Physiotherapy Management for Tennis Elbow

Tennis elbow has another name: lateral epicondylitis. It is a more accurate name for the condition as it better describes it, and (surprise!) reduces the stereotype that only people who play tennis get it.

Lateral epicondylitis starts as an inflammation of the tendon (where muscle meets bone) of the muscles at the back of the forearm. Progression of the condition is marked by degeneration and micro tearing of the affected tendon.

Individuals who suffer from lateral epicondylitis typically feel pain over the outside of the elbow. The pain is usually mild at first, starting a few hours after the aggravating activity. The intensity and duration of the pain increases with the progression of the condition which can lead to constant pain that prevents functional activity altogether. There are also cases of complaints of a loss of grip strength and/or tingling sensation in the fingers of the affected arm.

Repetitive and overuse of the affected muscles can cause lateral epicondylitis. Other than racquet games, activities such as typing, weight-lifting and prolonged gripping can cause lateral epicondylitis.

However, it is important to note that not all the pain over the outside of the elbow are caused by tennis elbow or lateral epicondylitis. Some of the differential diagnosis for lateral epicondylitis includes:

• Elbow bursitis

• Cervical radiculopathy

• Posterolateral elbow plica

• Posterolateral rotatory instability (PLRI)

• Radial nerve entrapment

• Radial tunnel syndrome

• Occult fracture(s)

• Capitellar osteochondritis dissecans

• Triceps tendinitis

• Radiocapitellar osteoarthritis

• Shingles

Due to the pain and inconvenience caused by the condition, it is important to seek treatment. General practitioners are likely to prescribe anti-inflammatories and painkillers to improve the symptoms of the condition. While medication and rest can help to reduce or even stop the pain in a few cases, it is advisable to see a physiotherapist.

Other than a full assessment to identify the root causes to your pain, physiotherapists can use the following method(s) to help you to recover from, and prevent future episodes of lateral epicondylitis:

• Personalized exercise program: Often neglected, strengthening & stretching of the relevant muscles are often considered the most effective components of recovery from lateral epicondylitis

• Soft tissue release External pressure to aid in the relaxation of the affected muscle(s)

• Joint mobilization Prolonged muscle can cause stiffness in the joints

• Ergonomic advice Better positioning can help to prevent recurrent injury

• Modalities (such as heat or cold packs, dry needling etc.) Depends on each individual’s condition - do discuss options with your physiotherapist

Feel free to contact our physiotherapy team if you have further questions on lateral epicondylitis!