Tennis or Golfer’s Elbow? We’ve Got The Know-How.

Tennis or Golfer’s elbow (aka lateral or medial epicondylosis) refers to a condition affecting the tendinous junction at the elbow. The name is very deceiving in that no tennis or golf needs to be played in order for signs and symptoms to occur. Treatment & management (as always) is case dependent however, there are consistencies for both treatment and management which are outlined below.

This condition occurs when the hand and wrist undergoes repetitive motion eg. typing, using a mouse, using a hammer, playing tennis or golf, forklift driving etc. The muscles in the forearm become overused and tightened causing the tendon (which attaches the muscle to the bone) to become irritated. It can be quite a painful condition, producing pain in the elbow, wrist, hand and/or fingers. Another common finding is weakness in grip strength (think: pouring water from a kettle, turning on taps, opening jars etc).

This is a complaint which responds quite well to manual therapy in addition to proper management and care outside of the treatment room. 

Manual therapy generally involves:

• Loosening the muscles in the upper extremity, neck & shoulders, 

• Mobilising the joints of the same upper extremity, neck & rib cage

• Multiple treatment techniques may be used including (but not limited to):

  • Soft tissue massage, 

  • Stretching, 

  • Muscle Energy Techniques, 

  • HVLA and/or 

  • Dry needling

  • Vacuum Therapy / cupping. 

If imaging is indicated, ultrasound is the most proven method to detect irritation to the tendon. 

Management is a major factor in the resolution of this condition in that irritation to the tendon can easily occur with simple day-to-day activities which you may not suspect to be enough to actually cause any irritation. 

Management strategies include:

• False insertion brace (acting to offload the affected tendon)

• Icing regularly 

• Ergonomic re-assessment of your desk setup, or whatever activity is thought to be the cause of the irritation

• Upper extremity stretches 

• Neck stretches 

• Wrist strength exercises - the type of muscular contraction and the timing of the introduction of these exercises is vital

  • In order to build strength in the forearm, without irritating the tendon, the muscles must undergo an eccentric contraction (ie. the muscle lengthens while it contracts) rather than a concentric contraction (ie. the muscle shortens while it contracts).

  • The Theraband Flex bar is a great non-invasive management tool which is used to lengthen and strengthen the muscles of the forearm (ie. provides an eccentric contraction).

For those elbows which prove themselves to be stubborn and persistently painful (even after adequate treatment and management), further intervention may be required. This may include:

• Shockwave therapy

• Cortisone injections

• PRP injections

*Even if these more ‘invasive’ techniques are used, adequate rest, management and treatment remains vital!

If this sounds like something you have been struggling with, get into contact with us by emailing or calling the clinic, we would absolutely LOVE to work with you.