Tennis Elbow is a frequently seen condition in physical therapy. Despite being widely known as tennis elbow, most cases are due to mechanical stress to the elbow muscles and tendons for reasons other than playing tennis. Heavy use activities including movements such as gripping, rotation of the forearm, pulling the wrist upward and carrying may all contribute to the onset of pain.
Imaging studies of the lateral elbow reflect a degenerative condition, rather than just inflammation, at the location of the tendon to bone junction. In addition to this tendon damage, disorganization of collagen fibers can be seen in most chronic cases.
Trends indicate rates are higher in populations whose job requires repetitive use of the arm, but not necessarily. Research shows most cases occur on the dominant side and within the age range of 45-54 years. Some sources say it is a self-limiting condition, meaning it will resolve on its own, but could take up to a full year without PT interventions.
- AVOID activities known to aggravate the elbow – a few weeks off, beats a year of pain!
- Soft tissue release by deep massage, instrument-assisted ‘scraping’, and dry needling
- Stretching exercises to realign dysfunctional tissues at the site of damage
- Wrist strengthening exercises, specifically eccentric in nature
- Elbow joint mobilizations/manipulation
- Ergonomic and body mechanics review, including splinting if necessary
Cases that are particularly stubborn may involve a referral pain pattern from the neck or actual nerve entrapments at the elbow. In these cases, treatment of the neck is imperative and adding other techniques such as nerve glides may be beneficial.
As mentioned, tennis elbow is a degenerative condition. This means the likelihood of it recurring is greater than other orthopedic conditions. A study conducted in 2015 noted that the rate of recurrence within a two year period from initial episode was 8.5%1.
Spring will be here before we know it, and I know you will not want to take a break from gardening or golf, so come in now and get your lateral elbow pain under control!
Sanders TL Jr et al; The epidemiology and health care burden of tennis elbow: a population-based study. Am J Sports Med. 2015 May;43(5):1066-71