For tennis fans everywhere, Wimbledon is an important date in their calendar. For many, the very idea of Wimbledon conjures up visions of strawberries and cream. For a relative few, however, what will come to mind is the problem medically known as lateral epicondylitis, commonly referred to as tennis elbow. By whatever name, it defines inflammation of the tendons on the outside aspect of the elbow, caused by over-use and repetitive movements.
Tennis is not the only cause though. In fact, only about 5% of tennis players will experience symptoms and usually only those that play more than three times a week, and for longer than 30 minutes’ duration. Any repetitive activity that uses the same action can cause LE; for example: electricians, mechanics, gardeners, painters and carpenters often complain of the same symptoms. The most common symptoms are weak grip, pain or burning felt on the outside of the arm, sometimes radiating up to the shoulder or down to the wrist. Pain is usually worsened by shaking hands, holding a racket, turning a screwdriver or wrench or any gripping movement
There are four known stages and it is usually not until a person reaches the fourth stage that they seek help:
• Stage 1 – Slight pain a few hours after the aggravating activity.
• Stage 2 – Pain immediately after the aggravating activity.
• Stage 3 – Pain during the aggravating activity, which increases in intensity after the activity.
• Stage 4 – Constant pain which limits all activity.
The management of LE depends on the stage and severity of symptoms. The first treatment protocol should always be PRICE:
The best way to protect the muscles and joints, reduce pain and speed up healing in LE is to use a brace. In most cases a simple tennis elbow strap will give relief from symptoms and allow pain-free movement. The strap should be placed just below the area of pain. It acts to reduce the tension on the muscles, allowing more function whilst the injured area is recovering.
REST: Avoid any movement that reproduces your pain. It does not mean stop moving completely. Quite often, total immobilisation can cause more disability. If you are able to move without worsening your symptoms, then keep moving. Wearing a brace may help but try to avoid extreme movements, overbending or stretching. ICE: As soon as you are able to, use ice. Ice can help to reduce pain and swelling. After the initial injury it is recommended to use ice for 20 minutes ever 2-3 hours.
COMPRESSION: Wearing an elastic bandage can help reduce swelling and also provide support.
ELEVATION: If you find your elbow is swelling up, rest with you arm supported higher than your shoulder. This will assist the body’s circulation, reducing the amount of fluid accumulating at the point of injury.
If your symptoms do not resolve, physiotherapy can help but in some cases an injection may be needed or, in extreme cases, surgery.
Whether you have suffered from tennis elbow before or just want to minimise the risk of developing this painful condition, there are steps you can follow to help prevent the problem: • Avoid repetitive movements.
• Take regular breaks.
• Where it is not possible to avoid risks, minimise the effects where possible or wear a brace.
• When using tools, use ones with a wider handle, whether it is a tennis racket or a hammer. You can also add padding around the handle to absorb the shock.
• When playing tennis, try to use a two-handed back hand.
• Do strengthening and stretching exercises on a regular basis.
There are other conditions that have similar symptoms so it is recommended that you seek advice from your doctor or physiotherapist to rule out any other cause or serious pathology.