All you need to know about Tennis Elbow

Tennis elbow, more common than golfer’s elbow, is the most prevalent overuse injury in the elbow. It involves the extensor muscles in the forearm. Here’s a fun fact: only 5% of people relating to this injury are from tennis.

The elbow joint comprises three bones, namely the humerus, radius, and ulna, whilst each side of the elbow features two distinct bony landmarks. Overuse, repetitive motions, or impact can lead to the injury, which tends to be more common among individuals aged 30 to 50.

Tennis elbow develops in four stages. Initially, you might experience pain a couple of hours post the provoking activity. This is followed by pain immediately after the provoking activity. As the condition progresses, you might feel pain during the provoking activity. In the final stage, constant pain prohibits activity. Sounds horrible, right? So, how do we manage tennis elbow?

Medical Management

Non-operative treatment is often the first line of defence. This may include:

• NSAIDs (Nonsteroidal anti-inflammatory drugs) to help reduce pain and swelling.
• Icing the area three times a day to reduce inflammation.
• Wearing a brace to support the joint during the healing process.
• Steroid injections, which are very effective anti-inflammatory medicines.
• Reducing your load, meaning you’ll have to stop or decrease participation in sports, heavy work activities, and other activities that cause painful symptoms for several weeks.

In cases where non-operative treatments do not provide relief after 6 to 12 months, surgery may be considered. Surgical procedures for tennis elbow typically involve removing the diseased muscle and reattaching healthy muscle back to the bone. There are two main types of surgery:

• Open surgery, which involves making an incision over the elbow.
• Arthroscopic surgery, which uses miniature instruments and small incisions.

Physiotherapy Management

Physiotherapy plays a crucial role in the management of tennis elbow. It may include:

• Manual therapy such as massage and mobilisation to help reduce pain and improve flexibility.
• Extracorporeal Shockwave therapy, which sends sound waves to the elbow to promote the body’s natural healing processes.
• Ultrasound, TENS (Transcutaneous Electrical Nerve Stimulation), and Laser therapy to promote healing and reduce inflammation.
• Exercises for strengthening and stretching the muscles of the forearm. These exercises can help reduce the load on the tendons, relieving symptoms and preventing further injury.
• Braces to help rest the muscles and tendons and relieve symptoms.
• Sport/occupation-specific rehabilitation to help you return to your regular activities without pain.

In conclusion, tennis elbow is a common but manageable condition. By understanding the causes and symptoms, seeking appropriate treatment, and taking steps to prevent overuse, you can keep your elbows healthy and pain-free.