Help! I have Tennis Elbow, What Should I Do?

Help! I have Tennis Elbow, What Should I Do?

It is tennis elbow season here on Waiheke Island. Tennis elbow pain is basically pain on the outside of the elbow.

The crazy thing is it is pretty rare to see it in a tennis player. Although tennis is going off on the island and shout out to coach Able for getting more people excited about tennis. At this time of the year when the garden is going crazy you are more likely to see it with line trimming, pulling weeds out or trimming the hedge. 

Tennis elbow or if you want to get technical “lateral epicondylosis” is effectively a gripping issue. Shaking hands, picking things up, holding a jug, hitting a backhand and even opening a door can be painful when they are irritated. When they are very painful they even hurt at night especially when you straighten your arm. 

So what causes it? 

A muscle called extensor carpi radialis attaches  to your wrist to provide stability when you grip something. The other end of the muscles attaches to your outside elbow and is the tendon.

When you are gripping repetitively with your wrist in an awkward position it overloads the tendon in the elbow. If it continues the tendon starts to fill with water and cells begin to become active. This reaction is extremely painful. The problem is if you keep doing this for long enough the tendon can begin to start degenerating. This starts to swell and make your arm sensitive to anything.

So how do you fix it?

The bad news is a 4 month recovery is considered awesome and a year recovery is considered average. The below protocol means it is more likely to be the quickest way out of the injury. 

The solution involves a few parts 

  • Reduce the load on the tendon

You need to understand what movements will normally flare it which is normally picking something up, wrist palm down with a straightish arm.

Turning your palm up to use more of your bicep helps reduce the load through the tendon. You can also use the optimal grip position which is a slight extension of your wrist. 

Trying to use your other arm more for a few weeks is also helpful and understanding the ideal grip position when lifting something.

See the below picture and notice how the wrist is slightly extended to pick something up.

 
 
 
  • Restore function to your tendon


We here at our Oneroa Physio clinic use a very systematic process to rebuild the tendon and because tendons' bloody supply is average they are slow to heal BUT exercise is the fastest way to fixing the tendon unfortunately. Cortisone injections are old school and a bad idea. They reduce the quality of the tendon and you only get one of them. PRP blood injections are experimental so you’ll have to trust me on it.


Where most people go wrong is they do the same exercises every week. You need to lift heavier every couple of weeks to stimulate growth and reduce pain. 


A big part of our job is to keep you accountable along the journey.

These are two of the exercises we prescribe early. When you contract your wrist gripping the band for 5 x 30 -45 seconds it has been shown to reduce pain. Try these two at home. Just remember they must be completely pain free!

 
 
  • Taping and braces

When they are really acute we have two tapings we like to use. One is quite “hard core” and looks like you’ve just had surgery and the other is lighter. Some people prefer one and some prefer the other. There is no right answer but one will work. I also encourage bracing to get out of the really painful stage.

 
  • Strengthen your upper body or stretch it.

There is a correlation between neck stiffness and pain, shoulder weakness or stiffness and weak tricep muscles. Our job is to find what that issue is, speed up the process with our hands or acupuncture needles then give you the right exercises to speed it up.

  • Fix any mechanical issues you may have with your body.

Believe it our not, due to old injuries, habits and muscle imbalances in our body, our elbow can be the victim of what isn’t working in the rest of the body. Sometimes we need to address this to fix the issue.

There are other sources of pain around the elbow such as the joint, the radial nerve and your neck. So if you’re having random pains like pins and needles or burning it is not tennis elbow. 

If you’re reading this you aren’t alone. It is one of the most common injuries for people over 30. It is really common on islands where everything grows like crazy and in our local tradies who basically grip things all day long for a job.

If it’s not getting better and you’re starting to get frustrated with it book online here and we’ll get you a plan to get it sorted within 4 months and not a year! 








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