Is a nagging elbow and forearm pain interfering in your daily tasks, hobbies, and physical activities? If so, you could be suffering from tennis elbow, a painful condition that typically occurs when the tendons become overworked due to repeated, strenuous movements. Despite what the name may suggest, you can suffer from this injury without ever picking up a racquet.
What is tTennis Eelbow?
Tennis elbow, clinically known as lateral epicondylitis, is a form of tendinosis. It is one of the most common painful conditions affecting the elbow and is commonly caused by using the muscles and tendons in your forearm too much or too intensely. This strenuous overuse and repetition can cause inflammation, scarring, degeneration, potential tearing, or tension around the bony bump on the outer side of the elbow where the muscles and tendons attach to the bone.
Tennis elbow can occur in a number of instances that involve repeated, strenuous movement, one such example would be while doing recreational activities or playing racquet sports. This is a result of repetitive swinging motions, such as a tennis backhand stroke, that put a strain on your muscles and tendons (the tissues that attach your muscles to your bones).
Its namesake aside, tennis elbow is actually more common in manual jobs that involve repeated gripping, twisting, or lifting. This can include:
- Desk work where you use a mouse and keyboard all day
- Gardening, landscaping, and cleaning
- Carpentry, mechanical work, painting, and plumbing
- Assembly line work
- Using heavy tools
Tennis elbow is also common in musicians, especially in pianists and musicians who play a stringed instrument like a guitar, violin, or cello. While the pain is generally felt in the elbow, it can also spread to your forearm and wrist.
The condition affects about 1-3% of the general population and occurs mostly in people between the ages of 40 and 50, as tendons grow less flexible. In almost 75% of cases, tennis elbow affects the dominant arm.
Tennis Eelbow Ssymptoms
The symptoms of tennis elbow usually start gradually and get worse over time if the repetitive activity continues, sometimes it takes weeks, other times it can take months to feel the symptoms fully enough to start worrying. It can have a significant effect on your functionality and everyday life. Simple tasks such as holding a cup or turning a doorknob can become quite painful. If you don’t get treatment, the pain can last a long time.
The warning signs vary from person to person and range from mild to severe. Some include:
- Tenderness, swelling, or burning sensation around the elbow
- Tingling sensation in the wrist and fingers
- Severe forearm or elbow pain even lifting light objects
- Weak grip strength
Some sufferers may experience neck stiffness and shoulder pain, as well as signs of nerve irritation. Those areas can become tender as your body tries to compensate for your elbow’s lack of strength and movement.
Here is a warning: having poor posture not only causes lower back problems, it can also be a contributing factor that stops your tennis elbow from completely healing.
Tennis Elbow Risk Factors
As mentioned previously, tennis elbow is not limited to athletes. There are various additional causes and risk factors that can cause it to develop. These include, but are not limited to:
- Age: The risk for tennis elbow accelerates after the age of 40, however, increased risk can start in people as young as 30.
- Occupation: Working in physically repetitive occupations such as carpentry, painting, brick-laying, instrumental music, intensive computer work, etc.
- Direct trauma to the elbow: This could include falling onto your elbow or even colliding with another player while playing sports.
- Not warming up: Failing to warm up before a strenuous activity increases the risk of tissue damage, which can lead to tennis elbow. This is because the muscles and tendons are more pliable and less prone to tearing after someone warms up before engaging in intense sports or physically demanding activities.
- Playing racquet sports in adverse weather: With racquet sports, poor weather conditions (such as rain or strong winds) often mean you need to try harder to get the power you need. Hitting rain-soaked tennis balls and/or playing into the wind makes the swinging action more strenuous.
- Poor athletic technique: Building on the previous point, poor athletic technique can also lead to strain on your elbow. For example, if a tennis player is using a hitting force that is supported more by their elbow than their core.
- Not using sports equipment properly: The wrong sports equipment can also have a detrimental effect on your tendons, for example, if a tennis player uses a racquet that is the wrong size (usually if it is too heavy) or is not strung perfectly (the head surface is too tight or too loose).
4 Tennis Eelbow Eexercises to Rrelieve Ppain
The good news is much of the time, tennis elbow gets better with rest, exercise and therapy. Here are four recommended tennis elbow stretches and exercises that you can try at home. Before attempting these exercises, wait for any swelling to go down. It’s also a good idea to check with your health-care provider first.
- Wrist extensor stretch: Start with a good standing posture and stretch your arm out, elbow straight, palm facing down. Using your other hand, point the fingers of the outstretched arm down, allowing the forearm muscles to stretch. Hold this stretch position for 20 to 30 seconds. You should feel a stretch sensation, but no pain. Repeat 2 to 3 times a day.
- Weighted eccentric wrist extension: Grab a light dumbbell or other light weights (1-2 lbs.) Start by sitting on a chair with your elbow resting on your thigh. Keep your elbow at 90 degrees. Hold the weight in your hand with your palm facing down, your wrist in neutral position (wrist joint is straight). Lift the weight up, bending at your wrist. If this is difficult or painful to do, use your other hand to assist with the movement. Hold the weight in that bent position for 3-5 seconds. Then slowly bring down the weight by bending your wrist the other way until it is fully bent (in the opposite direction). Repeat 6 to 8 times, twice a day.
- Hammer exercise: Use a hammer as your weight resistance. Hold the handle of the hammer with the head pointing up. Keep your elbow at 90 degrees, rested flat on your thigh. Slowly rotate your palm facing down (the hammer’s head will now face the centerre of your body). Be sure you’re twisting your arm using your forearm, not your elbow. Hold this position for 3 to 5 seconds. Then bring the hammer back to the starting position. Rest briefly. Repeat ten times. Too difficult or painful to do using only the arm you’re exercising? Assist with the movement by using your other hand.
- Grip strengthening: For this exercise, all you need is a squishy ball or stress ball. Hold the ball in your hand and gently squeeze. Hold for five seconds, relax and repeat ten times.
Tennis Eelbow Ttreatment Ooptions
There are many nonsurgical treatment options you can seek out as soon as symptoms develop. Some include:
- Rest: Take a break from repetitive sports or work activities. This is so you can rest your arm and avoid flair-ups.
- Physical therapy: Looking into physiotherapy for tennis elbow may be a good idea because the physiotherapist will assess your stage of injury and give you the right treatments and physio exercises for your tennis elbow. “They will discuss the best active approach for you to use based on your symptoms and your lifestyle. They will teach you preventative exercises to stretch and strengthen your forearm muscles. These physical therapy exercises can help ease your pain and increase your range of motion. The end goal is to prevent your injury from reoccurring.”
- Elbow brace: There can be benefits to wearing a brace. But it doesn’t treat the root cause of the injury. A brace can be worn around the elbow or on the forearm to reduce stress on the injured tissue. It can also offer pain relief caused by tight muscle tension.
- Ice or cold packs: To soothe and numb the pain, apply ice or cold packs for 10 to 15 minutes, a few times a day.
- Over-the-counter pain relievers: Ibuprofen or aspirin may help lessen pain and swelling.
- Steroid injections: Injections into the elbow can temporary ease some swelling and pain around the joint. Consider this option if the pain is especially bad and nothing else helps.
Depending on your level of activity, you’ll notice an improvement within one to three weeks with proper treatment. Most people can expect their injury to completely heal in four to eight weeks. However, if your tendon isn’t healing after six months of nonsurgical treatments, your doctor may recommend another course of action.
If you want to know how to prevent tennis elbow, the key is to avoid overuse. If you’re working a job where you’re gripping and using your hands a lot, just be aware of your posture, work space and behaviour. And every so often, switch hands to do your tasks if you can.
If you want help to work through a tennis elbow injury, you can consult a Sheddon physiotherapist. Contact us here.
For more info, contact Sheddon Physiotherapy and Sports Clinic at 905-849-4576.
We are located less than 10 min from Sheridan College Oakville and 4 min East from Oakville & Milton Humane Society.
Dana Clark, BScPT FCAMPT IDN(C) is a registered physiotherapist working in Orthopaedics for over 25 years. He has travelled with Sports Teams and worked on complex cases as well as professional, and Olympic Athletes. He previously instructed clinicians in the Orthopaedic Division of the Canadian Physiotherapy Association.
He continues to help teach clinical skills at the University of Toronto while sitting on the medical advisory board for complete concussion management and an advisory board member for private practice of the Ontario Physiotherapy Association.