Tennis Elbow

What is tennis elbow?

Tennis elbow, also known as lateral epicondylitis, is a painful condition that affects the outer part of the elbow. Despite its name, you don't have to play tennis to get it. It happens when the tendons that connect your forearm muscles to the outer part of your elbow become inflamed or develop small tears.

At Milsons Point Health, our team of Physiotherapists, Chiropractors, and Exercise Physiologists in Milsons Point often see patients with tennis elbow. We understand how worrying this condition can be and how it can really impact your daily activities and work. So we’ve put together this guide to help you understand more about tennis elbow, and the various treatments out there.

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What are the symptoms of tennis elbow?

The symptoms of tennis elbow usually develop gradually over time. Common signs include:

• Pain on the outer part of your elbow, which may travel down your forearm
• Weakness in your wrist and hand, making it hard to grip objects
• Pain when you do activities that use your wrist and hand, like turning a doorknob or holding a cup
• Stiffness in your elbow, especially in the morning
• Pain that gets worse when you straighten your arm fully

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What causes tennis elbow?

Tennis elbow is usually caused by overuse of the forearm muscles that extend your wrist and fingers. This can happen from:

• Sports activities: Not just tennis, but also sports like squash, badminton, and fencing
• Work activities: Jobs that involve repetitive arm movements, like painting, plumbing, or carpentry
• Everyday activities: Things like using scissors, chopping cooking ingredients, or excessive computer mouse use
• Poor technique: Using incorrect form when playing sports or doing work tasks
• Age: It's most common in adults between 30 and 50 years old
• Lack of strength or flexibility in the forearm muscles

Our Physiotherapists and Chiropractors in Milsons Point can help you identify what might be causing or contributing to your tennis elbow and develop a treatment plan to address these factors.

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How is tennis elbow diagnosed?

When you visit Milsons Point Health with symptoms of tennis elbow, our healthcare professionals will use several methods to diagnose your condition:

• Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
• Physical examination: Your Physiotherapist or Chiropractor will check your elbow, arm, and neck for signs of tennis elbow. They may apply pressure to different areas or ask you to move your arm in certain ways.
• Specific tests: There are several tests that can help diagnose tennis elbow, such as:
  • Cozen's test: extending your wrist against resistance
  • Maudsley's test: extending your middle finger against resistance
  • Mill's test: fully straightening your elbow while your wrist is flexed.
• Grip strength tests: To check if your grip has been weakened by tennis elbow
• Imaging tests: In some cases, X-rays, ultrasound, or MRI scans may be recommended.

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Do I need any scans for tennis elbow?

While tennis elbow is often diagnosed through physical examination, imaging tests can sometimes be helpful. These may include:

• X-rays: These can't show soft tissue damage but can rule out other problems like arthritis or a fracture.
• Ultrasound: This can show if there's inflammation in the tendons and can help guide treatment.
• MRI (Magnetic Resonance Imaging): This gives a detailed view of the soft tissues and can show the extent of tendon damage.

Our Physiotherapists and Chiropractors in Milsons Point can help organise and write referrals to imaging centres for these scans if necessary.

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How is tennis elbow treated?

Treatment for tennis elbow depends on the severity of your symptoms and how long you've had them. These include:

• Rest and activity modification: Avoiding activities that worsen your pain can help the tendons heal.
• Ice or heat therapy: To reduce pain and inflammation.
• Exercises: Our Physios, Chiros, and EP’s can teach you exercises to improve the flexibility and strength of your forearm muscles.
• Bracing: Wearing a special brace or strap can help reduce stress on the injured tendons.
• Manual therapy: Techniques like massage, mobilisation, and manipulation can help reduce pain and improve function.
• Pain relief: Over-the-counter pain medications or prescription drugs may be recommended to manage pain and inflammation.
• Injections: In some cases, corticosteroid injections or other types of injections might be used.
• Surgery: In severe cases or when other treatments haven't helped, surgery might be necessary.

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When is surgery required for tennis elbow?

Surgery for tennis elbow is generally only considered when:

• Conservative treatments haven't improved your symptoms after 6 to 12 months
• You have severe, persistent pain
• Your symptoms are significantly affecting your daily life or work

The most common surgery for tennis elbow involves removing the damaged tendon tissue and reattaching healthy tendon to the bone. This can be done through a traditional open surgery or a minimally invasive procedure.

If surgery is being considered, our Physiotherapists and Chiropractors in Milsons Point can recommend some good orthopaedic surgeons that perform this procedure, and provide any post-operative rehabilitation required afterwards.

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What role does exercise play in treating tennis elbow?

Exercise is a crucial part of treating and preventing tennis elbow. It helps to:

• Strengthen the muscles in your forearm
• Improve flexibility in your wrist and elbow
• Reduce pain and stiffness
• Improve your grip strength
• Prevent future episodes of tennis elbow

Our Physiotherapists and Chiropractors at Milsons Point Health can design you an exercise program tailored to your specific needs. This might include:

• Wrist extensor stretches
• Forearm strengthening exercises
• Eccentric exercises (lengthening the muscle while it's under tension)
• Grip strengthening exercises

Remember, it's important to start gently and gradually increase the intensity of your exercises. This helps respect the irritated tendon underneath and reduces the chance of acute flares of pain which often limit the speed of recovery.

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How does bracing help with tennis elbow?

Bracing is often recommended as part of the treatment for tennis elbow. Here's how it helps:

• Reduces stress on the injured tendons: By spreading the force over a larger area
• Provides compression: Which can help reduce pain and inflammation
• Reminds you to modify your movements: Wearing a brace can make you more aware of how you're using your arm
• Can be worn during activities: To provide support while you're working or playing sports

At Milsons Point Health, our Physiotherapists and Chiropractors in Milsons Point can all help fit you with a suitable elbow brace and show you how to use it effectively.

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How can I prevent tennis elbow or stop it from getting worse?

While you can't prevent all cases of tennis elbow, there are steps you can take to reduce your risk or prevent it from worsening:

• Use proper technique: Whether you're playing sports or doing work tasks, make sure you're using the correct form.
• Strengthen your forearm muscles: Regular exercises can help build up the muscles that support your elbow.
• Stretch before activities: Gentle stretching can help prepare your muscles for work or play.
• Use the right equipment: Make sure your sports equipment or work tools are the right size and weight for you.
• Take breaks: If you do repetitive arm movements, take regular breaks to rest your arms.
• Gradually increase activity: If you're starting a new sport or job, gradually build up your time and intensity.
• Maintain overall fitness: Good general fitness can help prevent many types of injuries.

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When should I see a healthcare professional about elbow pain?

You should consider seeing a healthcare professional if:

• You have persistent pain on the outer part of your elbow
• Your elbow pain is affecting your sleep or daily activities
• You're having difficulty gripping objects
• Your symptoms have been getting worse over time
• You've tried home remedies without success

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Can tennis elbow heal on its own?

In some cases, particularly if caught early, mild tennis elbow may improve with rest and simple home care. However, without proper treatment, it can become chronic and lead to long-term pain and decreased function. That's why it's important to seek professional help if you're experiencing persistent symptoms.

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How long does it take to recover from tennis elbow?

Recovery time can vary greatly depending on the severity of your condition and the treatment approach:

• For mild cases treated early: You might see improvement in a few weeks to a couple of months.
• For more severe or chronic cases: Recovery can take several months, with some people needing up to a year to regain full strength and function.

Remember, everyone's recovery is different. Factors like your age, overall health, and how well you follow your treatment plan can all affect your recovery time.

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Can I still play sports or work with tennis elbow?

Whether you can continue playing sports or working with tennis elbow depends on the severity of your condition and the nature of your activities. In many cases, you may need to modify your activities or take a break to allow healing. Your healthcare provider can give you specific advice based on your situation.

At Milsons Point Health, our Physios and Chiros can work with you to develop strategies for returning to playing sports safely, such as modifying your technique, using appropriate equipment, or incorporating specific exercises to support your recovery.

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Take home message

Tennis elbow is a common condition that can significantly impact your daily life and activities. However, with proper diagnosis and treatment, most people with tennis elbow can find relief and improve their elbow function.

At Milsons Point Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists in Milsons Point can help you understand and recover from tennis elbow effectively. We offer a range of treatments and can provide personalised advice on exercises, ergonomics, and lifestyle modifications to help you achieve long-term elbow health. Remember, early intervention is key in managing tennis elbow.

So if you're experiencing persistent elbow pain or weakness, don't hesitate to contact us at Milsons Point Health. We have clinics conveniently located around Sydney in Mt Kuring-Gai, Asquith, Willoughby, Dural, and Blacktown so you can get the right advice and treatment for your tennis elbow.

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