Tennis Elbow Physiotherapy

Tennis Elbow Physiotherapy

Overview

Tennis elbow (lateral epicondylalgia) is a condition in which the tendons attaching at your elbow become inflamed and painful due to repetitive wrist movements. The main muscles involved are the wrist extensors (especially extensor carpi radialis brevis).

It is a common condition among people who perform repeated wrist extension daily. This repetition is caused by scenarios such as sporting activities (tennis, badminton), work (carpentry, sewing) as well as working on a computer for desk duties.

Diagnosis

Diagnosis of tennis elbow is based off these main presentations:

  • Pain on grip
  • Pain on resisted wrist or middle finger extension
  • Tenderness on palpation over the common wrist extensor origin (where the pain manifests over the lateral elbow).

It is essential to rule out neurological involvement, thus booking in for an assessment by a qualified physiotherapist is strongly encouraged.

Treatment

Treatment of tennis elbow must involve a multi-faceted, combined treatment plan. This includes:

  1. Load Management: initial rest is integral in decreasing inflammation and pain. Thus, continuing with usual activity and routine will only maintain or worsen your symptoms. Relative rest is important – thus, you are not expected to do nothing. However, avoiding aggravating factors is expected (minimise lifting, reduce upper limb sports, protect whilst at work).
  2. Mobilisation with Movement: this is a technique performed by your physiotherapist in which they gently mobilise your elbow joint whilst you perform an aggravating movement (eg. grip or wrist ext). Evidence has demonstrated that a single application of this has resulted in an immediate increase in pain-free grip strength.
  3. Strengthen, Don’t Stretch: a common misconception is that stretching is beneficial for all injuries – this is false! Stretching will only aggravate the already inflamed tendons, thus this must be avoided. A graded- eccentric strengthening program is proven to assist with greater pain relief and functional improvements, as discussed here.

Summary

  • Tennis elbow is a condition of which the tendons attach at the elbow become inflamed and irritated – causing pain and weakness.
  • A multi-faceted physiotherapy treatment approach is required to effectively rehabilitate the tendons to pain-free function.