Tennis elbow | A common cause of lateral elbow pain.

Do you have pain on the outside of your elbow? Does it flare up when you grip or lift things with your wrist? Then you may be suffering from lateral epicondylitis (Tennis elbow).

Lateral epicondylitis or Tennis elbow is a common condition where patients present with pain on the outside of the elbow. It is typically considered an overuse injury commonly caused by repetitive strain involving wrist extension, radial deviation and/or forearm supination.  When the wrist and forearm is subjected to increased load and repeated gripping and/or wrist extension, sometimes the muscles that are typically involved in wrist extension are unable to keep up with the demands of the load. As a result, the muscles will tighten and subsequently pull on the adjacent tendon that attaches to the common extensor origin located on the lateral/outside of the elbow. This usually causes pain and discomfort.

 This kind of injury/condition can commonly be seen in activities that require twisting, gripping heavy objects and where the wrist is subjected to long periods of extension e.g keyboard typing. It is usually as result of poor mechanics and technique or improper use of equipment. Activities such as tennis, badminton, squash, and builders, and office workers are the most noticeable ones that present with this condition.

Patients with Tennis elbow usually present with:

• Pain with insidious onset 
• Pain over the lateral side/outside of the elbow 
• Pain that is precipitated by an acute injury or strain 
• Mild to severe pain depending on the activity/movement 
• Occasional tenderness over the common extensor origin 
• Reproduced pain with resisted wrist/finger extension and/or supination/turning the wrist inwards

In most cases, Tennis elbow will resolve itself over time with rest, activity modification and anti-inflammatories. Although, acute cases of lateral epicondylitis can progress into chronic cases and worsen over time if not treated and managed properly. This is where active rehabilitation and lifestyle modification is required.

Here are some common exercises that can be prescribed that may help you lateral epicondylitis (Tennis Elbow). This is general advice only and not to be substituted for personalised medical advice.  

• Extend your affected arm straight out in front of you with your palm face down, and drop your hand towards the floor. 
• With your other hand, apply a gentle pressure to the back of your wrist and hold. 
• You should feel this stretch down the back of your forearm.
• Perform for 30 seconds for 3 sets.
• Take a minute break between each set.

• Have your forearm supported on a table and allow the wrist to hang over the edge.
• Find a dumbbell that is 1-2kg, make sure the weight is challenging but not too difficult.
• Starting in the flexed position where your wrist is pointed down, extend the wrist up and then slowly lower the wrist all the way down.
• Perform 3 sets of 10 with a minute rest in between each set.

If you’re experiencing pain or had a recent flare up of an old injury, we recommend you consult with one of our Osteopaths to find out the “do’s and don’ts” depending on the severity of your injury as there is no ‘one size fits all’ with treatment plans.

References:

1. Buchanan BK, Varacallo M. Lateral Epicondylitis (Tennis Elbow) [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431092/

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