Who’s Affected By Tennis Elbow
Tennis elbow is a common condition that affects about 1-3% of the population every year.
It’s the most common cause of persistent elbow pain, accounting for two-thirds of cases. It affects women and men equally, and those affected are mostly between the ages of 35-54.
Page last reviewed: 10 November 2020 Next review due: 10 November 2023
How Can A Physical Therapist Help
For the first 24 to 48 hours after acute onset of your pain, your treatment may include:
- Resting the arm by avoiding certain activities and modifying the way you do others.
- Applying ice treatments to the affected area.
- Using elastic bandages or supports to take the pressure off the painful muscles.
Your physical therapist will decide if a brace or support to protect your muscles will aid your healing.
What Are The Complications And Related Diseases Of Tennis Elbow
Most patients experience improvement and pain relief within 12 months of conservative treatment. However, there is still a risk of developing complications such as:
- Chronic pain if the condition is left untreated
- Tendon rupture due to repeated steroid injections
- Recurrence of injury upon resuming normal activities.
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How Is Tennis Elbow Treated
Its important to avoid the movement that caused your injury in the first place. Treatment may include:
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Rest and stopping the activity that produces the symptoms
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Strengthening and stretching exercises
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Anti-inflammatory medicines
If these treatments do not work, your healthcare provider may talk to you about:
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Bracing the area to keep it still for a few weeks or use of a special brace with activities
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Steroid injections to help reduce swelling and pain
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A special type of ultrasound that can help break up scar tissue, increase blood flow, and promote healing
When To See A Doctor
Most cases of elbow pain will get better on their own or with simple self-help treatments. You should see a doctor if:
- your pain doesnt improve after two weeks of taking painkillers and resting your elbow, and you havent had an injury or infection
- you have tingling, numbness or weakness in your arm or hand.
You should visit a hospitals accident and emergency department straight way if:
- you notice symptoms such as severe pain that stops you from moving your arm, swelling, fever, heat and redness. These can sometimes be signs of infection.
- you think youve fractured your elbow this will probably follow an obvious injury such as a direct impact or fall onto an outstretched hand. A fracture will cause pain and usually bruising and swelling.
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What Is Tennis Elbow
Lateral epicondylitis, commonly known as tennis elbow, is swelling of the tendons that bend your wrist backward away from your palm.
A tendon is a tough cord of tissue that connects muscles to bones. The tendon most likely involved in tennis elbow is called the extensor carpi radialis brevis. Tennis elbow is usually diagnosed in both men and women between the ages of 30 and 50 years.
After The First 48 Hours
Your physical therapist will begin a treatment program specific to your needs to speed your recovery. They may use treatments such as:
- Manual therapy.
- Special exercises to relieve pain.
- Ice or heat treatments, or both.
They also will design an exercise program to help correct muscle weakness that you can continue at home.
Your physical therapy program will include:
Improving mobility. Your physical therapist may use manual therapy, such as massage or other techniques. This treatment helps to reduce tightness in the soft tissue and joints to enable your joints and muscles to move more freely with less pain.
Improving strength. Lack of muscle strength can lead to tennis elbow. Sometimes the weakness is in the muscles of the wrist and forearm. In many cases, the problem stems from weakness of the supporting postural, or “core,” muscles. In fact, you might find that you need to improve your overall level of fitness to help manage your elbow condition. Your physical therapist will work with you to determine the type and amount of exercise that is right for you.
Physical therapists prescribe several types of exercises during recovery from tennis elbow:
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What Are The Risk Factors
Lateral Epicondylitis is the most common reason that people see their doctors for elbow pain. While it is most common in people between the ages of 30 and 50, people can develop tennis elbow at any age. It also tends to affect men more than women.
This condition often impacts tennis players, athletes in racquet sports, and people who participate in leisure or work activities that require repetitive arm, elbow, wrist, and hand movements. Examples include golfers, baseball players, bowlers, landscapers, carpenters, and mechanics.
Recovering From Tennis Elbow
Of course, what you really want to know is when you can get back to your regular activities after having tennis elbow. That depends on your individual case and the extent of the damage to the tendon. People heal at different rates.
Whatever you do, don’t rush your recovery. If you start pushing yourself before your tennis elbow is healed, you could make the damage worse. You are ready to return to your former level of activity when:
- Gripping objects or bearing weight on your arm or elbow is no longer painful.
- Your injured elbow feels as strong as your other elbow.
- Your elbow is no longer swollen.
- You can flex and move the elbow without any trouble.
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When To See A Gp
You should avoid the activity that is causing the pain until your symptoms improve.
If the pain in your elbow does not go away after a few days of rest, visit a GP.
The GP will check for swelling and tenderness, and carry out some simple tests, such as stretching out your fingers and flexing your wrist while your elbow is stretched out.
If the GP thinks the pain is due to nerve damage, further tests, such as an ultrasound scan or an MRI scan, may be done.
How Is Tennis Elbow Managed Or Treated
Tennis elbow may get better on its own with little, if any, treatment. However, that recovery may take up to 18 months. Proven nonsurgical techniques exist that can accelerate your recovery. Nonsurgical and minimally invasive treatments for tennis elbow include:
If symptoms dont improve after six to 12 months of nonsurgical therapies, your provider may recommend surgery, like an arthroscopic or open debridement of the tendon or a tendon repair. Surgery typically involves removing the injured tendon and muscle. Your provider replaces the damaged tissue with healthy tendon and muscle from a different part of your body. Recovery can take four to six months. Once youve had tennis elbow, you may need to wear a brace to keep symptoms from returning.
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Whats The Difference Between Tennis Elbow And Golfers Elbow
Tennis elbow is a condition of the lateral epicondyle tendon, or outer part of the elbow. Golfers elbow is a condition of the medial epicondyle tendon, or inner part of the elbow. The medical term for golfers elbow is medial epicondylitis.
People with golfers elbow have inner elbow pain that radiates down the arm. They can also have finger numbness and tingling. Golfers can get tennis elbow, just as tennis players may get golfers elbow.
How Do You Get Tennis Elbow Without Playing Tennis
The Nirschl Orthopaedic Center reports that half of all tennis players will be diagnosed with tennis elbow at some point in their lives. However, people who play tennis make up less than 5 percent of all reported cases of the condition. This means the majority of people diagnosed with tennis elbow can attribute their condition to other causes.
Can you get tennis elbow from baseball and other sports, then? The answer is yes. Baseball pitchers are commonly affected by tennis elbow, especially if they havent been properly trained as to the correct pitching mechanics, frequently pitch curve balls or have a training schedule that is too vigorous. Younger players with elbows that are still developing are particularly prone to tennis elbow.
Other sports that have been linked to tennis elbow include football, javelin, discus, badminton and squash. The more frequently a person plays one of these sports, the more likely they are to develop the condition.
If you dont play sports at all, you can still get tennis elbow from any sort of regular manual labor that involves lifting of the wrist and/or repetitive turning motions. This includes plumbing, meat cutting, painting and bricklaying, as well as typing. Hairdressers are also vulnerable to tennis elbow due to their frequent use of scissors, shears and other styling tools.
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Should Ice Or Heat Be Used For Treatment Of Tennis Elbow Pain
Alternating ice and heat can both be used to treat tennis elbow pain.
Heat will facilitate motion and muscle relaxation, while ice acts as an anti-inflammatory. Alternating between the two can provide pain relief.
Does Therapeutic Kinesiology Tape Work to Heal Tennis Elbow?
While there is no scientific evidence to prove that K-tape can help heal tennis elbow, when placed in a proper position, K-tape could potentially help relieve pain by minimizing the pressure load where the tendon is most commonly being stressed.
What You Need To Know
- Tennis elbow can be caused by trauma to the elbow or more often by repeated stress on the elbow tendons such as from sports or use of certain tools.
- Symptoms of tennis elbow can include pain or weakness when grasping and aches or pain in the elbow area.
- Treatment of tennis elbow includes: activity modification, ice, medicine, stretching, braces and injections. Surgery is rarely used to treat tennis elbow.
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Traditional Tennis Elbow Treatment Options
To diagnose the source of your injury, your doctor will perform a thorough exam. They may also request imaging tests to diagnose the condition or rule out more serious injuries.
To treat tennis elbow, your doctor may suggest a variety of non-invasive options before considering injections or surgery. This injury often responds well to conservative care, including physical therapy, icing, pain medications, and rest. In some cases, a forearm brace is used to support the affected tendons and musculature. Topical cortisone gels may also be used to reduce inflammation.
In some cases, steroid injections may also be used to treat this injury.
While conservative treatment is often successful, the most important element in traditional care is rest. Depending on your conditions severity, you may need to rest your elbow for weeks before returning to activity.
This injury can take from 6 months to 12 months to fully heal. There are cases of pain persisting for more than a year.
Treatment For Elbow Pain
- exercises prescribed by your physiotherapist to gradually strengthen the tendons
- soft tissue massage
- taping or bracing your elbow
- anti-inflammatory and pain-relieving medication can help you cope with the pain, but do not improve long-term outcomes
- surgery in severe cases, and if pain has not resolved within 12 months.
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What Causes Tennis Elbow Pain
Tennis elbow is most common in people ages 30 to 50, although the condition can be seen in people of all ages. Depending upon their activity level, children and senior citizens can be diagnosed with tennis elbow as well. There is no gender-related component to tennis elbow, and men and women are equally likely to be diagnosed with the condition.
Overuse is the most common cause of tennis elbow pain. When you frequently engage in activities that place stress on the tendon attachments and the muscle-tendon unit, microscopic tears form in the tendon where it is attached to the bone. These tears lead to the inflammation and pain associated with tennis elbow. Typically, overuse is defined as a high activity level three or more times per week with activity lasting 30 minutes or more per session. A poor overall fitness level can exacerbate the problems caused by overuse of the forearm and elbow area.
Tennis elbow pain can sometimes be linked to specific injuries or traumas. If you suffer a direct blow to the elbow, this could result in the swelling of the tendon and subsequent degeneration. When seeking treatment for your condition, it is important to inform your doctor of any injury or trauma that could be linked to the development of tennis elbow.
What Are The Signs Of Tennis Elbow
Tennis elbow usually develops gradually, starting off as mild discomfort and worsening as time passes. In most cases, there is no specific incident that can be linked to the start of the symptoms.
Many people suffering from tennis elbow experience recurring pain radiating from the elbow all the way down the forearm, with pain that increases when they attempt to extend or straighten the elbow. Other common signs of tennis elbow include:
- Difficulty grasping or lifting objects
- Weak grip strength
- Sharp twinges when engaged in activities using the elbow
- Pain during and after activities involving the wrist
- Numbness or tingling in the fingers
- A dull ache when resting
Tennis elbow most often affects your dominant arm, meaning that right-handed people are more likely to develop tennis elbow in their right elbow and left-handed people are more likely to develop tennis elbow in their left elbow. However, it is possible for people to develop the condition in both arms. It is estimated that up to 20 percent of patients have some degree of bilateral tennis elbow.
Tennis elbow is usually considered degenerative rather than acute. If left untreated, tennis elbow can progress to the point where you have difficulty with simple everyday activities such as turning a doorknob, shaking hands, brushing your teeth or holding a coffee cup.
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How Is It Diagnosed
Tennis elbow most often occurs due to repeated movements. Other muscles and joints in the area may be affected as well. Your physical therapist will assess your elbow. They also will assess other areas of your body that may be affected or contributing to your pain.
They will perform special tests that detect any muscle weakness that might have led to the problem in the first place. Your physical therapist may ask you to gently tense or stretch the sore muscles. This will help them pinpoint the exact location of the problem. In some cases, they may refer you for an X-ray to aid the diagnosis.
Prevention Of Elbow Pain
- Always warm up and cool down thoroughly when playing sport.
- Make sure you use good technique and proper equipment when playing your chosen sports.
- Do strengthening exercises with hand weights your physiotherapist can prescribe the correct exercises for you.
- Avoid or modify work tasks that put excessive pressure on muscles of the forearm or that include the use of fingers, wrists and forearms in repetitive work involving forceful movement, awkward postures and lack of rest.
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Can This Injury Or Condition Be Prevented
You can help prevent tennis elbow by staying fit, using proper techniques in your sport or job, and using equipment that is designed well for your body type and activity level. Your physical therapist can show you how to achieve these goals.
If you had tennis elbow in the past, you may be at risk for reinjury if:
- Tendons did not have time to fully heal.
- Muscle strength and joint mobility were not fully restored.
- You have poor/improper hitting skills and racquet technique.
Returning to sports or activities before you have fully recovered can result in elbow pain that persists. It also can mean your elbow can be more easily or often reinjured. A physical therapist can help determine when you are ready to return to your activities and sports. They also can help make sure that your elbow, forearm, and wrist are strong and ready for action.
When To See A Healthcare Provider
The following symptoms should be discussed with your healthcare provider before initiating any treatment:
- Inability to carry objects or use your arm
- Elbow pain that occurs at night or while resting
- Elbow pain that persists beyond a few days
- Inability to straighten or flex your arm
- Swelling or significant bruising around the joint or arm
- Any other unusual symptoms
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Cause Of Tennis Elbow
Overuse
Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.
The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.
Activities
Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle.
Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.
Age
Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.
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What Is The Best Treatment For Tennis Elbow
As we alluded to earlier, the best treatment for tennis elbow, is the one that is tailored to your symptoms, activities and most importantly your goals. Many clients will ask does physio work for tennis elbow? and for most of our patients, luckily the answer is yes! Here is a list of some of the treatments you can expect from your Physiotherapist to help fix tennis elbow.
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