Tennis Elbow or Lateral Epicondylitis

With the Australian Open now over, I thought I’d take a moment to write about the injury “Tennis Elbow” or Lateral Epicondylitis as it is known in medical circles.

As is the case with many medical terms, Tennis Elbow is somewhat inappropriately named as we see as many, if not more of these injuries stemming from poor posture at work, excessive mouse use or lifting weights at the gym as we do from the tennis court.

However what is agreed is the problem comes from the extensi-carpi radialis brevis muscle or ECRB. This muscle goes from the outside point of your elbow and travels down to control the extension of your third finger.

Tennis elbow is a notoriously difficult injury to treat because of two main factors:

  • Because the initial pain is low-grade and does not limit function, most people who experience it are not prompted to get it treated early. Therefore it is not uncommon that we see someone who’s had this problem for 4-6 months before treatment is commenced.
  • The source of the problem can be multifactorial. A few different areas can create pain and irritation in this muscle such as
    (i) Irritation or possibly inflammation that is contained within the muscle itself.
    (ii) Restriction or tightness in the radial nerve which passes through the muscle.
    (iii) Referred pain from the neck (C6 level specifically) which then causes the muscle to function poorly and become overworked.

As a result, our physiotherapy treatment needs to consider all three possible causes, plus the history of the injury to ensure our treatment choice gives the quickest and most effective relief.

Common physiotherapy treatment techniques we use for Tennis Elbow are:

  1. Local soft tissue massage or “frictions” to loosen up the ECRB muscle.
  2. Stretching the ECRB muscle and tendon.
  3. Dry Needling the ECRB muscle
  4. Mobilisation of the elbow joint
  5. Mobilisation of the neck at the level specific to the nerve root that supplies the ECRB muscle.
  6. Mobilisation exercises for the radial nerve.
  7. Taping and bracing of the ECRB muscle
  8. Postural taping of the neck and upper back.
  9. Advice on loading and returning to injury
  10. Strengthening the weakened areas.
  11. Referral to a sports doctor, radiologist or GP for a corticosteroid injection to speed up muscle healing.

If you have any questions about Tennis Elbow or Lateral Epicondylisis please feel free to contact us.