November 25, 2021

Outer elbow pain making your life miserable? We can help!

Struggling with outer elbow pain when gripping and lifting? It could be Tennis Elbow! Tennis elbow is one of the most common upper body injuries that our patients complain of. It may have started bothering you recently after returning to training post-lockdown, or you may have been struggling with it for a while. The good news is it can definitely be fixed! Having treated a lot of these injuries, you can trust we’ll provide the help you need. The first step to treating it is correctly diagnosing the injury, and understanding how and why it develops.

What Is Tennis Elbow?

Tennis elbow, also known as “lateral epicondylalgia”, is a common injury on the outer (lateral) side of the elbow

Tennis elbow occurs on the outside of the elbow

It is often a chronic, overuse injury of the outer muscles of the forearm, where the attachment point (tendon) of the muscles to the arm bone becomes irritated and sometimes inflamed.

What causes Tennis Elbow?

Extensor muscles of the forearm

Tennis elbow is caused by repetitive stress of the extensor muscles in movements involving the elbow, wrist and hand. It is seen in many types of sports such as:

Racquet sports e.g. Tennis, Squash, Badminton
Batting sports e.g. Cricket
Combat sports e.g. BJJ, Wrestling, Judo
Climbing sports e.g. Rock Climbing, Bouldering

Lifting sports e.g. Powerlifting, CrossFit, Bodybuilding

It is also common in occupations with lots of gripping involved, for example trades like carpentry, but is also common in office workers.

As with all other overuse injuries, the stress placed on your extensor muscles over time exceeded the tendon’s ability to cope with the stress, causing it to get irritated. This commonly occurs from changes in load, for example:

Returning to sports/gym after a long period of inactivity, e.g. lockdown
Increasing amount of training/games suddenly, e.g. during Rep season
Altering technique or equipment used, e.g. changing racquets

It is very similar to its counterpart – “Golfer’s Elbow” – which occurs on the inner elbow

Do I need imaging for Tennis elbow?

Imaging is not required for diagnosis of tennis elbow. This can be performed in-clinic by your physiotherapist.

When other issues may be suspected as well, MRI’s are usually the best suited due to the clarity in picking up soft tissue injuries.

What Are The Rehab Options for Tennis Elbow?

Imaging is not required for diagnosis of tennis elbow. This can be performed in-clinic by your physiotherapist.
When other issues may be suspected as well, MRI’s are usually the best suited due to the clarity for picking up soft tissue injuries.

What Are The Rehab Options?

Tennis elbow bracing

Tennis elbow is managed conservatively with a combination of:

Relative rest from the aggravating activities
Manual therapy
Strapping/bracing
Inflammation management
Graded strengthening of the extensor muscles and entire upper limb.

In stubborn cases cortisone injections or PRP (Platelet-rich Plasma) therapy may be trialled by your doctor.

How Long Does It Take To Recover Whilst Receiving Tennis Elbow Treatment?

Tennis elbow can take between 3-6 months to recover if the aggravating activities are minimised and appropriate rehabilitation is started. If you are able to get the issue attended to early, it can often be improved in a few weeks instead of months.

Muscle belly tissue vs ligament

The long recovery time is due to the tendon’s slower rate of healing. This is because tendons have poorer blood supply compared to muscle tissue or ligament (making them appear white in the above diagram). Poorer blood supply means less nutrients are transported to the tendon for healing.

What Should I Do If I Think I Have This Issue?

I would make sure “Tennis Elbow” is indeed your issue by consulting your nearest Physiotherapist that has a great understanding and experience in dealing with this issue. All of our Physiotherapists have great experience with this issue as well as other elbow issues due to our extensive experience with Baseball players, Martial Arts athletes and Lifters – who are prone to experiencing Tennis Elbow.