What is Tennis Elbow?
Tennis elbow is a painful condition that can heavily impact your life. It happens when the tendons that attach at your elbow are overloaded, usually by repetitive motions.
Even though it’s named “tennis-elbow,” you do not have to be a tennis player to get it. It can be caused by repetitive motions as simple as typing or repeated gripping.
Conservative advice typically includes rest and over the counter anti-inflammatory medications. This advice can work if you don’t plan on going back to the activity that caused it in the first place. What if that’s not possible?
If conservative treatments do not work, many doctors suggest surgery. For those who do not want surgery, and those who simply prefer conservative treatment, there’s a better way. First, we have to dive into why it happens in the first place.
Why Tennis Elbow Happens
As mentioned before, tennis elbow happens when there’s overload in the tendons that attach to your elbow. These tendons also attach to your wrist, so any activity that you’re constantly doing with your hands can cause strain to these tendons.
One big cause of tennis elbow that many doctors don’t realize is shoulder weakness. Our society as a whole has started sitting and working at computers more often. This causes our shoulders to round forward.
This is a weakened position for the shoulders. What happens next? When you go to grip something, you start over-exerting the muscles in your elbow to help your hand grip the object. Try it. Grab something heavy, letting your shoulders slouch forward a bit, then pull the shoulders back slightly. Notice how the amount you grip with your hand changes?
Shoulder weakness is a leading cause in overusing the muscles of your forearm, leading to Tennis elbow.
What Tennis Elbow Feels Like
Tennis elbow most commonly feels like pain on the outside of your elbow. It bothers you with reaching out to grab something as light as a water bottle or bothers you when opening/closing your card door. Even if these are your symptoms, it could actually be something else entirely that’s contributing to your elbow pain. It’s important to know the difference.
What Else Your Elbow Pain Could Be?
Pain in the lateral elbow often gets quickly classified as tennis elbow. The problem is that without ruling certain conditions OUT, it’s often a misdiagnosis.
The most common misdiagnosis we see at our physical therapy clinic in Scottsdale, AZ is Thoracic Outlet Syndrome.
Thoracic Outlet Syndrome is a condition in which there are nerves entrapped in your neck or shoulder area that are giving you pain down the lateral arm.
The second issue you want to rule out is Cervical Radiculopathy. This means that there’s a nerve that’s getting irritated between the vertebrae of your neck. The lateral elbow area is where C5 and C6 nerve roots can cause pain to be perceived.
The good news is that you don’t often need imaging to rule these conditions out, you just need to find a good physical therapist.
Will Tennis Elbow Go Away?
If you catch it early on, Tennis Elbow can be fairly simple to fix. The problem occurs when it’s left untreated for a long period of time. Left untreated the tendons become very unhealthy and healing with conservative management becomes more difficult.
Also, if you plan on returning to the activities that you were doing that brought it on, it’s important to address the root cause, which as we mentioned earlier may in fact be shoulder weakness and postural issues.
Who Treats Tennis Elbow and How?
There are a lot of different treatment options for Tennis elbow. Physical therapy is the leading strategy for conservative management. A good physical therapist will also be able to help you rule out Thoracic Outlet Syndrome and Cervical Radiculopathy.
Your treatment will have exercises that load the tendons and muscles gradually to allow them to strengthen again without irritating them. You may also get a recommendation to use a brace.
Your treatment plan should also include addressing any shoulder pain or postural issues that are contributing to the development of your tennis elbow. This is extremely important and often left out. Dry needling is another physical therapy intervention that Mayo Clinic mentions as helpful in tendon repair.
If conservative management does not work, there are other procedures that are more invasive that could help.
- Injections: Platelet Rich Plasma or Prolotherapy are great treatments for Tennis elbow.
- Ultrasonic Tenotomy (TENEX) procedure. Your doctor uses a needle under ultrasound guidance to suction out the damaged tissue.
- Surgery. This is reserved for tough, non-responsive cases and involves removing damaged tissue.
Preparing For Your Appointment
Write a list that answers these question:
What makes it worse?
What makes it better?
Was there an event, or did it come on gradually?
How long has it been there?