A repetitive stress injury that is becoming more and more prevalent is tennis elbow. Not only limited to those playing tennis, recently it has become more common to those who do a lot of computer work. Plumbers, carpenters, hairdressers, weight lifters, and cooks; anyone that does a lot of repetitive wrist and forearm activity is also susceptible to this condition. Tennis elbow (TE) is an overuse and inflammation of the extensors of the wrist and hand; most commonly felt right below the bony prominence on the side of the elbow. Pain felt can vary from a dull ache, to a burning or sharp pain; weakness in the hand can also occur. The pain intensifies when motion is introduced, especially when extending the wrist, gripping and wringing motions. Muscles involved:
- Extensor carpi radialis brevis
- Extensor carpi radialis longus
- Extensor digitorum
These muscles are on the top of our forearms and are responsible for a good portion of the motion that takes place with our wrists and hands. When they get overworked, they can weaken and inflammation can occur. The bony bumps in that area cause also cause wear and tear over time on the muscles and can be a factor in TE.
What to do about it:
- Rest! The muscles and tendons are over worked, and what do we do when we as a whole are overworked? Rest, relax and take it easy. So why would it be any different for our elbow and forearm? Rest the area, the amount of rest time will vary from person to person, depending on the severity of the issue and how long it was been bothering you. If you keep doing the activity that aggravated it in the first place, it will not go away.
- Ice: Icing the inflamed region can help reduce pain, swelling and inflammation. Do not put the ice directly on your skin (wrap ice in a towel) and no longer than 15 minutes at a time.
- Anti-inflammatories:Like ibuprofen and aspirin have been known to reduce inflammation and swelling.
- Massage: Once the pain has decreased you can try massage with a professional therapist. They can work on the muscles of the forearm to loosen any restrictions, to aid in healing and recovery. In between sessions, self massage to the affected area can help. Try short 2 finger friction work back and forth over the area for a couple of minutes at a time, keep the pressure tolerable.
- Stretching (see below)
- Strengthening (see below)
- Other therapies: Forearm braces and Kinesiotape* can help rest the overworked muscles and reduce pain.
*Phila Massages can provide Kinesiotaping. If you are interested or have any questions about this service, please ask! [Edited to add by Phila Massages (2015): there is limited scientific evidence supporting the use of kinesiotape, see this article for more information. As such, Phila Massages no longer offers kinesiotaping and no longer recommends it for treatment.]
Stretching the muscles of the forearm is an important part of recovering from TE. Hold these stretches for about 15 seconds and repeat 2-3 times. As the pain decreases you can increase repetitions.
- To stretch the wrist extensors, hold your arm out straight and flex your wrist down. You can use the other hand to push down on the back of your hand to get more of a stretch.
- Stretching the muscles on the underside of the forearm is important too. To stretch the wrist flexors, hold your arm straight out and extend your wrist up. Again, you can use the other hand to increase the stretch. Push on the palm side back towards you.
There are also strengthening exercises to do once the pain and inflammation has decreased. Strengthening the muscles of the forearm will hopefully help keep the injury from re-occurring.
A couple of websites that have strengthening exercises for TE are:
- http://www.hughston.com/hha/a.seven.htm (viewed on 9/14/14)
- http://www.sportsinjuryclinic.net/sport-injuries/elbow-pain/tennis-elbow/tennis-elbow-strengthening-exercises (viewed on 9/14/14)
If these do not resolve the issue and you’re still having pain or you feel like you need more help, please seek a doctor, physical therapist or arm specialist. They can point you in the right direction.
References (viewed on 9/14/14):
-  http://orthoinfo.aaos.org/topic.cfm?topic=a00068
-  http://saveyourself.ca/articles/tennis-elbow.php
-  http://www.physioworks.com.au/injuries-conditions-1/tennis-elbow
-  http://www.hughston.com/hha/a.seven.htm
-  http://www.sportsinjuryclinic.net/sport-injuries/elbow-pain/tennis-elbow/tennis-elbow-strengthening-exercises
This article/video is for educational purposes only; do not attempt without your physician’s clearance. If you are in pain or injured, see your physician.
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