonged use of some tools can cause the same injury.

How is Lateral Epicondylitis treated?

If left untreated, lateral epicondylitis can last from 6 months to 2 years [5] but there are many ways to successfully banish it.

The first step is to modify the offending activity. Relative rest (not complete rest!) from the activity will give your body the chance to start healing the injury itself. Simple adaptations like, in the case of tennis, having a larger grip will also help [6] and taking anti-inflammatories and using ice on the area can also reduce symptoms.

The next step is to actually treat it! In my clinics, I use a combination of massage, manipulation, ultrasound and dry needling to initially get my patients pain-free. We then work on exercises to improve the strength and endurance of the forearm extensor muscles to keep the elbow pain-free in the future.

If you’d like some help with your elbow pain, please get in touch or book an appointment online using the Contact and Appointments pages.

[1] Verhaar JA. Tennis elbow. Anatomical, epidemiological and therapeutic aspects. Int. Orthop. 1994;18:263–7

[2] Calfee RP, Patel A, DaSilva MF, Akelman E. Management of lateral epicondylitis: current concepts. J. Am. Acad. Orthop. Surg. 2008;16:19–29.

[3] Descatha, A., Despreaux, T. and Calfee, R.P. et al (2016) Progressive elbow pain. British Medical Journal 353, 1-3

[4] Cassvan A, Weiss LD, Weiss JM, et al. Cumulative trauma disorders. Boston ; Butterworth-Heinemann; 1997:123-125

[5] Hudak, P.L., Cole, D.C., Haines, A.T., Understanding prognosis to improve rehabilitation: the example of lateral elbow pain. Archives of Physical Medicine and Rehabilitation, 77, 1996: 586-593

[6] Braddom RL, Physical medicine and rehabilitation. Philadelphia: WB Saunders; 1996:222.