by John Zieour, PT
Think about the time you went to pick up your coffee cup in the morning, only to be awakened by a sharp, stabbing pain along the outside of your elbow! "Tennis elbow" is a fairly common musculoskeletal problem that affects about 2% of the population in the U.S. People suffering from this condition generally will report pain or soreness along the outer portion of the forearm or elbow. They usually describe the symptoms varying from a dull, constant ache...to a sharp, stabbing pain that occurs usually when they are doing activities that either involve gripping, twisting, or lifting motions using the hand, wrist, forearm, and/or elbow. This condition many times is found in occupations that require repetitive motion. It is typically referred to as an overuse injury that occurs as a result of repeated strain to the muscles and tendons in the area around the outside part of the forearm/elbow. It is referred to as "Tennis Elbow" because 40-50% of recreational tennis players will suffer from this problem sometime while participating in this sport.
The initial pain felt in the elbow is usually the result of inflammation in the soft tissues (muscle, tendon) of the elbow during the acute stages of the injury. It is often referred to as "Tendonitis" of the elbow or medically diagnosed as "Lateral Epicondylitis". If it becomes more chronic, it is often referred to as "Tendinosis" where the tendon shows degenerative changes such as increased "fibroblasts" (cells that create scar tissue), and new blood vessels not normally seen in the tendon. A newer term being used for this condition is "Lateral Epicondyalgia." There is a continuum of stages that one suffering from this condition can be assigned depending on the length of time since the onset of symptoms began. Knowing this can help the condition to be treated and better managed by those individuals experiencing symptoms.
Often, the condition is treated initially with rest, ice, and perhaps over the counter anti-inflammatory medication. In some cases, a cortisone injection may be administered and physical therapy treatment prescribed. Evidence-based research has shown cortisone injections are the most effective in providing pain relief in the SHORT-TERM (6 weeks); however, this treatment provided the worst outcome over a long-term (52 weeks) when compared to physical therapy or a "wait and see" approach. Physical Therapy programs that included graded (supervised) loading (strengthening) programs had the best LONG-TERM results (52 weeks) for those diagnosed with tennis elbow.
As with most over-use injuries, there are things you can do to prevent this type of injury from occurring. Often the tissue is “strained” because TOO much load is applied to the muscles and tendons in the elbow when a new activity is initiated, whether it's work or play. An example, would be a person who is not used to using a hammer decides to do a home improvement project over the weekend and this requires a lot of hammering which is something that over a couple hours can be enough OVERLOAD to create an injury. Try to limit the time, and intensity of the new activity in order to allow the tissues to ADAPT to the new stresses they are being asked to perform. They will gradually become stronger and better able to withstand the physical demands (loads) they are subject to without breaking down. The single-handed backhand, is the stroke in which most tennis players usually suffer this injury when playing. Tennis players who have this problem need to be concerned about things such as; poor stroke mechanics, string tension, type or pattern, racquet weight, length or balance.
It is a good idea to make sure the appropriate professional is able to help evaluate factors that may be contributing to those who are experiencing this type of pain. Physical Therapists are trained in how to evaluate strength, range of motion, and flexibility of the elbow and surrounding joints in order to determine if there are problems that may have contributed to straining the elbow tissues. Hopefully when you go to pick up your early morning cup of coffee or newspaper you won’t be greeted by a stabbing elbow pain!
Often, the condition is treated initially with rest, ice, and perhaps over the counter anti-inflammatory medication. In some cases, a cortisone injection may be administered and physical therapy treatment prescribed. Evidence-based research has shown cortisone injections are the most effective in providing pain relief in the SHORT-TERM (6 weeks); however, this treatment provided the worst outcome over a long-term (52 weeks) when compared to physical therapy or a "wait and see" approach. Physical Therapy programs that included graded (supervised) loading (strengthening) programs had the best LONG-TERM results (52 weeks) for those diagnosed with tennis elbow.
As with most over-use injuries, there are things you can do to prevent this type of injury from occurring. Often the tissue is “strained” because TOO much load is applied to the muscles and tendons in the elbow when a new activity is initiated, whether it's work or play. An example, would be a person who is not used to using a hammer decides to do a home improvement project over the weekend and this requires a lot of hammering which is something that over a couple hours can be enough OVERLOAD to create an injury. Try to limit the time, and intensity of the new activity in order to allow the tissues to ADAPT to the new stresses they are being asked to perform. They will gradually become stronger and better able to withstand the physical demands (loads) they are subject to without breaking down. The single-handed backhand, is the stroke in which most tennis players usually suffer this injury when playing. Tennis players who have this problem need to be concerned about things such as; poor stroke mechanics, string tension, type or pattern, racquet weight, length or balance.
It is a good idea to make sure the appropriate professional is able to help evaluate factors that may be contributing to those who are experiencing this type of pain. Physical Therapists are trained in how to evaluate strength, range of motion, and flexibility of the elbow and surrounding joints in order to determine if there are problems that may have contributed to straining the elbow tissues. Hopefully when you go to pick up your early morning cup of coffee or newspaper you won’t be greeted by a stabbing elbow pain!
RSS Feed
