HEALTHY AND ACTIVE | Tennis elbow not just for tennis players

As the days get shorter you may be feeling the wear-and-tear of an active summer. After a season full of home projects, matches at the Seattle Tennis Club, golf and gardening, many are dealing with lingering elbow pain. If that twinge of pain just isn’t going away, you may have what is commonly called tennis elbow. Despite it’s name, most people with this diagnosis don’t play tennis.

Tennis elbow, also referred to as lateral epicondylosis, affects the tendons on the outside of the elbow that work to bend the wrist back, straighten the fingers and help provide strength to the hand during gripping and carrying. This painful condition, if left untreated, can become debilitating and impair all daily activities that rely on hand use.

Tennis elbow is related to overuse and repetitive stress on the tissue, which leads to micro-tears of the tendon over time. This is a condition that can become chronic if not cared for promptly and properly.

Individuals with tennis elbow will typically feel pain and tenderness on the outside of the elbow. Simply holding up this newspaper or reaching out to grab the morning cup of French roast coffee may be uncomfortable. Shaking hands can be extremely painful.

Carrying a full grocery bag out of Bert’s Red Apple may cause shooting pain down the forearm into the hand, while turning a doorknob or opening a jar may be impossible.

Stressful motions

Although 50 percent of tennis players will have tennis elbow at some point in their career, 1 to 3 percent of the general population between the ages of 30 and 50 also suffer from this.

Picking up objects with the palm facing down and elbow in a straightened position places extra stress on the tendons and can lead to epicondylosis.
Activities that require repeated forceful gripping, such as pruning, can be a cause, as can having a poor ergonomic desk set-up. With a desk that’s too low or a chair that’s too high, the tendons around the elbow must work extra hard to support the hand, and this may lead to tendon inflammation.

Repetitive pinching while twisting the arm and wrist — motions often used in craft projects such as jewelry making and clothing design — can damage the tendons, as well.

A sudden increase in lifting tasks, such as picking up a newborn baby or cleaning out a garage, can also cause this trauma to the tendons.

For tennis players, using a racquet that is too stiff with high-tension strings can place a heavy load on the tendons of the elbow. When people overreach for the ball, as often happens as leg speed and agility decrease, the tendons of the elbow must absorb much more force.

Helping to heal

The first line of treatment for tennis elbow includes modifying or decreasing the frequency of the activities that cause pain. This gives your body a chance to start the healing process. Rest, icing two to three times a day for five to 10 minutes and wearing a compressive sleeve over the elbow may help relieve pain.

Your physician may prescribe anti-inflammatory medication or offer a steroid injection to relieve intense symptoms.

An occupational therapist who specializes in rehabilitation of the arm can assess symptoms and develop a program to regain pain-free arm use. Your therapist will also assess shoulder strength and mobility because weaknesses and imbalances in the upper arm can lead to overstressing the muscles around the elbow.

Therapy will include education on activity modification, safe lifting techniques and specific exercises that speed healing.

Various treatments are used for pain relief, including massage, ultrasound and therapeutic laser.

A removable custom wrist-support brace is often made to support the injured tendons in the initial phase of healing. The splint may be transitioned to kinesiology tape to facilitate supported motion and function as healing progresses.

A snug, but not tight, strap worn around the top of the forearm often decreases the pull of the muscles on the elbow and lessens pain.

For the athlete, a therapist can issue agility and sport-specific training exercises that improve performance without stressing the elbow as it heals. For the non-athlete, core, lower body and select upper-body exercises can be utilized to maintain or improve overall fitness and decrease risk for re-injury.

Preventing pain

A simple step to prevent tennis elbow is to perform a gentle warm-up before engaging in a strenuous activity or sport. This may include 10 to 15 repetitions of making a fist, bending and straightening the elbow and reaching arms overhead.

Going for a brisk walk down McGilvra Boulevard before hitting the Madison Park public tennis court is an effective way to gradually increase heart rate and get blood pumping to all the muscles and tendons of the body, making them more supple for activity.

Making sure tools are sharpened and in good working order and the workstation is ergonomically fit will lessen stress on tendons and muscles.
Tennis players should use new, pressurized balls and consider a more flexible racquet with lower tension strings. Working with a coach can help assure proper footwork and swinging technique to help prevent elbow strain.

AARON SHAW is an occupational therapist and certified strength and conditioning specialist at MoveMend (www.MoveMend.info) in Madison Valley.
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