By Sarah Krummenacher
Physiotherapist at Life Ready Physio Bayswater

What is tennis elbow?
Tennis elbow refers to an overuse injury related to the group of muscles that extend the wrist and fingers. This group of muscles are located in the forearm and attach via a common tendon onto a bony lump on the outside of the elbow (the lateral epicondyle). This attachment site is typically where the injury occurs.

Signs and symptoms

• Pain on the outside of the elbow with gripping tasks, and tasks involving repetitive or resisted wrist or finger extension. Some common examples include lifting the kettle, opening jars, weeding in the garden, typing on the computer, heavy pulling or lifting, and playing tennis
• Tenderness or pain when pressing on or poking the bony lump on the outside of the elbow (the lateral epicondyle)
• Tightness and/or tenderness in the wrist extensor muscles
• Sometimes there can be pain or discomfort when stretching the wrist extensor muscles
• In some cases, there may also be irritation of the radial nerve. This may be felt as “nerve pain”

Causes
Tennis elbow occurs when more force or load is applied to the muscle attachment area than the tissue can tolerate. This may occur due to:

• One episode of excessive and/or unaccustomed activity involving the wrist extensor muscles. For example, a weekend spent doing manual labour such as hammering, screw-driving or gardening
• Ongoing repetitive overuse of the wrist extensor muscles. For example, an occupation involving lots of typing on the computer
• Weakness and/or tightness of the wrist extensor muscles. A weak muscle is not able to tolerate as much load/activity as a strong muscle and therefore will become “overused” more easily

Management
Treatment will vary depending on individual patient presentation. Physiotherapy treatment may include the following:

• Techniques to reduce muscle tension. For example, dry needling or massage
• Exercises to strengthen the wrist extensor muscles
• Mobilisation of the elbow joint
• In some cases, neural mobilisation and treatment of the neck and shoulder
• Use of a tennis elbow brace or strapping

Additional treatment options may include:

• Cortisone injection – there are both pros and cons to receiving a cortisone injection. Make sure to discuss these with your physiotherapist

Things to be aware of

• Not every person with tennis elbow requires the same treatment. Treatment will be guided by individual assessment findings
• Not every person with pain on the outside of the elbow has tennis elbow. Pain can be referred to the elbow from another site, such as the neck. Therefore, it is important to get your symptoms assessed to determine the appropriate management pathway for you.

If you feel that you’re experiencing tennis elbow pain, contact your local Life Ready clinic for a thorough, individualised physiotherapy assessment.