Tennis Elbow

What is tennis elbow?

Tennis elbow, clinically known as “lateral epicondylagia”, is a pain experienced into the outer side of the elbow due to overuse of the muscles that extend the wrist and fingers. These muscles are located in the forearm and attach onto a bony lump on the outside of the elbow (known as the lateral epicondyle).

Causes

Tennis elbow occurs when more force or load is applied through the wrist extensor muscles and tendon than it can tolerate. This may occur due to:

• An episode of unaccustomed activity: such as a weekend doing manual labour, for example gardening, screw-driving, hammering.
• Ongoing repetitive overuse of the wrist extensor muscles: For example an occupation involving lots of typing on the computer, brick layers, painters.

Signs and symptoms

• Pain on the outside of the elbow with gripping tasks and tasks involving repetitive or resisted wrist/finger extension such as lifting the kettle, opening jars, weeding the garden, typing on the computer, heavy lifting/pulling or playing tennis.
• Pain/tenderness when poking the bony lump on the outer side of the elbow (lateral epicondyle).
• Tenderness/tightness of the muscles on the top of the forearm (wrist extensors)
• In some cases, there may be irritation of the radial nerve causing “nerve pain”.

The diagnosis

When this type of pain arrives at the clinic door, there are many structures we need to assess and look at to diagnose the condition:

• Forearm extensor tendons
• Forearm extensor muscle bellies
• Radio-humeral joint
• Elbow ligaments

Not everyone with pain on the outside of the elbow has tennis elbow. Pain can be referred to the elbow from other sites such as the neck, therefore it is common that we will assess the nerves from the neck.

The treatment

Management will depend on individual client presentation. Physiotherapy treatment may include the following:

• Techniques to reduce muscle tension: such as massage and dry needling.
• Mobilisation of the elbow joint.
• Exercises to strengthen the wrist extensors.
• In some cases, neural mobilisation and treatment of the neck and shoulder.
• Elbow braces and taping.

For more advice on tennis elbow, please ask your physiotherapist.

Written by Collie Physio, Eliza Hickey.