Tennis elbow, also known as lateral epicondylitis, is characterized by pain on the lateral (outside) of the elbow due to degeneration, tendonosis (non-inflammed degeneration of a tendon) or periostitis (inflammation of the periosteum of the bone). It affects the extensor carpi radialis brevis and the extensor digitorum communis. Tennis is elbow is actually the most common overuse injury of the elbow and accounts for almost 90% of the tendonitis of the elbow. Tennis elbow is most commonly found in tennis or other racket sport players, sometimes in golfers,carpenters, mechanics, plumbers….basically anyone who uses their arms on a regular basis.
Patients with this condition may experience gradual development of pain in the elbow, especially in the morning or after a long rest. Many people experience pain on grasping or gripping things. Typically, during a physical exam, there will be tenderness around the lateral aspect of the elbow, especially where the tendon attaches. Usually there is no swelling and range of motion is only affected when the elbow is completely extended. Some patients may experience increased pain with resisted wrist extension and flexion or with flexion of the middle finger.
This condition can be managed effectively with conservative treatment, but it may be slow to respond. In the initial stages, the elbow should be rested and repetitive activities (such as lifting, gripping, or twisting of the elbow) should be avoided. Ice will help reduce the inflammation and decrease the pain. There are usually many trigger points throughout the extensors of the forarm, so massage therapy or myofascial release is beneficial. A Chopat strap or tennis elbow wrap can also be beneficial. Electrotherapy or ultrasound may also be beneficial.
Two to three months after the acute phase of this condition, manipulation of the elbow should be administered (see your local chiropractor!) and continued massage therapy and ultrasound. Home exercises of various stretches of the extensor and flexor muscles of the arm should be done on a regular basis. Graston is also a great tool for treating this condition because it can break up adhesions that have formed in the muscle and tendon. It usually provides a little more friction for the massage and helps blood flow get to the area more easily to promote healing. If any scar tissue has formed, it helps to break that up.
Generally, this condition can be resolved in less than 3 months with the appropriate treatment. So if you think you may have this condition, you should contact your local chiropractor and get an evaluation!