People use the term tennis elbow or lateral epicondylitis, because tennis is the sport that most often cause this injury. Overload of specific muscles in the arm is resulting in soft tissue injury.
Not only tennis, but also other sports and daily activities, which include a large number of repetitions of extending the wrist or palm, can cause the injury and pain on the elbow. Read more about tennis elbow in the article.
Tennis elbow – elbow pain syndrome
Tennis elbow – pain on the lateral side of the elbow
A tennis elbow is not necessarily related to playing tennis. It very often occurs to people who put excessive strain on the forearm in their daily lives, especially when they put extreme strain on the wrist extensors. This usually happens when performing repetitive movements.
People who work a lot with a computer often suffer from such injuries – typing and clicking on a computer mouse, and those who work a lot physically with tools.
People feel pain on the outside of the elbow, right where the wrist extensors attach to the bone. The wrist extensors are group of muscles that run from the fingers to the elbow along the upper forearm. It is the performance of this movement that is limited by pain.
Which other symptoms can lateral epicondylitis cause?
Some even feel pain in the back of the forearm. There may also be parenthesis (tingling) in the forearm and pain in the middle finger.
Inflammation of the tendons attached on the lateral side of the elbow causes pain.
In severe cases, pain at the tennis elbow also hinders daily activities. Even activities like grabbing and lifting a coffee cup or just a pencil can cause sudden and sharp pain.
When do we say tendinitis and when tendinosis?
Tendinitis of the extensors of the wrist or inflammation of the tendons attached to the elbow, not only causes pain, but also reduced function of the hand. We talk about tendinitis when it is an acute injury lasting a maximum of 6 weeks. A period of more than 6 weeks, however, is considered to be an injury of a chronic nature called tendinosis.
Muscle lesion is not felt immediately
The injury is common in people between the ages of 30 and 60. Under the age of 20, such injuries or lesions rarely occur.
The muscle lesion occurs suddenly. Although there is a small tear in the tendon or muscle, the patient does not feel much pain at that moment, in fact he does not feel anything special at all.
Nature does not heal 100%
The first mild pain manifests itself as muscle fatigue within a few days after the injury. The greater pain only occurs after about 14 days.
Nature itself tries to heal the lesion. However, this is repeatedly prevented by hundreds of muscle contractions, leading to an irritated scar (we call it “self-perpetuating inflammation”).
Which muscles do most commonly cause tennis elbow injury? These are extensor carpi radialis longus,
extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum communis and others.
Depending on the location of pain there are different types of lesions (type 1,2,3 or 4). Depending on the injury, the physiotherapist then decides on the type of therapy. The site of injury may be:
- supracondylar part,
- tenoperiosteal part,
- part at head height of radius and
- part at the height of the neck radius.
Tennis elbow physiotherapy requires perseverance
Tennis elbow or lateral epicondylitis is not a completely innocent injury. It requires perseverance and patience because we cannot eliminate it quickly.
Shock wave therapy is extremely effective in treating tennis elbow
We can use electrotherapy and ultrasound as an addition, however, these two are just a good support to other therapies. Manual therapy is also urgently needed, more specifically we are talking about the local transverse friction. It is performed in a certain time sequence in order to prevent scar tissue.
But most physiotherapies use an extremely good substitute for manual treatment – therapy with shock wave or extracorporeal shock wave therapy.
Tennis elbow treatment procedure
To prepare the tissue for therapy, as a kind of heating of the soft tissue, we use Tecar therapy. It causes better elasticity and suppleness for further treatment. Then, depending on the type of injury, we choose transverse friction therapy or ESWT therapy.
We do not want to stretch the injured site longitudinally (longitudinally), but in width. Only in this way do we “multiply” the fibers, breaking up possible adhesions between the layers and scars.
After, we use electrotherapy, ultrasound therapy, kinesio tapes, ect. We must not forget about therapeutic exercises for tennis elbow. These are eccentric exercises or exercises, which strengthen the muscle in the direction of stretching.
In some cases, it is even necessary to infiltrate the anesthetic (injection) into the injured area and only then comes the physiotherapy.