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Conditions: Advice

Tennis Elbow, Courtyard Clinic © 2011

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Tennis Elbow

What is Tennis Elbow?
Tennis elbow occurs when there is damage to the muscles, tendons and ligaments around the elbow joint and forearm. Small tears, called micro tears, form in the tendons and muscles which control the movement of the forearm. They cause a restriction of movement, inflammation and pain. Tennis elbow does not only affect tennis players who of course frequently strain the muscles in this area. It is also caused by other sports and by work or hobbies that involve repetitive movements. Movements where the elbow is bent while holding tightly onto something such as a racquet or a tool, are the most common causes of tennis elbow.

What does tennis elbow feel like?
Tennis elbow usually starts with gradually increasing pain on the outer side of the elbow. It is painful if someone presses on the area. If you bend the wrist upwards against pressure, it will hurt around the projection of the bone on the outer elbow. The pains may eventually radiate up into the upper arm and down along the outer side of the forearm. There may be a feeling of weakness in the wrist which makes it difficult to do things that require strength in the hand.

What can be done at home?
At first, the pain may be relieved by applying an ice pack (wrapped in a cloth to avoid contact with the skin). The ice pack can be applied for 10 to 15 minutes at a time and again after an interval of about an hour. The arm should be rested and any movement that causes the pain should be avoided. Stretching exercises may help. The wrist must be bent all the way down and pressure applied to the fingers with the opposite hand. The elbow must be stretched out entirely and the forearm turned inwards so the fingertips point to the side. The stretch should be held for about 15 seconds then repeated after a brief interval. This should be repeated several times a day. A tennis elbow support, which is worn just below the elbow helps to relieve the stress on the tissues, can be supplied by the clinic who will provide information about specific exercises.

How does an Osteopath make a diagnosis?
Diagnosis is made by listening to the patient's description of symptoms and by making an examination of the arm. The area around the elbow will be sore when pressed and bending the hand upwards against pressure will produce pain.

How is it treated?
Osteopathic techniques to relax the muscles and reduce scar tissue are often helpful in reducing the pain and promoting healing. Ultrasound plays an important role as does specific stretching and strengthening exercises If symptoms do not settle, a corticosteroid and local anaesthetic injection can be tried, however, recent evidence suggests that whilst reducing pain in the short term corticosteroids does little to promote recovery may weaken the tissues and encourage patients to reengage in activities that may cause further damage. In rare cases, it may be necessary to perform an operation to release the tendon from the bone.