Tennis Elbow

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse and a form of repetitive strain injury. Not surprisingly, playing tennis or other racquet sports can cause this condition. However, several other sports and activities can also put you at risk.

Tennis elbow involves the degeneration (wearing down) or, in some cases, micro-tearing of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again, which leads to pain and tenderness on the outside of the elbow. ^[1]

Tennis elbow develops when the muscles and tendons in your forearm get damaged. This can happen if you’re repeating the same motion over and over again. Tiny tears develop in the muscles, and over time this leads to swelling and thickening.

You may be more likely to get tennis elbow if you:

• have a job where you’re doing a lot of heavy lifting or using heavy tools
• have a job where you’re making repeated movements in an awkward position – such as squeezing or twisting movements (eg typing and using a mouse)
• make forearm movements that you’re not used to – such as taking up a new hobby, doing DIY such as hammering or painting, or moving to a new house
• are unfit or have a poor technique when you’re playing racquet sports such as tennis – such as not holding the racquet properly ^[3]
• 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 or repetitive extension of the wrist and hand.
• 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 weightlifting required in these occupations leads to injury.
• 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 ^[1]

What can you do?

If you can, avoid repetitive movements of the elbow and hand.

• Painkillers if necessary – simple pain relief such as paracetamol and ibuprofen to reduce pain and inflammation are often enough
• Ice or heat therapy - Heat may be helpful in the form of a hot water bottle, wheat pack or hot shower. This can help to relax the muscles around your elbow and may allow exercises to be more effective.

For ice therapy use a damp cloth containing an icepack (or bag of frozen peas) over the top of the painful area to help numb the pain. Leave it on for up to 20 minutes and use up to three times a day.

• You should be cautious using these treatments if you have altered skin sensation or circulatory problems.
• Check the skin regularly during and after the ice pack application
• Stop if there is excessive pain, numbness or tingling
• Do not put ice directly on to the skin as this may cause a burn. ^[4]

For some conditions, such as tennis elbow, using a splint to support your elbow may ease the strain when you’re doing certain activities that cause it to flare up. They’re available from chemists, sports shops and physiotherapists. They’re also known as epicondylitis clasps. Ask a healthcare professional or a pharmacist if a splint would help you, and when and how you should wear it. ^[5]

Your pain should ease within 2 weeks and you should recover over approximately a 4–6 week period. You should carry on with the exercises overleaf for at least 6–8 weeks after the pain disappears to help prevent symptoms returning.

Bend your elbow at a right angle and hold out your hand, palm up.

Turn your wrist slowly so that your palm is now facing down. Hold for 5 seconds, and then slowly release.

Do 3 sets of 10 repetitions. ^[6]

Repeat the exercise while holding a light weight (e.g. a tin of beans). ^[6]

Bend your elbow at a right angle. Hold a light weight (e.g. a tin of beans), palm up.

Bend your wrist slowly towards you. Hold for 5 seconds, and then slowly release.

 Do 3 sets of 10 repetitions. ^[6]

Stand up straight and lower your arm to one side.

Bend your arm slowly upwards so your hand is touching your shoulder.

Hold for 15–30 seconds.

Repeat 10 times. ^[6]

Keeping your arm straight in front with your palm facing down, gently bend your wrist down.

Use the opposite hand to press the stretching hand back towards your body and hold for 15–30 seconds.

Straighten your wrist. Gently bend the stretching hand backwards and use the opposite hand to pull the fingers back. Hold for 15–30 seconds.

Do 3 sets with each wrist. ^[6]