By Tracy Rodriguez, PT, Atlantic Physical Therapy Center
One of the most common causes of elbow pain is called Lateral Epicondylitis or Tennis Elbow. Whether it’s due to a sudden trauma or the result of repetitive strain, once damaged, the elbow can be incredibly resistant to healing. Patients with Tennis Elbow rarely take the time necessary to rest their elbow so it can heal completely.
Although tennis elbow commonly affects tennis players, it also affects other athletes and people who participate in leisure or work activities that require repetitive arm, elbow, wrist, and hand movement, especially while tightly gripping something. Examples include baseball players, bowlers, gardeners or landscapers, house or office cleaners (because of the repetitive nature of vacuuming, sweeping, and scrubbing), carpenters, mechanics, and assembly-line workers. Click here to watch a YouTube video on Tennis Elbow or continue reading below.
The primary symptom is tenderness on and around the tendons that attach to the small bony part on the outside of your elbow (lateral epicondyle). These tendons extend into your forearm and help to extend your wrist and fingers. The wear and tear on these tendons is a result of small tears in your tissue that don’t heal properly. The inability of your tendon to heal properly causes the tendons to weaken until the tissues become very thin, and eventually wear out. There may also be swelling in that area.
Other Symptoms of Tennis Elbow include:
- Pain is worse when shaking hands or squeezing objects or using the mouse or keyboard.
- Pain is made worse by stabilizing or moving the wrist with force, especially with your palm facing downwards. Examples include lifting, carrying grand kids, using tools, opening jars, or even handling simple utensils such as a toothbrush or knife and fork.
It is important to address your symptoms early when you start to feel the pain to avoid it becoming a chronic injury which is much harder to treat.
If you seek out medical attention your doctor may treat it conservatively with anti-inflammatory medications, a topical anti-inflammatory cream, or a brace to absorb the shock through the inflamed tissue. Depending on the severity, you may benefit from a cortisone injection.
You may be referred to physical therapy which can be very helpful in facilitating your healing. Along with giving you stretching and strengthening exercises, they will perform manual techniques such as massage and soft tissue mobilization to allow for increased blood flow to the affected area to promote healing and reduce pain. Modalities such as ultrasound and electric stimulation as well as iontophoresis may be beneficial as well. Click here to watch a YouTube video on Tennis Elbow or continue reading below.
Here are 4 tips to facilitate the healing process:
- Initially follow the guidelines of RICE – Rest, ice, compression, elevation – This is important for initial healing because without proper rest you are putting yourself at risk for increased pain and inflammation. This can make your elbow even worse and turn an acute injury into a chronic one. You can take an NSAID (non-steroidal anti-inflammatory) such as ibuprofen or Motrin.
- Avoid activities that caused your injury – While resting your elbow it’s also important to avoid all activities that may have caused your tennis elbow (especially any repetitive arm, hand or wrist movement). Continuing on with regular activities will not only make your injury worse, but can add a significant amount of time to the healing process.
- Extensor muscle stretching – hold each stretch for 30 sec and repeat 3-5x a few times throughout the day.
- Straighten your affected arm out fully and keep a loose fist and push the top of the hand down with your other hand so you feel a stretch across the top of the forearm.
- Eccentric strengthening of the wrist extensors. Often it is the repetitive concentric (muscle shortens as it is working) contraction that cause overuse injuries. This is an exercise used to help strengthen your wrist extensors eccentrically (meaning they lengthen as they are working).
- Sit with affected forearm supported on a table or on your lap.
- “Pick up” your affected hand with your opposite hand.
- Make sure you keep your affected hand relaxed and allow it to be “picked up” with the other hand. (Do not move balistically or rapidly and do not lift your hand on its own).
- Slowly lower your hand without the assistance of the other hand for a count of 5 seconds.
- Repeat this 15x for a count of 5 when lowering, do this 2x/day.
If symptoms persist after trying these tips, contact your doctor who will most likely treat you conservatively with anti-inflammatory medications, a topical anti-inflammatory cream, or a brace to absorb the shock through the inflamed tissue. Depending on the severity, you may benefit from a cortisone injection.
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