Dan Armena, registered physiotherapist at Sheddon Physiotherapy and Sports Clinic
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.
What is tennis elbow?
Tennis elbow is a form of tendinosis. It’s commonly caused from using the muscles and tendons in your forearm too much or too intensely. It can cause inflammation, scarring or tension on the bony bump on the outer side of the elbow.
Tennis elbow can occur when doing recreational activities or playing racquet sports. This may be a result of repetitive swinging motions. But it’s 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
The condition occurs mostly in people between the ages 40 and 50, as tendons grow less flexible. And in almost 75% cases, tennis elbow affects the dominant arm.
Tennis elbow symptoms
Tennis elbow symptoms usually start gradually and get worse over weeks or months if the repetitive activity continues. 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 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 exercises to relieve pain
The good news is much of the time tennis elbow gets better with rest, exercise and therapy. Here are four recommended 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 weight (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, 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 (hammer head will now face the centre of your body). Be sure you’re twisting your arm using your forearm, not your elbow. Hold 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 elbow treatment options
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: Your physiotherapist will assess your stage of injury. “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 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 surgery.
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.