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Tennis Elbow Causes, Symptoms, And The Best Treatment

Tennis elbow or it’s medical name lateral epicondylitis is a frequent injury to not only tennis players, but also weight lifters and anybody that grips objects frequently.  We see this injury so often in our Denver clinic that we wanted to answer many of the most common questions around tennis elbow.


What is tennis elbow (lateral epicondylitis)?
Tennis elbow is an inflammation of the wrist extensor tendons that attach to your lateral arm (this is if you are standing in anatomical position with your palms facing forward).  These elbow tendons are attached to the muscles that pull back your wrist.  The injury became associated with tennis players as they frequently pull their wrists back when they are hitting backhands and irritate the tendons in the elbow.  However, once the tendons are irritated many day to day tasks may be affected like opening jars, gripping and lifting things, and even shaking hands. When the tendons are inflamed and injured inflammatory fluid invades the area to try to heal the injury but when it surrounds the tendons and nerves in your lateral elbow it can make it painful to use these tendons and grip or move your wrist. 


What causes tennis elbow?
It is basically an overuse injury, but that is likely oversimplifying it just a bit, because if it were that simple you could just stop your activity, rest it, and it would go away.  You have likely tried that and discovered that this didn’t get rid of your injury and your good old friend “pain” was still there when you tried to use your wrist again.  That is because the injury likely occurred because there was a muscle imbalance somewhere.  For tennis players many times this is a relative weakness in their rotator cuff for what they are trying to do.  It’s important to realize here that we are saying relative weakness.  You may be strong, but just need to be stronger for what you want to do and the demands you are trying to place on your body.  It can also be a technique issue or that you are just underutilizing other areas of your body.  For example in a tennis player that is hitting that backhand and they are as strong as they need to be, maybe they are not swinging enough with their shoulders or hips and therefore are using their wrists more than they need to.  This would overwork and overuse the wrist muscles and tendons which eventually would cause pain and an overuse injury. 


How do you know if you have tennis elbow?
Symptoms of tennis elbow include: pain over the lateral elbow, pain on the muscles and tendons over the lateral elbow are painful if you rub over them with some pressure, pain with gripping, pain with pulling your wrist backwards against resistance, weak grip strength.  You don’t have to have all of these symptoms to have tennis elbow and these are only the most common symptoms. 


What does tennis elbow pain feel like?
The pain from tennis elbow is usually sharp with specific movements like gripping or pulling the wrist back against resistance.  After the pain has been around for a couple of days an aching or throbbing pain can occur much of the day.  Because there is a nerve near the tendons the pain can get quite intense.  Prolonged inflammation of a nerve can cause damage so you do want to get this checked out by your physical therapist sooner than later. 


How long does tennis elbow take to heal?
If you read online you will see a common time frame thrown out of 6-8 weeks.  However your individual timeframe really depends on what caused the injury in the first place.  I have treated patients (that received care somewhere else first) that have had this pain for 6+ months and even one severe cause that had it for 2 years before we started working together.  Our usual time frame in the clinic is around 5 weeks to get you back to everything you love to do without pain. 


What is the Best Treatment for Tennis Elbow (lateral epicondylitis)?
Physical therapy is the suggested treatment for tennis elbow.  Some doctors will suggest a cortisone injection.  However, this only calms down the inflammation and doesn’t do anything to work on what caused the inflammation in the first place.  Physical therapy will work on both.  You will see other players with braces or straps around their wrists that claim it helps with their pain.  And it does.  It does this by changing the anchor point on the wrist and causing the wrist muscles to not have to work as hard.  The other thing this does.  Makes your muscles weaker as they no longer have to work as hard.  Then when you try to play without it and now weakened muscles the pain comes back and you now have to play with the brace again.  Braces are fine if you are just going to use them for a short period of time or during a short period of the rehab process but shouldn’t be used long term. 


How do I fix tennis elbow?
See your local physical therapist who will perform hands-on treatments to reduce the pain and help your muscles and joints move more smoothly. They may also give you things like kinesiotape to aid in reducing the tension and pressure on the tendons when you leave.  A simple (3-5 exercises) home exercise program should be provided so you can start working on not only reducing the pain, but to start to address any muscle imbalances that could have caused this in the first place.  If necessary they may also work with you on form and technique issues or contact your coach to help you. 

If you would just like more information consider reading our free tennis elbow download:

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