Tennis Elbow Specialist

What is Tennis elbow?

It is a general term people use to describe pain on the outside of the elbow. However, the specific diagnosis may be lateral epicondylitis, which is tendon inflammation. Or more likely, tendinopathy, which describes wear and tear or degeneration of the tendon.

The wrist extensor muscles attach to the lateral epicondyle (bony bit) on the outside of the elbow. Tennis elbow pain usually occurs where the tendon of the ‘extensor carpi radialis brevis’ muscle inserts into the bone. At this point, there are a large number of pain receptors. As a result, the region is particularly tender to touch. Symptoms are either acute or chronic.

Acute Tennis elbow

• Acute injuries occur immediately after an activity such as hitting a backhand shot in tennis with poor technique.
• The extensor muscles on the back of the forearm (wrist extensors) become suddenly overloaded. This causes small micro-tears in the tendon where it attaches to the elbow.

Chronic Tennis elbow

• Chronic injuries normally develop over a period of days/weeks. It often follows a bout of intense exercise or unaccustomed activity. For example, lifting heavy boxes and other DIY jobs.

Is it lateral epicondylitis or extensor tendinopathy?

• The medical term often used is lateral epicondylitis. However, this can be misleading as the ‘itis’ on the end of the word implies that there is inflammation.
• In long-term cases, the acute inflammatory stage has passed and tendinopathy is an appropriate term. This is because it describes degeneration of the tendon rather than acute inflammation.

Tennis elbow symptoms

Symptoms usually develop gradually over time becoming progressively worse and include:

• Pain approximately 1 to 2 cm down from the bony protrusion (lateral epicondyle) on the outside of the elbow.
• Symptoms may flare up suddenly but they usually develop gradually over time.
• You may have weakness in the muscles around the forearm and wrist.
• As a result, performing simple tasks such as gripping objects, opening a door handle, or shaking hands is painful.
• A professional therapist may perform a number of specific assessment tests including resisted wrist extension, ‘Mills maneuver’ and the ‘neural tension’ to help diagnose lateral elbow pain.

What causes tennis elbow?

The most common cause of Tennis elbow is overuse or repetitive strain. In particular, repeated extension (bending back) of the wrist. For example:

• Gripping or turning objects like a manual screwdriver.
• Lifting heavy weights during strength training.
• Repeatedly performing occupational activities, such as lifting bricks.

How is tennis elbow traditionally treated?

Typical treatments for tennis elbow includes a series of at-home exercises, rest, ice, and stretching to help reduce the pain in your elbow. If this fails, the following treatments are typically tried.

• Tennis Elbow Brace
• Physical therapy
• Ultrasound
• Cortisone injections
• Night Wrist splints

If these treatments fail to improve your pain, surgery may be recommended.