What is tennis elbow?

Tennis elbow is a common injury and got its' name because tennis players tended to get it. It is inflammation or degeneration of the tendon that attaches to the bony bit (lateral epicondyle) on the outside of the arm or elbow. A common cause in tennis is poor backhand technique or a grip that is too small. A small grip will mean the muscles in the elbow must work harder and become inflamed. The majority of people getting tennis elbow are between 40 and 50 yrs but it can affect athletes of any age. (Is this because 40 - 50 yr olds are the ones with more time to play?)

Hitting tennis backhands with a 'wristy' action will put far too much strain on the elbow. The wrist should be firm and not bent when the ball is struck so the forces can be spread over the arm, shoulder and the rest of the body.

Tennis elbow can be a difficult injury to treat so it is important you do the correct thing as early as possible. The symptoms for this injury are very similar to Entrapment of the radial nerve which I recommend you also have a look at.

Symptoms include:

• Pain on the bony bit (lateral epicondyle) on the outside of the elbow, or 1-2cm forward of it on the tendon.
• Weakness in the wrist.
• Pain in the outside of the elbow when the hand is bent back (extended) at the wrist against resistance.
• Pain on the outside of the elbow when trying to straighten the fingers against resistance.
• Pain when pressing in on the bony bit on the outside of the elbow.

It is important to have the neck examined as well as elbow pain can be referred from problems in the neck.

What can the athlete do?

• Ice the injury for two days (20 min's on up to six times a day)
• Rest.
• Wear a brace or support to protect the tendon whilst healing and strengthening, particularly when returning to playing / equivalent.

What can a sports injury specialist or doctor do?

• Apply ultrasound or laser treatment.
• Use massage therapy.
• Advise on rehabilitation.
• Prescribe anti-inflammatory medication.
• Give a steroid injection.
• Operate - if the usual treatments have failed for about a year then this might be considered.

Rest is a very important component in the healing of this injury. It may heal quickly within two weeks but you could suffer with this problem for up to two years. When the symptoms have settled down it is essential you fully rehabilitate and strengthen the elbow and follow guidelines that will help you avoid the injury in the future:

• Correct technique - play the backhand with the arm not the wrist!
• Use a forearm brace or heat retainer if you have a weak wrist or elbow.
• Do not play with wet, heavy balls.
• Use a light racket if you do not play very often.
• Make sure your strings are not too tight.