Recognizing the Signs: Symptoms of Tennis Elbow
Tom was an elevator technician who came to All Care Physiotherapy for pain on the outer aspect of his elbow. The pain had come on gradually over the last month after he had been doing longer hours at work. Tom also likes going to the gym 3 times a week to do weights but is struggling to do this currently because of his pain. After completing an assessment, Tom was diagnosed with tennis elbow, or lateral epicondylalgia.
What is Tennis Elbow?
Tennis elbow is the common term for ‘lateral epicondylalgia,’ which means pain over the area of the lateral epicondyle. The lateral epicondyle is a bony prominence on the outer (or lateral) side of the elbow and is the origin of the muscles responsible for bending your wrist back (called the wrist extensors). You also use these muscles when gripping and picking up objects.
The pain in tennis elbow arises when the tendons that join your wrist extensor muscles to your lateral epicondyle become damaged due to muscle overload. Contrary to what its name suggests, tennis elbow doesn’t just occur in tennis players! Up to 40% of people will experience the symptoms of tennis elbow at least once in their lives.
Due to the actions of the wrist extensor muscles, this often occurs with repetitive and prolonged use of your hands including:
- Sports: tennis, squash, badminton, weightlifting
- Occupations and Hobbies: carpentry, bricklaying, sewing, knitting and typing
After excessive use of these muscles, the tendon can start to change structure which results in pain.
Symptoms of Tennis Elbow:
Tennis elbow is typically identified by the following features:
- Pain over the lateral epicondyle that could be of gradual or sudden onset
- Increased pain with palpation/touching of the lateral epicondyle
- Increased pain with resisted wrist extension and resisted 2nd or 3rd finger extension (bending backwards)
- Pain increases with gripping and picking up objects
How Does All Care Physiotherapy Diagnose Tennis Elbow?
All of our All Care Physiotherapists are trained to be able to successfully diagnose tennis elbow. Our physiotherapists will first start by asking a series of questions about the type, onset and behaviour of your pain, any activities you do and will get a short history of your pain to date.
Next, our physiotherapists will complete a comprehensive assessment that may include:
- Range of movement of your elbow, wrist, neck and upper back
- Ligament tests
- Nerve mobility tests
- Grip and forearm muscle strength
- Muscle length
- Posture
So What’s Next for Tom?
Now that Tom has been diagnosed with tennis elbow, his All Care Physiotherapist began implementing his treatment plan. All Care Physiotherapists have a multitude of techniques and modalities to help manage tennis elbow, including:
- Advice and education on tennis elbow, and ways that you can help to manage the load on your tendons as you recover
- Soft tissue massage
- Joint mobilisations
- Dry needling
- Extracorporeal Shockwave Therapy (1 session per week for a minimum of 4 weeks)
- Taping or bracing
- Home exercises to improve the tolerance of the tendon to load, and to strengthen your forearm muscles
Tom had an intensive block of physiotherapy sessions over the course of 6 weeks which included all of the above treatment methods. After that, he had significantly decreased pain and had recommenced doing light weights at the gym. He continued with his physiotherapy treatment plan with ongoing sessions fortnightly, and over the next few months continued to improve to the point where he had no pain at work and was back doing his full gym routine again.