Picture this: your elbow hurts so bad, you go to the doctor, and they tell you that you have a condition known as tennis elbow, yet you have not played tennis for years, or you don’t play it at all! Well, you shouldn’t panic as this condition can be treated.
Physical therapy is one of the most effective ways to treat tennis elbow. However, you want first to understand the problem to ensure therapy is the right treatment option for you. Remember that not all tennis elbow conditions are the same, and each condition has to be evaluated and treated differently to ensure success.
At Suarez Physical Therapy, we assess each case thoroughly before providing treatment. We also treat each case differently, specific to every patient’s needs. We’ll walk you through our therapy treatment plan and what we’ll expect of you before we embark on the treatment. Call us right away for a consultation. We serve patients looking for physiotherapy services in Las Vegas, NV, and the surrounding areas.
What’s Tennis Elbow?
Tennis elbow, also known as lateral epicondylitis, is a painful condition that arises when the tendons in the elbow are overworked, often by repeated movement of the arm and wrist. Despite being termed ‘tennis elbow,’ tennis players are not the only ones to develop lateral epicondylitis. People whose occupations feature the kinds of movements that could result in tennis elbow are butchers, carpenters, painters, electricians, and plumbers. Playing other racket sports such as swimming, baseball, badminton, squash, and field throwing events may also cause this condition.
Tennis elbow pain is primarily experienced where the tendons of the forearm muscles attach to a bony bump on the outer part of your elbow. Pain may also spread to the wrist and forearm. The muscles in your hand used to twist, carry, and grip objects attach to the lateral epicondyle at the elbow. That is why moving your hand or wrist can cause pain in the elbow.
Using your hand or wrist for a prolonged period, for instance, when operating machinery, typing on a computer, or playing tennis using a poor technique or grip, can cause tennis elbow. This condition can affect both adults and children. It’s more common in men than women and mainly affects persons between thirty and fifty years old.
Symptoms of Lateral Epicondylitis
Tennis elbow symptoms can occur unexpectedly due to overusing the hand or wrist for activities requiring force, like pulling, twisting, or lifting. Forceful activities such as using a hammer or screwdriver or carrying a heavy item like a suitcase can hurt the extensor muscles and unexpectedly result in the tennis elbow condition. However, in many cases, tennis elbow symptoms develop progressively over months or several weeks due to forcefully or repetitively using the elbow, hand, and wrist.
Tennis elbow-related pain may radiate from the outer part of the elbow into your wrist and forearm. Weakness and pain might make it challenging for you to hold a cup of coffee, turn a doorknob, grip an item, or shake hands.
Other symptoms could include:
- Increased pain whenever you’re using your hand or wrist to open a jar, lift objects, or grip something tightly like a fork or knife
- Weakness in your hand, wrist, or forearm
- Elbow stiffness
Your dominant arm is the most frequently affected, but both arms can be affected.
When to Visit a Doctor
Visit your physician if self-care tips like using over-the-counter pain medication, ice, and rest do not alleviate your elbow tenderness and pain.
Causes of Tennis Elbow
As we mentioned earlier, lateral epicondylitis is a muscle strain and overuse injury. Its cause is the repetitive contraction of the forearm muscles you use to raise and straighten your wrist/hand. The repeated movements and stressing of the tissue might lead to several small tears in the extensor carpi radialis brevis muscle tendon that joins the forearm muscles to the lateral epicondyle. This results in pain and inflammation.
Like the term suggests, playing tennis, particularly repeatedly using the backhand stroke with improper technique, is a likely cause of lateral epicondylitis. However, other prevalent arm movements can cause this condition, including:
- Repeated use of computer mouse
- Cutting cooking ingredients, especially meat
- Driving screws
- Using plumbing tools
- Unknown— tennis elbow can develop without any known repeated injury or motion. This occurrence is known as ‘of unknown cause’ or ‘idiopathic.’
Several factors can elevate the risk of developing tennis elbow. These include:
- Engaging in certain sports— taking part in racquet sports raises the chances of having tennis elbow, particularly if you use improper stroke technique
- Occupation— people with jobs involving repeated arm and wrist movement are highly likely to have tennis elbow. They include cooks, butchers, carpenters, painters, and plumbers.
- Age— tennis elbow can affect anyone regardless of their age. However, as we mentioned, it is most prevalent in adults aged between thirty and fifty years old.
How Is Tennis Elbow Diagnosed?
Your physician will consider several factors in diagnosing this condition, including recreational sports involvement, work-related contributing factors, and how your signs and symptoms developed. They will then speak to you concerning what activities bring about the symptoms and what part of your arm experiences them. Ensure to inform the doctor if you’ve ever hurt your elbow. Also, tell your physician if you have a history of nerve disease or rheumatoid arthritis.
During the physical examination, your physician will use numerous tests to diagnose the tennis elbow. For instance, they might apply pressure on the impacted area or request you to move your finger, wrist, and elbow in different ways to see if it’s painful. They may also ask that you try straightening your fingers and wrist against resistance with your arm completely straight to find out if you will feel pain. If these tests turn out to be positive, it’ll tell your physician the muscles aren’t healthy.
In most cases, physical examination and your medical history provide enough info for your physician to diagnose tennis elbow. However, if your physician suspects something else is causing your signs and symptoms, they may recommend more tests to rule out these other causes. These tests include:
- X-ray— X-ray tests generate clear photos of compact structures like bone. They might be conducted to rule out elbow arthritis.
- EMG (electromyography) — your physician may recommend this test to rule out compression of the nerves. Most nerves travel around your elbow, and nerve compression symptoms are similar to those of lateral epicondylitis.
- MRI (magnetic resonance imaging) scan— an MRI scan generates soft-tissue images, including those of the tendons and muscles. Your doctor may recommend this scan to establish the level of damage in the tendon or rule out other injuries. If the doctor thinks that your symptoms may be associated with a neck-related problem, they may conduct an MRI scan of the neck to determine if you have arthritic changes or a herniated disk in your neck. These two conditions can make you experience pain in your arm.
Treating Tennis Elbow
Lateral epicondylitis often goes away by itself. However, if over-the-counter pain relievers or other self-care tips are not helping, your physician may suggest physiotherapy. Severe tennis elbow cases may require a surgical procedure.
How Physical Therapy Can Help
If your signs and symptoms are associated with tennis elbow, your physician may recommend that a physical therapist assess your tennis playing techniques or the movements involved when it comes to work-related tasks to establish the ideal steps to minimize stress on the injured tissue.
Physiotherapy aims to improve the flexibility and strength of your forearm muscles so tennis elbow won’t bother you again. It can also help enhance blood flow to the tendons, which do not receive the same oxygen and blood supply as muscles usually receive. Exercises that enhance blood flow improve healing as well.
Your physiotherapist may teach you various exercises to slowly strengthen and stress your muscles, particularly your forearm muscles. Eccentric exercises are beneficial. These exercises involve lowering your wrist slowly after raising it. A brace or forearm strap may minimize stress on the hurt tissue.
Here are more details on how a physiotherapist may help you achieve different goals in treating tennis elbow and managing pain:
Relieving Pain Within 48 Hours
Within 48 hrs. after acute pain sets in, therapy treatment includes:
- Using elastic supports or bandages to eliminate the pressure on and around your painful muscles
- Using ice treatment
- Resting your arm by not doing given tasks and modifying how you do the ones you cannot avoid
Your physiotherapist will decide whether you have to use a support or brace to hold and protect the muscles as the area heals. Based on how severe your condition is, your physical therapist may suggest that you see another healthcare provider for more tests or for them to determine if you need additional treatment like medication. As we mentioned, treatments like surgery or cortisone injection may be necessary in severe tennis elbow cases, though this is rare. Your physiotherapist can assist you in determining whether you should be referred to another healthcare provider.
After the pain eases, your therapist can create a special treatment program that’ll help you have a speedy recovery. They will highly likely need you to do various exercises or other treatments at home. The therapist may also use specific physiotherapy treatments to relieve your pain. These treatments may include special exercises, manual therapy, and heat or ice treatment, or both.
Exercises Your Therapist May Recommend
General exercises your physiotherapist may recommend are:
Stretching and strengthening exercises aim to enhance the flexibility of the extensor tendons. Your therapist may require you to continue with these exercises until the wrist’s range of motion is the same as the unaffected wrist. Some of the stretching exercises the therapist will require you to do are finger stretch, ball squeeze, wrist flexor stretch, wrist extensor stretch, wrist turn, and forearm strengthening.
Other exercises are:
- Theraband exercise
- Flexbar exercises
- Concentric and Eccentric Exercises
If yours is an acute case, it is critical to treat it as soon as possible. If left untreated, this condition could become chronic, lasting several months. This is particularly true if the treatment focuses only on alleviating pain instead of correcting muscle weakness or poor habits that may have resulted in your condition.
Enhancing Your Capability to Move
Your therapist might utilize manual therapy to help your arm move properly and enable your muscles and joints to move freely, experiencing less pain.
Improving Your Strength
Reduced muscle strength may result in tennis elbow. At times this weakness is experienced in the forearm and wrist muscles. In most cases, the tennis elbow arises when the core or supporting postural muscles become weak. You may find it necessary to enhance your general fitness level to help alleviate your tennis elbow condition. Depending on their evaluation, your therapist can dictate the amount and type of exercises you should do.
Physiotherapists prescribe different exercises when a patient is recovering from lateral epicondylitis. For instance:
- In the early stages of your treatment, when you’re feeling intense pain, your physical therapist might suggest passive exercises whereby your elbow and wrist are moved without using your muscles
- With time, as your signs and symptoms improve, the therapist may need you to move the elbow and wrist actively without help.
- As your muscles strengthen more and more and your symptoms have reduced, the therapist may recommend that you start using resistance bands or weights to improve your strength further. The therapist will have to carefully monitor the quantity of weight to ensure you continue progressing and avoid reinjuring your muscles.
Using Your Muscles Properly
Your therapist can assist you in retaining your muscles so you utilize them appropriately. For instance, when lifting a heavy bag, you have to contract the body muscles in your trunk and shoulder blade to support the arm muscles. Your therapist can easily teach you simple movements like what we just mentioned, which can reduce the stress or pressure on your injured muscles, helping you resume your day-to-day chores while avoiding being re-injured.
Resumption of Activities After Treatment
Your physiotherapist will assist you in remaining active by showing you how you can modify your day-to-day activities and avoid further injury and pain. You may have to make a few alterations at work, home, or on your playing field. Your therapist can assist you in modifying your kitchen and sports equipment, worksite, gardening tools, and even computer set-up so you can minimize straining your forearm, wrist, and hand. The therapist will stress the importance of breaking to stretch so your muscles can frequently rest from repeated motions and sitting or standing in one position.
As we mentioned, playing tennis can contribute to lateral epicondylitis for many reasons. At times, the condition arises due to over-training. Other times the racquet weight or grip may require adjustment. For others, this condition may result from poor general or improper form of fitness or the lack of strength in the core or supporting shoulder blades and trunk muscles. A therapist will help you analyze where the problem is stemming and the best solution.
Preventing Tennis Elbow
You can prevent lateral epicondylitis by keeping fit, applying proper techniques in your job or sports, and using tools and equipment that are properly designed and ideal for your activity level and body type. Your physiotherapist can teach you how to do it. If you’ve suffered from tennis elbow before, you may be at a higher risk of developing the condition again in case tendons didn’t have sufficient time to heal completely or if your joint mobility and muscle strength weren’t fully restored. Resuming sports or other activities before you’ve fully recovered may lead to an elbow that’s frequently or easily re-injured or one that has persistent pain. Your physiotherapist can help decide when you’re ready to resume your sports and other activities and may help ensure your wrist, forearm, and elbow are strong enough and ready to be engaged in work.
You should also be mindful of the following factors and change them if necessary to help prevent tennis elbow:
- Grip size— if you’re using a tool, you must check if the grip size is appropriate for your hand. If it’s too big or too small, you’ll have to apply more force for you to do the same job. This isn’t only true with tools but also with sporting equipment such as tennis racquets or squash.
- Sitting position— is the mouse and keyboard height ideal for your elbow position? Does your forearms have proper support, and does your chair promote the right sitting position and alignment?
- Vibration— does the task you’re doing expose your arm to vibration? The vibration could be highly stressful on the supporting muscles and joints. Therefore, you have to perform the task well, with high-quality tools and regularly planned breaks.
Find an Expert Physical Therapist Near Me
No two lateral epicondylitis conditions are the same. To cure your specific condition with physical therapy, a skilled physical therapist must first evaluate what factors contribute to it and understand its severity. Only then will they be capable of creating a treatment plan that’s sure to reach your goal of a pain-free elbow. At Suarez Physical Therapy, we boast expert physiotherapists in the whole of Las Vegas, NV, who will ensure you receive treatment specific to your condition and produce the best possible outcome. Call us at 702-368-6778 for a consultation in which we’ll walk through how we may help you.