Tennis elbow is a problem that many of us will experience at one point or another – although funnily enough, tennis itself is rarely the cause. According to the British Medical Journal it’s most common in those aged between 40-50, but you can find it in a variety of populations.
What does cause tennis elbow?
Tennis elbow usually comes about because of an overload of some of the tendons on your forearm. The medical term for the condition is “lateral epicondylalgia”, which is a long-winded way of saying “pain on that lumpy bit of your elbow”. Some of the activities that can trigger a bout of tennis elbow include:
- Starting a new sport that involves a lot of gripping
- Repeated lifting at work with your hands
- Doing some DIY or gardening and being over-enthusiastic with the tools
You might sometimes hear people describe the condition as “tendonitis”, which suggests that it’s a problem of inflammation. While that might be the case initially, in the medium to longer term it’s more to do with changes in the types of collagen that make up the tendon. The rate at which you’re challenging the body’s repair mechanisms is exceeding the rate at which your body can adapt.
So, with that said – what should you do about it?
1. Stop overloading it!
At the risk of sounding too obvious… you need to stop doing whatever is irritating it! This might mean taking a break from your sports or putting your DIY vision on hold for a little while. If you think it’s something at work that is causing the problem, then that can be a little trickier to manage, but we generally wouldn’t advise taking time off completely. Instead, it’s more about changing your hand and arm positions in ways that make the gripping easier. For example:
Try to pick things up with a neutral or “thumbs up” grip, rather than palms down:
Hold heavy objects such as full kettles, work tools or your crying children close to your body with the elbow bent, rather than at arm’s length:
If problems come on after a certain time period, try to pace yourself so that you’re not pushing yourself to the absolute limit – stop before you need to stop and take a rest. Often these tips will allow tennis elbow to calm down, but if not then you may need to do a bit more rehab.
2. Start loading it!
Wait, what? Didn’t we say just that loading it was the problem? Well, a bit like a vaccine, the treatment for tennis elbow is actually a little bit of what causes the problem – just in small enough quantities that your body can manage. Tennis elbow comes about because your tissues can’t keep up with the demands put on them – but if you follow step one and take away the things that are irritating the tendon most, you can slowly start to build up some quality tissue that tolerates the demands you put on it.
One of the best ways of loading the tendon is to use a resistance band, although you can get by with a small hand weight. Here’s a typical example of how we start off a tennis elbow patient’s exercises:
We might recommend a 30 second hold in this position before progressing onto something trickier.
3. See a physiotherapist
A qualified physiotherapist will be able to build a tennis elbow rehab programme that is tailored for you and your work, sports and general life needs. They will also do a thorough assessment to rule out any other conditions that could be causing your pain. Treatments might include:
- Progressing your exercises from the basic one above to more challenging and complex ones involving the whole arm
- Mobilising the joints around the elbow to provide pain relief
- Massage to the muscles around the tendon (but not usually to the tendon itself, as this can sometimes make it worse)
- Nowadays we prefer not to do corticosteroid injections in most patients with tennis elbow as it doesn’t usually help.
Tennis elbow is a treatable condition that can benefit from being reviewed by a chartered physiotherapist to help get you back to full health.