22 November 2019

Sharp elbows!

If you have had it, you will know it. Tennis elbow is a very painful problem. It is not, necessarily, anything to do with tennis but if your racket is too heavy, you use the wrong technique or play for the first time in a long time, you may find yourself suffering. Here is what you need to know to mimimise the risk or getting tennis elbow and to cope if you do...

Tennis elbow or to give it its full name, lateral epicondylitis, is a tendon problem. It involves the piece of tissue which attaches the muscles in your forearm to the outside of your elbow. If this tendon gets inflamed or develops small tears it will cause pain and tenderness on the outside of the elbow

Illustration from the Chartered Society of Physiotherapy

According to the NHS, tennis elbow is often an overuse injury, but it can also be caused by a knock or doing something you’re not used to doing like gardening, decorating or any activity involving gripping and twisting. Most common in those aged 40-50, it effects 1-3% of the population according to Bupa and usually develops in the arm you use most often. It should not be confused with golfer’s elbow which is pain on the inner side of the elbow.  

So what can you do? 

“Tennis elbow is a self-limiting condition, which means it will eventually get better without treatment,” says the NHS. But that may not be very helpful in the short term!

If the problem was caused by over-use, stop whatever you were doing and rest but maintain gentle movements so your elbow doesn’t get stiff says Bupa

Modify any movement that may be causing your symptoms says the National Institute of Clincical Excellence and lift objects with your palms facing upwards and elbows bent. This shifts the strain from the wrist extensors to the wrist flexors. 

Ice or heat: a bag of frozen peas (funny how no other vegetable seems to do the trick!) or a hot water bottle may help. Heat increases bloodflow, can ease stiffness and encourage recovery but should not be used if the elbow is swollen says Versus Arthritis. Ice reduces bloodflow and swelling. Alternating both may help but don't apply either directly to the skin!

The Chartered Society of Physiotherapy has illustrated exercises on a PDF you can print out here, including this:

Painkillers like paracetamol or ibuprofen

A support like an epicondylitis clasp, £5.99 from Amazon (see below). Wear it while you are playing tennis and it will provide mechanical relief to the overworked tendon according to an NHS leaflet

Acupuncture. Bupa says experts don’t recommend it because there is not enough proof that it works, and you might want to consult your GP or physiotherapist first, but it may work for some. Use an acupuncturist from a recognised professional body.

Carry on
Exercising. Continue with the Chartered Society of Physiotherapy exercises for at least 6-8 weeks after the pain goes to prevent the problem returning

Your GP if it’s not better after a couple of weeks. Physiotherapy may be offered or a steroid injection but this is a short term solution not a cure and NICE points out this may have side effects, including muscle wasting. Other options, such as shockwave therapy and platelet rich plasma injections, may help but these treatments need more research says the NHS. Surgery, in which the damaged part of the tendon is removed, may be offered as a last resort.


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