Lateral epicondylalgia/ epicondylitis, more commonly known as tennis elbow, is a tendinopathy injury, where the overuse of the extensor muscles of the wrist and forearm causes pain in the elbow.
These muscles all originate from a common region of the elbow and repetitive stress through the tendon, near the attachment into the humerus, causes pain, inflammation and swelling.
Only around 5% of cases of tennis elbow are caused from playing tennis! Repetitive activities, such as computer work, heavy lifting and fine wrist and hand movements, can lead to lateral epicondylalgia. Individuals may also develop tennis elbow due to poor biomechanics of the arm or technique while participating in arm and elbow dominant activities.
Anatomy:
The elbow joint is made up of 3 bones, the humerus (the upper arm bone) and the radius and ulna (forearm bones). The humerus has 2 epicondyles (bony prominences), one on the inside and one of the outside of the arm. The epicondyle on the outside (lateral) is where the extensor muscles (muscles on the back of your forearm, that help extend the wrist) attach to, with the most effected muscle being the extensor carpi radialis brevis (ECRB).
What causes the pain:
Overuse of the muscles and tendons of the forearm and elbow, together with repetitive contractions or manual tasks, can put too much strain on the elbow tendons. The increase in stress that is placed through this tendon causes micro-tearing of the tendon, leading to an inflammatory response. This inflammatory response causes an increase in inflammatory mediators, which results in swelling, pain and reduction in movement.
As the tendon continues to be overloaded, the tendon changes its cellular make up, leading to a tendon that is unable to work efficiently. As this condition continues, the inflammatory response reduces, and the condition may become chronic.
If the condition becomes chronic, the tendon goes through degenerative changes (think wear and tear). Unlike the inflammatory component of the condition, the affected tissues undergo a reduction in blood flow, as scar tissue develops. This weakened tendon tissue and degeneration within the tendon further exacerbates the pain and stiffness associated with the condition.
What can I do about this?
If you begin to feel some discomfort in your elbow coming on, try and have a look at the activities you have been doing recently. Have you increased your computer work, work around the house such as hammering nails, cleaning or activities that require gripping such as tennis or playing the drums? If you can find a reason this may be coming on (aka the aggravating factor), reducing how often or the intensity to which you are doing this activity can help provide a break in the cycle of aggravation.
Additionally, ensuring you are properly warmed up prior to any activity and being mindful of maintaining good form and using the appropriate equipment while doing the aggravating task(s), can help reduce the progression or development of this condition.
If altering your activity doesn’t work, our practitioners at Retrain Health may be able to help. Treatment for tennis elbow may include hands on manual therapy, dry needling, activity modification, biomechanical changes, or referral for additional management strategies, such as cortisone injections (where required).
If you have further questions around this condition or about any of the treatment options give us a call on (02) 6680 7447.
Retrain Health is based in the Northern Rivers, NSW. From our Byron Bay and Ballina clinics, our team provides a range of quality healthcare services and products.
Retrain Health offers osteopathy, remedial massage and strength and conditioning sessions with qualified practitioners.
If you are interested in finding out more information or would like to book an appointment, please contact the clinic by phone (02) 6680 7447, send us an email or click here to book an appointment online.