Tennis Elbow – The Facts

It’s that time of year again when we all hope to hit sun drenched tennis courts. Unfortunately it also means that it’s the time of year for tennis related injuries.

One of the most common is tennis elbow (lateral epicondylitis), a pain on the outside of the elbow, which can radiate down into the forearm. This involves a sprain of the tendons of the forearm where they attach onto the bony ridge on the outside of the elbow. It can cause the local tendon tissue to degenerate and may have an inflammatory reaction. This can be a stubborn problem resulting in long lasting symptoms, which are resistant to treatment and, it can be brought on by any activity involving gripping, digging, hammering or even carrying a heavy case.

New research may have discovered another possible cause, which can improve assessment, treatment and outcome of many tennis elbow sufferers. It suggests that the nerve system can play a major role in this condition.

Often this pain is referred from the neck and upper back and has associated sensory symptoms such as burning, pins and needles and numbness. It can be persistent and unpredictable.

Irritation of this system can be caused by bad postures and unhelpful movement patterns sometimes related to poor ergonomics at work.

Cases of tennis elbow directly related to playing the sport have many possible causes including poor tennis training methods (especially incorrect backhand technique or excess wrist flicking during service), unsuitable rackets (often too heavy), wrong grip sizes (often too small), incorrect string tension and ball weight. Treatment will involve local electrotherapy, massage, acupuncture,stretching, exercising and strapping, which when applied appropriately can reverse the local mechanical degeneration and decrease the inflammatory changes. More importantly, therapists will also assess the patient’s total body posture. This includes both their stationary posture and movement patterns and will also often include an assessment of their nerve system.

From this assessment, treatment will be modified to include nerve mobilisation and often techniques directed to the spine and shoulder. Also, advice will be given to correct bad ergonomics at work and sports specific requirements will be considered. Therefore I hope that with appropriate holistic assessment and treatment we will all enjoy a long, hot, pain free summer playing the game we love.

Simple guidelines for good ergonomics at work:

1. Place your monitor directly in front of you rather than off to one side
2. Position the top of the monitor at eye level
3. Have the keyboard at a comfortable height to reach with bent elbows
4. Then set appropriate chair at correct height
5. Use a foot, hand and mouse rest
6. Learn to be ambidextrous with the mouse
7. Take regular breaks and stretch

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