Talofa Samoa and welcome back to your weekly health column! This week we take a look at the condition commonly known as Tennis Elbow.

What is a Tennis Elbow?

Tennis elbow is the more common name for the condition “Lateral Epicondylitis”. It is the most common overuse injury in the elbow. While “tennis” is in the name, only about 5 per cent of people who have tennis elbow play tennis! The elbow is made up of three bones (the humerus in the arm, and the radius and ulna in the forearm). At the end of the humerus, there are two epicondyles, one on the medial side (closest to your torso) and one on the lateral side (the outside of your elbow). Tennis elbow is a condition where the tendons of the muscles that straighten the elbow and wrist suffer from overuse or too much load placed on them over time. These tendons are attached to the lateral epicondyle and so most symptoms of this condition are felt on the outside of the elbow.

What are the causes and symptoms?

This injury is often work-related. People who have to repeatedly extend their wrist and/or repeatedly turn their elbow and wrist are more likely to develop this condition; these people are usually tennis players, those who have a job with high manual labour demand, and those who use their hands often for their housework, hobbies, or occupation. The most obvious symptom of tennis elbow is pain when pressing into the area where the muscles attach, the lateral epicondyle. The pain can radiate upwards along the upper arm and downwards along the outside of the forearm and in rare cases even to the third and fourth fingers. There are four stages of development when it comes to the intensity of symptoms:

1. Faint pain a couple of hours after the provoking activity.

2. Pain at the end of or immediately after the provoking activity.

3. Pain during the provoking activity, which intensifies after ceasing that activity.

4. Constant pain, which prohibits any activity.

Symptoms can last on average from two weeks to two years.

How do I recover faster from tennis elbow?

When diagnosed with tennis elbow, the first steps towards recovery are on-operative, meaning no surgery. The most important principles will be relieving your pain and controlling the amount of inflammation around your elbow. The first step towards recovery is an accurate diagnosis. Physiotherapists don’t quickly jump to conclusions, so when they look at the elbows, they will consider all factors about your injury and body before confirming a diagnosis. 

They will ask specific questions about your symptoms and the history of your injury so that they can say with confidence what is causing your elbow pain. After obtaining the correct diagnosis your rehab can begin. It will start with gentle but specific exercises that will be graded over time so that you can return to your activities, pain-free. The rehab may include a supportive device or counterbrace, k-taping, needling, or soft tissue therapy. If non-operative management fails for more than 6 months., surgical treatment may be indicated. Most surgical procedures for this condition involve removing diseased muscle and reattaching healthy muscle back to bone. The right surgical approach will depend on a range of factors. These include the scope of injury, general health, and personal needs. The physiotherapist who is taking care of your elbow will make good judgment calls on what the appropriate rehab plan will be for you and will know when to refer you for a surgical review if that becomes necessary.

Eliana Viali is a physiotherapist and can be contacted at [email protected] for further inquiries