RALLY
Get back in the game by treating the pains of tennis elbow.
As is often the case with medical conditions, “tennis elbow” is a simple title for an issue with a much longer name, lateral epicondylitis. This condition prompts pain along the outside of the elbow that can radiate down the backside of the forearm to the wrist. Discomfort generally occurs with gripping and extending the wrist, as if hitting a backhand shot in tennis.
Tennis elbow commonly affects individuals who perform forceful grasping, lifting and small hand movements like sewing. It can be caused from a single, acute injury like pulling the starter cord on the lawn mower, or from chronic overuse activities like doing assembly line work. Because it can act up when gripping, this condition makes lifting items a challenge.
Acute cases of tennis elbow can be treated best by starting with the basics, like rest, icing and light stretching. Try rubbing an ice cube on the area until the cube melts (about 5-7 minutes). To stretch the affected tendon, make a loose fist with your palm down and your elbow out straight in front of your body. With the opposite hand, gently pull the hand down to stretch the forearm.
Chronic cases are a bit more difficult to treat and might require intervention from a medical professional. Physical therapists can offer various treatments for the pain and help with restoring normal function, including strength and range of motion. Anti-inflammatory interventions may not be as effective, as many chronic instances are from an accumulation of fibrosis in the muscle or tendon. Fibrosis is essentially very small areas of scar tissue that form over time as a result of a minor injury. These minor, repeated injuries are caused by overloading the muscle and tendon without giving the tissue ample time to heal. As the scar tissue is formed, it gets reinjured before it has time to mature, which stimulates the body to make more. The presence of this scar tissue in the muscle and tendon causes limited function as the arm muscle contracts during use.
A new treatment for chronic tennis elbow is available through specially trained physical therapists. Augmented soft tissue mobilization (ASTYM) was developed to assist and stimulate the body in remodeling and absorbing the excess scar tissue. It is also used to treat other forms of tendonitis.
Counter pressure braces are commonly prescribed for both acute and chronic cases of tennis elbow. These bands have a small pad that is placed on the forearm muscle near the area of pain. This brace should not be used as a cure, but rather for helping get through a rough time while maximizing the use of the arm.
In severe cases, surgery may be recommended to treat the excessive scar tissue and allow proper healing of the tendon. Rehabilitation following surgery usually lasts 1-3 months depending on the needs of the patient. The more demand expected on the arm, the longer the therapy generally lasts.
A similar condition, called radial tunnel syndrome, has comparable symptoms and can be caused by the same stresses. Weakness and pain in the hand, wrist and forearm are common symptoms. Counter pressure braces can actually make radial tunnel syndrome worse. Numbness and tingling are usually not symptoms of this condition since the nerve affected does not provide significant sensory responsibilities.
If you think you may have tennis elbow, start with icing and stretching as described above. If your symptoms last longer than 2 weeks, contact your physician or physical therapist to have an evaluation and start some more in-depth treatment.
