Tennis Elbow

Tennis elbow, medically known as lateral epicondylitis, is a common condition that involves pain and inflammation in the tendons that join the forearm muscles to the outside of the elbow. Despite its name, it’s not exclusive to tennis players and can affect anyone who repeatedly uses their wrists or forearms in a way that puts stress on the tendons.

Tennis elbow (lateral epicondylitis) is primarily associated with overuse and strain of the tendons in the forearm, but it can be related to or occur in conjunction with other conditions:Golfer’s Elbow (Medial Epicondylalgia: Similar to tennis elbow but affects the tendons on the inside of the elbow.

• Carpal Tunnel Syndrome: Repetitive hand and wrist movements can contribute to both tennis elbow and carpal tunnel syndrome.
• Cubital Tunnel Syndrome: Compression or irritation of the ulnar nerve, near the elbow, can be related to similar repetitive movements.
• Radial Tunnel Syndrome: Compression of the radial nerve near the elbow, which may be confused with tennis elbow due to similar symptoms.
• Inflammatory conditions: Arthritis including osteoarthritis and rheumatoid arthritis can affect all joints including the the elbow and can increase the risk of developing tendon related issues such as tennis elbow or generate symptoms which feel like tennis elbow.
• Bursitis: Inflammation of the bursa in the elbow may occur with or resemble tennis elbow.
• Shoulder Injuries: Problems in the shoulder can sometimes lead to issues in the elbow, including tennis elbow, due to compensatory movements or imbalances in the muscles.
• Neck injuries: Problems in the lower neck or upper back involving nerves can sometimes generate symptoms in the arm and around the elbow which can masquerade as tennis elbow due to the location of the symptoms.

The symptoms of tennis elbow, or lateral epicondylitis, primarily include:

• Pain and Tenderness: Often felt on the outside of the elbow, the pain might also radiate down the forearm.
• Stiffness: The elbow might feel stiff, especially in the morning or after periods of inactivity.
• Weakness: There may be a noticeable weakness in the forearm, affecting the ability to grip objects.
• Worsening with Activity: Pain and other symptoms often become more pronounced with activities that involve gripping, lifting, or repetitive use of the forearm and wrist, such as turning a DIY, shaking hands, or lifting a heavy object.

Tennis elbow, or lateral epicondylitis, is caused by overuse and strain of the tendons that join the forearm muscles to the lateral epicondyle, or the outer part of the elbow. Here’s what contributes to this condition:

• Sudden Increase in Activity Level: Jumping into an activity without proper conditioning or a sudden increase in intensity can cause strain on the tendons.
• Activities Requiring Gripping and Twisting: Playing tennis, particularly with poor technique, or engaging in other sports and occupations that require constant gripping, lifting, or twisting, such as using tools, painting, and carpentry.
• Repetitive Motions: Continual strain from repetitive hand, wrist, or forearm movements can cause small tears in the tendons, leading to inflammation and pain.
• Previous Injury to the Area: A history of injury or strain to the elbow or forearm can make the tendons more susceptible to tennis elbow.
• Improper Equipment or Technique: In sports like tennis, using the wrong racket, incorrect grip size, or poor technique can contribute to tennis elbow.
• Age: It’s more common in adults between 30 to 50 years old, possibly due to reduced tendon elasticity as people age.

The best treatment for tennis elbow (lateral epicondylitis) typically involves a combination of rest, physiotherapy to strengthen the muscles, over-the-counter pain relievers to manage discomfort.

In more persistent cases, corticosteroid injections may be considered, and the approach should be individualised with the guidance of a physiotherapist or injection-qualified healthcare professional.

For tennis elbow, you should initially consult with a physiotherapist, who will assess and create a rehabilitation program to improve your symptoms and get you back to the things you enjoy doing. 

Specific exercises guided by a physiotherapist are beneficial for tennis elbow, as they can help strengthen the muscles and tendons in the forearm, promote healing, and alleviate symptoms.

Surgery for tennis elbow is typically considered a last resort, used only when conservative treatments fail, and it can be effective in chronic or severe cases; however, it carries risks and requires careful consideration with an orthopaedic specialist.