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“Typically, tennis elbow comes from hyperextension of the wrist. It depends on bad mechanics,” says Dwayne Hultquist, head tennis coach at Florida State University in Tallahassee, Florida.
If you’re a frequent tennis player, chances are you’re familiar with some form of “tennis elbow.” So here is some advice on how to treat and prevent this painful injury.
“Tennis elbow,” known medically as “lateral epicondylitis,” is a condition in which the outer part of the elbow becomes sore. Inflammation occurs in the tendons that join the forearm muscles on the outside of the elbow.
This is due to a repeated overuse of the forearm, as may be common in tennis and some other sports. Tennis elbow typically affects adults 40 to 60 years of age, those who are just learning a sport, or those who play frequently. Males and females are equally affected.
Any activity that involves a repeated use of the forearm’s extensor muscles may result in an acute or chronic tendonitis condition. So tennis elbow may not occur because of tennis, or even because of sports.
For example, the injury is not uncommon among carpenters, laborers whose job requires that they repeatedly swing a hammer or other tool, butchers, plumbers, and so on. So even though it’s known as “tennis elbow,” you don’t have to play tennis to suffer from this painful ailment.
Tennis elbow, then, is a common musculoskeletal condition, and as many as one in three people may experience a type of tennis elbow injury at some point in their lives. In the UK, one half of one percent of the population consult a doctor about this condition each year.
If you have tennis elbow, you’ll probably notice soreness on the outside of your upper forearm, just below the bend of your elbow. You may find it difficult to fully extend your arm. You’ll likely experience pain when lifting or bending your arm, turning a door handle or opening a jar, gripping a small item such as a pen, or shaking hands.
The first step in treating tennis elbow is to stop playing tennis and rest your arm until the soreness abates. This may take as little as 2 or 3 days.
As the National Health Service (NHS) asserts, “Tennis elbow is a self-limiting condition, which means it will eventually get better without treatment.” (However, those who refuse to rest and who continue the activity that caused the injury may find themselves in near-constant pain with a condition that’s treatable only via surgery to remove the damaged part of the tendon.)
The NHS recommends using cold compresses such as ice at least three times daily to relieve the pain, as well as painkillers such as paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce inflammation.
The NHS further advises a visit to your doctor if the pain persists despite giving the affected area complete rest for several days. A doctor will check for swelling and perform simple tests in the surgery. If nerve damage is suspected, you may be referred for an ultrasound scan or a magnetic resonance imaging (MRI) scan.
Fortunately, however, in 9 of 10 cases, a full recovery from tennis elbow occurs within a year or less—often, much less.
“Physiotherapy may be recommended in more severe and persistent cases,” according to the NHS. Massage may relieve the pain and stiffness, improving the range of movement.
Another form of physical therapy may include strength-building exercises. One of these that is most commonly recommended by healthcare professionals involves using a rubber bar. The patient grasps the bar, twists it, and slowly untwists it.
Other physical therapy might involve joint manipulation of the elbow and wrist.
A low-level laser therapy technique has been shown to provide short-term relief when used both by itself or in conjunction with exercise and other physical therapy.
Orthotic devices may be prescribed to improve arm functionality and reduce soreness. These are particulary useful for those who’ve just begun to experience tennis elbow.
The NHS recommends that you wear a tennis elbow splint when you’re using your arm, and take it off when resting or sleeping. Your doctor or physiotherapist can advise you about the best type of brace, splint, or orthotic device for your injury.
The NHS acknowledges, “It’s not always easy to avoid getting tennis elbow.” However, when the condition is caused by playing tennis, changing your technique may solve the problem and avoid further injury, or it may prevent the condition from occuring in the first place.
As Florida’s Coach Dwayne Hultquist says of tennis elbow, “You see it in people who don’t have good form. Bad form forces you to overstretch the muscle on the outside of the elbow.”
His colleague, tennis trainer Clay Johnson, agrees: “The higher skilled players don’t have a lot of issues with [tennis elbow], because they have good form.” Johnson adds, “The wrist controls the form, because all the muscles that are responsible for those actions originate there.”
Having a proper tennis technique is crucial to preventing tennis elbow injury. This is because the proper technique avoids undue strain on your elbow’s tendons. If you already have tennis elbow, the proper technique is likely to keep it from getting worse.
The best way to improve your technique is to get coaching advice about improving your grip, swing, and overall form. The coach will probably advise you to avoid using your arm to generate force and to avoid hitting the ball close to your body. These cause stress to transfer to the elbow.
“It’s important to have a quarter degree turn to keep the pressure off,” Coach Hultquist recommends. “That’s where a tennis professional can help you prevent tennis elbow,” he concludes.
Your coach will probably also suggest warm-up activities, including gently stretching your arm muscles before you pick up the racquet. These will help avoid a new injury or exacerbating an existing condition.
If you’re using an old and outdated racquet, it’s time to buy a new one. Most new racquets are lightweight and player-friendly, built to reduce the shock transferred to your arm when you hit the ball. An enlarged grip will also help you avoid putting too much stress and strain on your tendons. And a racquet with a large head is designed for power; this means you’ll do less overswinging.
Regardless of the sport, always be sure you’re using equipment that’s right for your ability, body size, age, experience, and strength.
Finally, work on exercising the area above and below the elbow, as well as your shoulder and your wrist. (However, if you experience pain while exercising, stop immediately and seek medical advice.)
Eliminating weaknesses in joints and muscles—particularly in your forearm—will help minimize stress on your elbow, preventing injury and avoiding aggravation of an injury you already have.