Tennis Elbow, or lateral epicondylitis, is a very common problem that involves pain and inflammation along the outer aspect of the elbow. It is arguably one of the most nagging problems that we see here at the clinic, and it is most likely caused by repetitive activities involving extension of the wrist and the fingers.
Unfortunately, research done on treatment of tennis elbow has been largely inconclusive in terms of reaching the best outcome. There are many factors that play a role in how this diagnosis is treated. The age of the patient, the daily activities of the patient, and how long the patient has encountered symptoms are all factors that need to be taken into account when devising a treatment plan.
Here is a list of interventions that most physical therapists will agree on in terms of dealing with tennis elbow.
1. Stop performing the activity that is the likely culprit.
This can range from playing tennis to carrying grocery bags to using hand-held devices. There is no way around this. In my opinion, decreasing the amount of insulting activity is not good enough. The causal activity needs to be stopped until the pain is entirely gone.
The muscles that extend the wrist have direct attachment onto the lateral epicondyle. It is thought that repetitive pulling of these muscles on their origin site starts the cycle of inflammation and degradation. If your wrist is immobilized, it is much harder to inadvertently use these muscles. (View an example of a wrist immobilization brace on the right.)
3. Having tender points in the forearm muscles massaged and released can help.
There are some researchers that believe that the wrist and finger extensor muscles are not the only muscles that can play a role in this diagnosis. If you are going to see a physical therapist or a massage therapist, have them work on your triceps, brachialis, and supinator muscles as well.
4. Perform “eccentric” wrist exercises
Once the symptoms have subsided, there is published research that suggests performing “eccentric” wrist exercises can increase the overall tensile strength of the tendons and the overall health of the muscles. There are many resources online that show examples of these types of exercises. View one of our brief patient instruction videos below.
5. Have your office ergonomic set-up assessed.
If you have to contort your wrists in order to type or use your mouse, you are most likely chronically over-using muscles in a way that is not sustainable.
Image credit: Top © sungaBOYD/iStock