Tennis Elbow – What is it? And why you can get it even if you don’t play tennis!

What is it?

Tennis elbow, clinically termed lateral epicondylitis or elbow tendonitis, is a degenerative condition of the tendons that attach to the outer side of the elbow. These tendons anchor the muscles that are responsible for extending the wrist, which brings the back of the hand towards your forearm.

Tennis elbow mostly affects adults between the ages of 30 and 60 and not just those involved in racquet sports. Many individuals are involved in recreational or work activities that overuse the forearm muscles such as with typing, golfing, pruning, or painting.

The term lateral epicondylitis describes the origin of the tendons at the elbow, at the lateral epicondyle, with “itis” implying inflammation. However, current research is showing that there is actually no evidence of inflammation. According to Brukner and Khan’s studies, symptomatic tissue under a microscope shows no acute inflammatory cells but rather a disorientation and disorganization of fibres (see link below). Therefore the terminology used should change. We should stay away from using epicondylitis and start using epicondylosis, which describes a degeneration of the tissue without inflammation. Similarly we should use the term tendonosis instead of tendonitis. There may be a brief period of tendonitis in the acute stages of a tendon injury, but clinically, patients usually seek help when the condition is already chronic.

www.clinicalsportsmedicine.com/articles/common_tendinopathies.htm

What are the Symptoms?

Most common symptoms include pain in the elbow with or without pain down the forearm, tenderness, weakness of the wrist, and stiffness of the elbow joint.

How is it Diagnosed?

A physiotherapist will start off by asking questions about your medical history and review your daily activities. A physical examination looking at range of motion, strength, and areas of tenderness will also help in the diagnosis. If the injury is due to use of a computer, a racket, or golf club, the physio may ask to see how use them.

How is it Treated?

Tennis elbow can take weeks even months to recover and your physiotherapist has all the right tools to treat it. Treatment includes modified rest, manual therapy, and specific stretching and strengthening exercises. Modalities such as ultrasound and ice can also be used. Education on modified rest, the proper desk/keyboard set-up, and proper gripping are also an essential part of recovery. There are elbow braces on the market that a physio can recommend if needed.