By Ryan Jones, DPT, CSCS
This is a common question that many people ask themselves after a doctor or friend has told them their pain is likely from "tennis elbow." The real name for this injury is called lateral epicondylitis. (Now you understand why everyone calls it tennis elbow!) Simply stated, it refers to pain on the outer elbow due to inflammation of the tendon that extends the wrist. Symptoms also may include pain with gripping and twisting activities. It is commonly diagnosed by performing this test: while holding your arm out straight with hand open and fingers extended, push down on your middle finger and try to resist this motion. If this resistance causes a fair amount of pain along the outer part of your elbow the test is positive for lateral epicondylitis.
While this injury can be caused by many different factors, it's typically associated with overuse from manual labor and workouts at the gym that involve repetitive lifting or gripping. The nickname "tennis elbow" was given to this injury because it is very common amongst the tennis community, in which there is a considerable amount of recurring stress placed on these muscles.
The muscles that are responsible for extending your wrist originate from a large tendon on the outer portion of your elbow. Several muscles come from this broad tendon and continue on into your hand and wrist to help with extension motions of your hand and fingers. With ongoing stress placed on these muscles, they can become aggravated. The root cause may stem from a variety of factors, including weakness in these muscles; weakness of muscles in the shoulder that causes you to compensate and put more stress on your elbow; tightness in your neck; or tightness or poor flexibility of your wrist/elbow muscles.
Fixing the problem most efficiently requires a little sleuthing to determine the exact cause of your symptoms. (A good physical therapist -know any? wink, wink-can conduct a thorough evaluation and point you in the right direction.) The three most important factors in recovering from tennis elbow are stretching/strengthening the muscles, avoiding activities that cause pain, and icing on a regular basis.
The key strengthening exercises -- wrist extension eccentrics -- involve holding a weight with your wrist extended and then slowly lowering it. These should only be performed once each day for 20-30 repetitions. While this may actually cause some discomfort, it is vital to help repair and restore the tendon to its healthy state. Unlike strengthening exercises, stretching exercises should be done several times throughout the day. Further, a type of massage called transverse friction can also help with the healing of the tendon.
Regarding other treatments, you may have noticed the tennis elbow straps worn by several ARXers. These straps are an effective way to help decrease symptoms if you must continue with any painful activities. However, these straps are a pain management technique. They do not eradicate tennis elbow.
If you are experiencing symptoms - and have been for a while - it would be wise to seek a professional consult. Your friends at JumpStart can provide you with a detailed explanation of specific strengthening and stretching exercises, proper massage technique, and more information about rehabilitation for this injury.