Its name doesn’t correlate well to the degree of pain it can cause our patients. No, Tennis Elbow isn’t just a casual ache or soreness nor does it only occur in tennis players; for many patients, it’s a total show-stopper.
Tennis Elbow often begins with a seemingly innocent dully ache. Many times, patients report feeling pain when lifting something up in the way that may feel natural to them – with their palm facing down. It could be a opening jar, lifting a child, or grabbing a bag of groceries. It can rapidly advance to sharp pain, radiating up the arm on the lateral, or outside of the elbow.
What is Tennis Elbow?
Tennis Elbow is typically caused from overuse. Repetitive motions. Practicing sports and going through the same motions again and again. The repetition causes the tendons in your hands, arms and elbows to become inflamed. And, once they’re inflamed, they stay that way. The muscles just can’t recover.
It can happen slowly over time, such as may be the case with many athletes or folks who spend a significant amount time at their computer, moving their mouse in the same way, again and again. Or it can feel like an overnight injury. Ty Pehrson, MOTR/L, CHT recalls a recent patient who spent an entire day in her yard, moving around rock and lifting heavy loads. He explains, “The next day she simply could not move her hand; she could not bend or straighten her elbow without excruciating pain.”
Tennis Elbow can happen to anyone but it’s more common in females ages 20 to 45. It’s unclear why, but one theory is that it’s a time in a person’s life when they are challenging their bodies to get everything done, and don’t “train for life”. They are completing house projects. Caring for children. Spending time working at the computer without breaks. Lifting heavy objects, moving, and so on.
Treatments for Tennis Elbow
Many athletes take a proactive approach to Tennis Elbow. They train their bodies from the bottom up and the top down, and understand that stress on the elbow can come from movement restrictions, poor sequencing or weakness in the hips, core, neck, or shoulder. So they regularly seek a movement assessment and train for the specific needs of their body and their sport. They may also get regular deep massages to help eliminate the build up of tension and they use ice to help their muscles recover. Even the “worker athlete” or the “mom athlete” should be training their body for their daily activities and take breaks from repetitive movements to avoid overuse.
Others put off treatment. They may not realize they have a serious problem, or they think it will just go away on its own. Rest and ice do help, but rest has proven to be the biggest challenge for our clients. (We get it, it’s hard to stop all activity for several weeks!).
Some doctors will use cortisone shots to help mitigate the pain and inflammation, but it’s not always a sure bet. There’s about a 50 percent success rate. If the problem worsens and surgery is required, that means that the affected tendons will be cut away from the inflamed bone and then reattached. Recovery for surgery takes approximately six to eight weeks.
What happens in therapy?
Most of the time in therapy, we first start from a place of rest. We may immobilize your elbow and treat the tissues around the elbow with specific techniques to relax them, loosen and stretch the tissue fibers. We may also give patients a night time splint to keep the arm at consistent rest. The rehab progresses through specific stretching and strengthening, as well as retraining movement mechanics to lesson the load on the injured tendon.
And, for patients who have undergone surgery, the goal is to re-strengthen the muscles and to retrain the body to withstand the load of their daily, work, or athletic activities. It is also to teach strategies to keep their body healthy long term and to avoid re-injury. To do this, we leverage progressive strengthening, from isometrics to passive, active, and resistive exercise. Over time, we slowly widen the range of motion, moving more and more to get our patients to a place where they can perform motions comfortably.
Lastly, and probably most importantly, we’ll also look to discover the root cause for why you got Tennis Elbow in the first place! We’ll assess your movement mechanics and look at the surrounding joints and musculature, including your shoulder, neck, mid-back, and maybe even your hip and core.
The goal: get you back to an active, healthy lifestyle and make sure you don’t wind up in therapy again.