Elbow, Health, Upper limb

Epicondylitis: What is it and why Tennis…

January 29, 2015 • By

Tennis elbow or Epicondylitis is very common, affecting 1-3% of the population but the name can be very misleading and misunderstood(1). I am going to clear that up for you by telling you what it is, why it happens and how to treat lateral Epicondylitis through effective exercises at home!

Epicondylitis tennis elbow exercises

Epicondylitis is actually an overuse injury – rather than an inflammatory problem as is commonly thought. The research is fairly conclusive that it is not an inflammatory condition, so technically it should be called lateral elbow tendinopathy… but lets just stick with tennis elbow! (2)

 

Tennis elbow originates from the extensor muscles of your wrist, just before it attached onto the lateral epicondyle as you can see int he image to the left. It is brought on by any work or sports that need repetitive wrist movement or gripping. So not just tennis but a wide range of activities can cause it, such as:

  • Building, plumbing and electrical work
  • Computer work – yes using a mouse can cause injury!
  • Racquet sports
  • Mechanical work and much, much more…

So, yes it does affect a lot of tennis players (more than 50% of amateur tennis players!), hence the name, but it can also cause pain and limitation in a range of other sports and professions as well.

Tennis elbow physiosteps ashburton nz

Courtesy of: M. Waseem et al. / Lateral epicondylitis: A review of the literature

How:

It happens through repetitive overloading of the tendons, leading to micro-tears and the initiation of degenerative changes – Thickening of the tendons, sensitization, increase in blood vessels and building cells.

Think of it like this: You are using the tendon the same way over and over and over again and this overuse is too much for the tendon to handle – it gets tired, and fair enough too. So because of this it gets little micro-tears, kicking your body into action. It decides it needs to make it stronger by laying down more tendon fibres and other building blocks. But the problem is that this makes it thicker and dysfunctional because the new fibers are layed down all over the show – not in the correct alignment, leading to weakness and a real pain in the elbow.

Pain usually comes on gradually and generally worsens with use, such as gripping or lifting.

Main points:

  • Epicondylitis initially is a degenerative over-use injury
  • It is caused be repeated or sustained gripping or wrist movement
  • It can improve faster in the short term with rehab exercises and physio

 

So what can you do to help your Tennis Elbow?

  1. Relative rest: This has happened because the arm was overused, so it makes sense to ease off on the aggravating activity if possible. So try to avoid things that make it sore and ensure you have plenty of mini-breaks to that the muscles can have a breather
  2. Pain relief: Both ice and heat are effective in decreasing pain – use what works for you and if in doubt ask your local health professional
  3. Brace up: Tennis elbow braces really do help – in the majority of cases. They act to: Provide compression, warmth for healing and change the angle of pull on the tendons, reducing the stress and strain. These give some great relief, especially during work or sport.
  4. Most importantly – do the right exercises. Doing the right exercises is so important because as mentioned above, the tendon fibers become messy and not aligned well at all. In order for it to heal strongly the fibers need to be re-aligned along the correct line of pull. So putting the right, controlled force through the tendons helps align the fibers in the right direction, meaning it heals strong and fast! This is why doing the right exercises are so important – better than old mister wait and see. In my next post I will be outlining the most important rehab exercises for tennis elbow to get you back to it as soon as possible – so keep tuned!

 

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