A pain in the outside of your elbow when you lift something or twist your arm could be tennis elbow, otherwise know as Lateral Epicondylitis. Any repetitive or excessive use of the muscles that extend the wrist and fingers can result in degeneration of the muscle tendons.
A Little Bit of Anatomy
The most commonly affected muscle is Extensor Carpi Radialis Brevis, which allows you to extend your wrist. Other muscles that can be affected are Extensor Carpi Radialis Longus, Supinator (another wrist Extensors), Extensor Digitorum (extends the fingers), Extensors Digiti Minimi (extends the little finger) and Extensor Carpi Ulnaris (another wrist Extensor). This can also affect the muscles on the other side of the wrist that flex the wrist.
It was commonly thought that Tennis Elbow was an inflammatory condition. Recent research has shown that it is in fact a symptomatic degeneration of the tendon. As you load the tendon it responds by increasing cross linkages and depositing collagen. If the load or stress on the tendon is more than the tendon’s tolerance to stretch, then micro-tears form. When multiple micro-tears form this can lead to degeneration of the tendon, which is known as tendinosis.
Tennis elbow will affect between 1-3% of the population. The biggest risk factor is if you have had the tendon issue before. After that it appears to be most prevalent in the middle-aged population, with no preference to gender.
How to Fix it?
You may think that resting the injury will help it heal. While this will allow the tendon to recover and will reduce you pain, it also weakens the tendon and reduces it’s tolerance to stretch.
- Release the tight – you need to massage the tight muscles in the forearm, both the extensor and flexors. You also need to stretch the muscle to maintain the tolerance to stretch
- Shockwave Therapy
- Strengthen – tendons actually love being loaded; they just need the right kind of load to recover. Start with Isometric exercises first, that are relatively pain free.
- Get your posture checked – often the overload on the elbow is due to poor posture elsewhere.
- Modify you activities – to begin with you may need to modify how you are doing thing to help reduce the load on the elbow.
- Splints and braces – sometimes it is necessary to try a tennis elbow brace or even to use a wrist splint to limit the load on the tendons. See one of our expert physiotherapist to if it this is right for you.
Everyone will be different some will get almost instant relief while others will need to look at their posture and start to change that before they start to get relief. If you do nothing the research suggests that the condition is self-limiting, however it may take 12-18 months to resolve. Physiotherapy studies have shown greater improvement with stretching and strengthening than the traditional rest regime.
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