Lateral epicondylitis, or tennis elbow, is a common repetitive strain injury (RSI) of the flexor tendons resulting in pain in the forearm or elbow. And despite the name, repetitive workplace actions, not tennis, is the most common way to develop it. Approximately 1-3% of Americans annually suffer from tennis elbow. Yet despite the common occurrence of these types of injuries, understanding its cause is somewhat of a messy situation.
Why? For one, it’s rarely studied and poorly understood. Many unexplained tendon issues around the elbow are commonly labeled tennis elbow, the same way that pain on the bottom of the foot is broadly labeled plantar fasciitis without much investigation into its cause.
Although computer work can be an aggravating factor, it has little to do with causing it. Also, not everyone who does a job where the physical load is repetitive experiences tendonitis. Some factors can and cannot be controlled, making you more vulnerable to RSI, such as genetics, lifestyle habits, and even nerve conditions in the neck, arm, or shoulder.
What is tennis elbow? Tennis elbow is characterized by swelling and pain in the back of the forearm and near the outside of the elbow. It’s considered tendonitis but may not be the result of inflammation, at least not the way we think of it. When we think of tendonitis, we think of an inflammation of the tendon, but it turns out the most common symptom is muscle pain. This probably explains why anti-inflammatory medications do not help to alleviate the pain in long-term tennis elbow injuries. Hairdressers, Construction Workers who use vibrating equipment, Painters, Dentists, Cooks, and Musicians are just a few of the professions that are likely to develop tennis elbow.
What does tennis elbow feel like? The most commonly reported symptoms of tennis elbow are burning or pain near the outside of the elbow, weak grip strength, and numbness or tingling in the forearm. Picture the muscles on the hairy side of the forearm, those are the extensors of the forearm. The extensor tendons attach to the outside of the elbow, lateral epicondyle, and this is where the discomfort and pain is felt in tennis elbow.
How is tennis elbow treated? ICE and LESS OF THE OFFENDING ACTIVITY
ICE
Ice is often thought of as an effective treatment for inflammation; although there isn’t enough solid evidence to say whether or not it works on tennis elbow, it certainly can’t hurt. Just remember not to use ice directly on the skin or leave it for more than 20 minutes at a time.
ANTI INFLAMMATORIES
– As mentioned above, anti-inflammatory drugs have little effect beyond reducing pain at the initial onset of tennis elbow, but they aren’t without their usefulness. In addition to anti-inflammatory drugs, some people use topical analgesics, creating an opportunity for the pain to subside, so healing treatments like physical therapy can be used.
REST
Rest, one of the best forms of treatment for tennis elbow. Rest does not mean total inactivity, but if you can reduce the offending activity that is causing the injury, it will help speed up the healing process.
Physical Therapy
Physical therapy can be particularly helpful in treating tennis elbow by introducing baby steps to increase the extensor muscles’ load capacity gradually.
In some cases, steroid injections or surgery may be the only option, but these are rare. Especially considering that the long-term studies on the use of corticosteroids to treat tendinopathy are not positive due to the fact that, over time, corticosteroids eat connective tissue, they should be considered carefully.
What about massage? Massage has been shown to be helpful in reducing the pain caused by trigger points in the extensor muscles and tendons ( muscles on the back of the forearm) using long strokes from the wrist toward the elbow. Massage can also break down adhesions and increase local circulation within this muscle group and on the point of attachments of the elbow, the point most painful in tennis elbow. Massage also works on releasing the wrist and hand flexors, the muscles used in gripping something for they tend to be short and tight with repetitive use. The key is to start off with gentle pressure and then build up to slightly deeper but tolerable pressure.
What about a strap? There is a forearm strap or wrist extension strap you can wear which passively places the extensor muscles in a less lengthened or shorter position which will help to reduce the stress applied to the extensor tendons, during physical activity involving the hand and wrist.
If you’re looking to treat your tennis elbow in a non-invasive, cost-effective way, massage might be a great option for you. The easiest way to get started is to call me at (210) 705-0644 or email me at vikki@skillfultouchmassage.com.
