Tennis Elbow

Tennis elbow (lateral epicondylitis) is one of several overuse injuries that can affect your elbow. As you might guess, playing tennis is one cause of tennis elbow — but many other common activities can cause tennis elbow, too.

What is it?

 The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to the bony prominence on the outside of your elbow (lateral epicondyle). Pain can also spread into your forearm and wrist.

Tennis elbow is similar to golfer's elbow. But golfer's elbow occurs on the inside — rather than on the outside — of your elbow.

Tennis elbow is most common in adults ages 30 to 60 — but the condition can affect anyone who repetitively stresses the wrists. Tennis players, carpenters, gardeners, dentists and musicians may be at particular risk.

What causes it?

Tennis elbow is an overuse injury. It's caused by repeated contraction of the forearm muscles that you use to straighten and raise your hand and wrist. The repeated motions and stress to the tissue may result in inflammation or a series of tiny tears in the tendons that attach the forearm muscles to the bone at the outside of your elbow.

As the name tennis elbow indicates, playing tennis — particularly, repeated use of the backhand stroke with poor technique — is one possible cause of the condition. However, many other common arm motions can cause tennis elbow, too — including using a screwdriver, hammering, painting, raking, weaving and others.

What are the symptoms?

  • Pain that radiates from the outside of your elbow into your forearm and wrist.
  • Pain when you touch or bump the outside of your elbow.
  • Pain when you extend your wrist.
  • A weak grip.
  • A painful grip during certain activities, such as shaking hands or turning a doorknob.

The pain often gets worse over weeks or months. Sometimes you may feel pain even when your arm is still.

Are there any natural therapies?

Initial treatment of tennis elbow usually involves self-care steps such as using the R.I.C.E. method – rest, ice, compression, elevation.

In the acute phase (when the elbow is very painful) it may be worth while taking a natual anti-inflammatory and muscle relaxant. In the acute phase there will always be inflammation and muscle spasm, so the combination of these two styles of products may be required. For example we often recommend Bioceuticals InflamEze Active and Eagle Pharmaceutical's Mag-oro. Depending on the pain levels and extent of the inflammatory changes you may may need to take two to three times the recommended dose, until the elbow settles. Reduce the dose down slowly over time, as the symtoms decline.

Over time, in the chronic phase, or in an attempt to help prevent the return of the condition, consider the use of a Magnesium based product. Magnesium is a very good muscle relaxant and will help your recovery from sport or physical activity. A great product suitable for providing nutritional support to the muscles is Bioceutical's Ultra Muscleze. This can be used on an ongoing basis.

Regular massage into the area every second day will also be of value. You can do this yourself by stripping the muscles of the forearm from the wrist to the base of the bicep, lightly working on the tender points. Suitable products to assist with this are Tiger liniment, which is an oil based product, or the popular Zen liniment; similar to the old style alcohol rubs but with a pleasant peppermint scent. If you are not confident with the massage then use your health professional.

If these steps don't help and you still have pain and limited motion, you may need to:

  • Analyse the way you use your arm. Try to avoid any lifting where you have your palms facing the ground. For example, if you are going to lift a bag, make sure your plams face upward, NOT DOWNWARD. Lifting anything with your palms facing the ground will significantly aggravate the insertion of the muscles in your elbow and therefore aggravate hyour condition.
  • Try a firm (not too tight) bandage around the upper forearm. Some people use a brace, velcro strap or even tape around the forearm to help provide support for the extensor muscles of your arm. The brace should be placed one fifith of the way down the forearm, just below the elbow crease, around the muscle bulk of the forearm.
  • Other treatments for tennis elbow are highly effective particularly acupuncture and myofascial work to the forearm.

What else can I do?

  • Review your technique. Have a tennis professional review your technique to see if you're using the proper motion. Swing the racket with your whole arm and get your entire body involved in the stroke, not just your wrist. Keep your wrist rigid during ball contact. Also, make sure you have the proper racket grip size and string tension. Lower string tension of around 55 pounds transmits less force up to the elbow.
  • Build your strength. Prepare for any sport season with appropriate preseason conditioning. Do strengthening exercises with a hand weight by flexing and extending your wrists. Letting the weight down slowly after extending your wrist is one way of building strength so that force is absorbed into your tissue.
  • Keep your wrist straight. During any lifting activity — including weight training — or during tennis strokes, try to keep your wrist straight and rigid. Let the bigger, more powerful muscles of your upper arm do more of the work than your smaller forearm muscles do.
  • Warm up properly. Gently stretch the forearm muscles at your wrist before and after use.
  • Use ice. After heavy use of your arm, apply an ice pack or use ice massage. For ice massage, fill a sturdy paper or plastic foam cup with water and freeze it. Then, roll the ice directly on the outside of your elbow for five to seven minutes.

Did you know?

The technical name for tennis elbow is “lateral epicondylitis”.