Two terms that are synonymous with elbow pain and discomfort are tennis elbow and golfers elbow. Tennis elbow, medically known as lateral epicondylitis, occurs to the lateral aspect of the elbow. Golfers elbow, medically know as medical epicondylitis, occurs to the medial aspect of the elbow. The occurrence of tennis elbow is much more common than golfers elbow, with 80% of cases typically relate to tennis elbow. Therefore, for this we will talk more about tennis elbow.
Tennis elbow is caused through repetitive computer use, heavy lifting, and a majority of sports. More so, the repetitive wrist flexion combined with a rotation of the hand and wrist will lead to this overuse. Less than 5% of cases will actually be to tennis players, as the injury is brought on through the repetitive motion. Jobs that this typically occurs in is desk jobs, electricians, carpenters and gardeners to name but a few. This injury usually occurs in the age range of 35-50.
Three reasons why there is pain over the insertion site are well documented. Firstly, inflammation over the insertion site, however, this is only present in the early stages of the issue. Secondly, microscopic tears in the muscle can cause significant pain, whilst, if not treated properly can cause long term pain/disability. Finally, degeneration of the area can lead to this issue. This can’t be prevented and will just come on with age. Tennis elbow develops in four ways:
- Faint pain that is present a couple of hours after activity.
- Pain is present at the end of or immediately after activity.
- Pain present whilst completing activity, which intensifies after finishing that activity.
- Constant pain, which prevents any activity from being performed.
Treatment of Elbow Pain
There are a wide varieties of treatments that can provide a significant benefit to you and your symptoms. Examples for treatment are:
- Deep transverse friction massage (DTFM) – this is a technique that helps to invoke an analgesic effect within the tissues. It is performed by working across the tissue rather than working in the direction of the fibres. DTFM have been shown to increase blood flow to the affected area and can help to break down the scar tissue that could be present.
- Strengthening exercises – these should start off at a low intensity and progress through to more difficult exercises following a decrease in pain and an increase in function. Initially this will start with isometric contractions (simply put it is a contraction of the muscle without movement). This will progress onto harder exercises that will increase the stress through the joint. Progressions include an increase in the resistance throughout the exercise, a change in the length of the lever and how the muscle is working e.g. with or against gravity.
- Patient education – information surrounding possible exercises and activities that are performed during your activities of daily living that can exacerbate the symptoms you are already suffering with.
- Icing – following the RICE principles this will help manage your pain and swelling.