What is Tennis Elbow?
Lateral Epicondylopathy, or Tennis Elbow as it is commonly known, is the term used to describe a painful condition of the outside elbow. This pain usually occurs as a result of overuse of the tendons in your elbow, from repetitive motions of the arm and wrist.
The body employs a range of muscles to move the wrist joint, many of them start at the elbow. When the elbow is straight, the main muscle which stabilizes the wrist is called the Extensor Carpi Radialis Brevis (ECRB). Repeated or over-use of the ECRB makes it weaker and may cause tiny microscopic tears to appear in the tendon at the point of attachment to the outside of the elbow (lateral epicondyle). As a result, you experience pain and tenderness. The location and orientation of the ECRB, near bony bumps, increases the likelihood of damage from wear and tear. When the elbow bends and straightens it can cause the muscle to rub.
There are 3 zones where the ECRB can become injured:
• Where the tendon meets the bone
• Where the muscle meets the tendon
• Within the muscle itself
The amount of time it will take you to get better is very much connected to which zone you have injured. Also, over time, the body often compensates by using other muscles instead. In the case of the Tennis Elbow - this is most often the Triceps muscle.
Although Tennis Elbow can occur as a result of a sudden injury it is usually due to a slow build up of damage to or overload to the muscle and tendon around the outer elbow region.
What are the Symptoms of Tennis Elbow?
In most cases, the pain develops slowly and gradually over weeks and months in the elbow area. It is less common for the symptoms to occur suddenly.
The pain can be anything from mild discomfort to severe, and it may affect your sleep. It will increase when forcibly trying to stabilize or move the wrist.
Your pain will feel worse when:
• Shaking hands
• Using tools
• Gripping objects e.g. cutlery, pen, computer mouse
• Fully extending your arm
• Turning a door knob
Although Tennis Elbow is more likely to occur in your dominant arm, it can in fact occur in either arm.
Who is Prone to Tennis Elbow?
Evidence shows that only 1-3% of the population suffers from Tennis Elbow.
Men between the ages of 30-50, tend to be the most affected. Those who play tennis or other racquet sports on a regular basis are at a higher risk (as high as 50%) of developing this condition, however in 95% of cases it occurs in people who are not tennis players.
Anyone who participates in activities that require repetitive and vigorous use of the forearm muscle, especially while gripping something, are more susceptible to this condition. This broadens its reach to a variety of professions: cooks who chop, cleaners who vacuum, butchers, gardeners, assembly- line workers, bowlers and golfers.
If your forearm muscles are unfit and you suddenly start to play a racquet sport or take on a new DIY project, you are also more likely to get Tennis Elbow.
TRIGGER POINT SELF TREATMENT TECHNIQUE:
This technique involves locating the heart of the trigger/tender point. When this is compressed it may well trigger a specific referred pain map (preferably reproducing your symptoms). This technique involves applying direct, gentle and sustained pressure to the point:
1. Identify the tender/trigger point you wish to work on (as shown in the illustration below)
2. Place the host muscle in a comfortable position, where it is relaxed and can undergo full stretch.
3. Apply gentle, gradually increasing pressure to the tender point until you feel resistance. This should be experienced as discomfort and not as pain.
4. Apply sustained pressure until you feel the tender point yield and soften. This can take from a few seconds to several minutes.
5. Steps 3-4 can be repeated, gradually increasing the pressure on the tender/trigger point until it has fully yielded.
6. To achieve a better result, you can try to change the direction of pressure during these repetitions.
TRIGGER POINT SELF HELP - ADVICE
There are many reasons why you might have trigger points, so it is important to consider your trigger point pain in the context of the rest of your body. It must be stressed that the techniques offered on this page are not a substitute for therapy from a qualified practitioner; although aches and pains from trigger points are common, there can sometimes be an underlying pathology. It is advisable to always seek a proper diagnosis from a qualified medical practitioner or experienced manual therapist.
Stretching is an important part of the rehabilitation process and should begin as soon as pain allows and be continued throughout the rehabilitation program and beyond - Good maintenance prevents re-injury.
• Hold the arm straight out before you with the palm facing up
• Stretch your fingers downwards
• With the opposite arm, pull fingers towards you for maximum stretch
Hold for 20-30 seconds and repeat 3 times, twice daily