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Complete Guide To Tennis Elbow

Tennis elbow, also known as lateral epicondylitis is a discomfort felt in the tissue that connects the muscles of the forearm to the elbow. It is often caused by repetitive arm and wrist movements.

Despite the name, athletes are not the only ones that are susceptible to tennis elbow. Other people who can develop tennis elbow are those whose jobs entail repetitive arm movements such as plumbers, painters, carpenters, and butchers. Tennis elbow pain usually happens where the tendons of your forearm muscles connect with a bony bump on the outside of your elbow and it can also spread into your forearm and wrist. Tennis elbow is one of the reasons people often consult their doctors for elbow pain. It can affect anybody regardless of age, but it is commonly seen among people within the age of 40. 

Typical signs and symptoms of tennis elbow include pain, burning sensation on the outside of the elbow, and weak grip strength. Symptoms progress over time and may worsen over the incoming weeks or months. 

Causes of Tennis Elbow

Tennis elbow is often caused by overuse and muscle strains. The repeated contraction of the muscles of the forearm, which is in charge of straightening and aiding you in raising your hands and wrist also is also a cause. Tennis elbow often develops as time goes on. Repetitive movements such as gripping a racket during a swinging motion can strain the muscles and place an immense burden on the tendons. The frequent pulling and dragging will result in microscopic tears in the tendons that connect the forearm muscles to the bony part outside your elbow. Tennis elbow can be developed through the following sports:

  • Tennis
  • Racquetball 
  • Squash
  • Fencing
  • Weight lifting.

It can also affect people in certain professions that involve lots of repetitive actions. These include:

  • Making use of plumbing tools
  • Painting
  • Driving screws
  • Dicing and slicing up cooking ingredients, which include meat, onions, etc.
  • Repeated and constant use of the computer mouse. 

While overuse and repetitive movements or actions often result in Tennis elbow, other things can cause Tennis elbow pain. These include:

  • Blunt force on the elbow joint.
  • Direct impact on the epicondyle.
  • An abrupt forceful pull
  • Forceful extension of the arm
  • Repeatedly missing or mis-hitting a tennis ball in the beginning stages of learning the sport can cause shock to the elbow joint and may increase the severity of the condition.

Symptoms of Tennis Elbow

Pain is often the main symptom. It is commonly felt on the outside of the elbow and on some rare occasions, the forearm, and wrist. Symptoms of tennis elbow often include:

  • Discomfort on the outer part of the elbow (lateral epicondyle).
  • Feelings of tenderness in the lateral epicondyle which is an important part of the bone on the outside of the elbow.
  • Sharp and sudden pain from gripping and wrist motion, especially wrist extension (for example, turning a screwdriver) and from lifting movements. 
  • Swelling or inflammation in the lateral epicondyle. 

Symptoms also include discomfort and tenderness on the bony knob on the outside of the elbow. This knob is where the injured tendons are connected to the bone. The pain may also move towards the upper or lower arm. Although the discomfort is in the elbow, you might feel pain when performing certain activities such as:

  • Lifting objects.
  • Balling the palms into a fist.
  • Grabbing or gripping an object such as a tennis racket.
  • Opening a door.
  • Shaking hands.
  • Lifting the hands and straightening the wrist. 

Tennis Elbow Relief

The good thing about tennis elbow pain is that it often heals on its own. All you have to do is reduce the burden on the elbow and give it a break. However, there are things you can do to speed up the healing. Such treatment or relief include:

  • Icing the elbow: In a bid to reduce discomfort, irritation, and swelling, it is recommended that you place an Ice pack on the affected elbow for a duration of 20 to 30 minutes. Repeat this every 3 to 4 hours for 2 or 3 days until the pain is gone.
  • Using an elbow strap: You can also use an elbow strap to protect the affected tendon from further damage.
  • Taking NSAIDs (Nonsteroidal anti-inflammatory drugs): Drugs like Ibuprofen, naproxen, or aspirin help relieve pain. However, these drugs have adverse side effects like bleeding and ulcers. You should only use them once in a while, unless your doctor says otherwise, since they may slow down the healing process.
  • Performing range of motion activities: These exercises help curtail stiffness, paralysis and boost flexibility. Your doctor may ask you to perform the exercises 3 to 5 a day. 
  • Getting Physical Therapy: Through the aid and advice of a physical therapist, you can rapidly strengthen the elbow muscles.
  • Taking Painkiller injections or steroids: While steroids do more harm than good in the long run, they can be used to temporarily lessen the swelling and discomfort around the joint. Painkillers can also be used to alleviate the pain.

Tennis Elbow stretches

Below is some stretching exercise you can perform to stretch and strengthen the muscles:

Finger stretch

  • Touch your fingers to your thumb and hold them together with a rubber band, including your thumb.
  • Gently open your thumb and fingers all the way, then close them.
  • Repeat the action up to 25 times. 

Do this stretch 3 times a day. If you feel it’s too easy, use two rubber bands.

Wrist flexor stretch 

  • Straighten your arms while making sure your elbow is not bent. Make sure your palms face up.
  • Using your other hand, hold the fingers of the outstretched hand and bend it backward in the direction of your body until you can feel a stretch in your inner forearm.
  • Maintain the position for 15 seconds.
  • Repeat 3 to 5 times. 

Do this three times daily. You can hold the position for 30 seconds and slowly work your way up to repeating it 5 to 10 times daily instead of 3 to 5.

Wrist flexor/extensor strengthening 

  • Pick up a 1-pound dumbbell and take a seat.
  • Place your forearm on your thigh as a mode of support. You can also place it over the edge of a table so that your wrist hangs over the edge.
  • Hold the weight in your hands with your palm facing up.
  • Raise your hand slowly, then lower it at the same speed. Ensure your hand stays on your thigh as your hands bend up and down at the wrist. 
  • Repeat 10 times.

Tennis Elbow vs Golfer’s elbow

Tennis Elbow

Tennis elbow is a variant of tendinitis which is a swelling of the tendons. It often causes pain, discomfort, and irritation in the elbow and arm. The tendons are a group of tough tissues that act as a connection between the muscles of the lower arm and the bone. It is often caused by repetitive gripping activities, especially those that require the use of the thumb and first two fingers.

Symptoms of Tennis elbow include:

  • Pain and discomfort in the bony part on the outside of the elbow.
  • Tenderness, swelling, and inflammation of the elbow.

Golfer’s Elbow

Golfer’s elbow is an ailment that causes pain on the inner side of the elbow. It is often caused by excess or repetitive stress, which is often caused by forceful wrist and finger movements. 

Symptoms of golfer’s elbow include:

  • Stiffness or paralysis of the elbow.
  • Weakness of the hands and wrists.

Although Golfer’s elbow and Tennis elbow sound the same, the cause, symptoms, and treatment vary. In addition, a golfer’s elbow affects the inner side of the elbow, while the tennis elbow affects the outside of the elbow.

However, both conditions can be treated in the same manner which includes:

  • Adequate rest
  • Physiotherapy 
  • Acupuncture 
  • Stretching.
  • Pain relievers
  • And using an ice pack.

Tennis elbow treatment

Physical Therapy

Physical therapists are experts who enhance the quality of life through hands-on care, educating patients, and recommending movement exercises. Your physical therapist will determine if you need a brace or other forms of support to protect your muscles while you are in the healing process. Your physical therapist will also design a specific treatment program for you to hasten your recovery. It will include exercises, physical activities, and other former treatments that you can do from the comfort of your home. Ice and heat therapy and exercises may also be recommended. The exercises would aid you in improving your ability to move, enhance your strength, how to use your muscles the right way, and finally return to your daily activities.

Acupuncture

Acupuncture effectively treats tennis elbow by allowing the natural flowing of energy flow throughout the body. In the Traditional Chinese Medical beliefs, Qi (energy) flows through the body via pathways known as meridians. Using this principle, one can see tennis elbow as a river that has been blocked or dammed. Acupuncture treatment should be administered daily for about 3-5 days, before stretching it to 2-3 times a week spanning over several weeks. Often, several needles will be placed on the affected tendon and any other points on the body that reduce pain and inflammation. 

Surgery

Surgery is often recommended depending on the severity of the injury. Surgery gets rid of the affected tendon to alleviate pain and aid you in moving your elbow more easily. There are two types of surgery that can be done for tennis elbow, namely:

Open Surgery

In this mode of surgery, the surgeon makes an opening above the bone on the side of your elbow. The damaged piece of tendon is then removed and the healthy part is reattached to the bone. The surgeon might also remove a tiny piece of bone in your elbow to ease blood flow and boost the healing process.

Arthroscopic surgery

In this type of procedure, the surgeon makes some tiny cuts in the skin over your elbow. Some small instruments along with a camera go into the holes. The surgeon then removes the damaged part of your tendon. With either type of surgery, the openings are closed with sutures (a row of stitches) or some staples. It is then covered with a bandage or other dressing. 

Braces and compression sleeve

Using a supportive brace on your forearm may also aid in reducing the burden on the tendon’s face. Before you use a brace, speak with your doctor or physical therapist if you require one and the right kind of forearm brace that is suitable for you. You should ask your doctor if you can use a wrist splint at night before you go to bed. Wearing a compression sleeve will protect an injured elbow from further injuries. 

Exercises for Tennis Elbow

Below are some lists of exercises that can be used to relieve Tennis elbow pain. 

Fist Clench

Poor grip strength is also a symptom of tennis elbow. This exercise will help you increase your grip strength by building the muscles of the forearm.

  • Sit at a table while resting your forearm on the table.
  • Hold up a roller towel in your hand.
  • Squash the towel in your handholds for 10 seconds.
  • Release and repeat 10 times. Switch to the other arm.

Towel Twist

  • Sit in a chair while holding a towel with both hands, while making sure your shoulders are relaxed.
  • Twist the towel in the opposite direction with both of your hands as if you are trying to wring out water.
  • Repeat 10 times and do it in the other direction as well.

Wrist flexion

This exercise works on wrist flexors.

  • Sit in a chair while grabbing a 2-pound dumbbell in your hand while your palm is facing up. Ensure your elbow rests comfortably on your knee.
  • Keeping your palm in its upward position, flex your wrist by curling towards the direction of your body.
  • Return to the initial position and repeat 10 times on both sides.
  • Try to keep the rest of the arm still, making sure only the wrist performs the movement. 

Natural Remedies for Tennis elbow

Treating tennis elbow at home will help you avoid medical treatment and surgery. Below are some of the natural remedies that could work for tennis elbow:

Rest your elbow

This might seem like a simple treatment, but it can be quite effective if there is too much pain or swelling in the elbow area. Keeping your elbow at rest and refraining from performing activities that will prompt the pain and irritation.

Topical Treatment

In addition to resting, you can try a topical natural ointment that will decrease pain and increase mobility. Joint Mud is a good choice if you’d like natural ingredients and something that won’t stain your clothes. 

Place an ice pack on your elbow

Placing an Ice pack on the affected elbow can help in lessening the swelling and pain. Do not apply the ice directly to your skin as it would damage it. Wrap the ice in a cloth or a towel and place it on the affected part for 15-20 minutes. Do this 3-4 times a day.

Brace your elbow

Bracing your elbow and giving it support may be useful in lessening elbow pain. Although you can get braces in different stores, it is advisable to talk to your doctor so you can get the right one for you. You may also want to consider using products like KT tape (kinesiology tape). These tapes aid the muscles and tendons but don’t restrict movement as braces do. Elbow straps also give compression and support, so you have different options to choose from.

Conclusion

While it is called Tennis elbow, playing tennis is not the only way you can get it. Repetitive motions also result in tennis elbow pain.

If you feel any sudden pain in your elbow and you are unable to grip or grab objects, do not hesitate to contact your doctor and seek medical aid. You may also try the home treatment option which includes the ice and heat system, but if you do not see any changes, consult a medical expert.

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