Tennis & Golfers Elbow

Tennis & Golfers elbow (aka: Lateral & medial epicondylitis) is an overuse injury occurring on the outside & inside of the elbow, or more specifically, at the common extensor & flexor tendons that attaches to the lateral & medial epicondyle of the humerus.

Tennis & Golfers elbow (aka: Lateral & medial epicondylitis) is an overuse injury occurring on the outside & inside of the elbow, or more specifically, at the common extensor & flexor tendons that attaches to the lateral & medial epicondyle of the humerus.

It gets its common name from the fact that it is a common injury among tennis and golf players, however, anyone can get this condition if they over-stress the muscles that attach at the elbow.

What are the signs/symptoms?

- Pain on the outer or inner part of elbow

- Gripping objects and wrist extension or flexion is usually painful

- Morning stiffness.

- Weakness of the forearm

What causes it?

- Commonly caused by repetitive microtrauma from overuse of the muscles forearm muscles.

- Other possible risk factors for epicondylitis include taking up tennis or golf later in life, poor ergonomics while typing for a prolonged period of time, or other unaccustomed strenuous activities.

- Some studies have shown that trauma such as direct blows to the elbow, a sudden forceful pull, or forceful extension can also cause these conditions.

How can it be treated?

The British Medical Journal (BMJ) tells us that most cases of tennis & golfers elbow will get better all on their own within 6-12 months (See reference 1). However, there are treatments that research has found can shorten this recovery time:

Non-surgical treatments that can help

Elbow Mobilization – Research studies suggest that elbow joint mobilization can provide immediate, short-, and long-term benefits such as pain reduction and improved function (See reference 2 and reference 3).

Manipulation/ articulation – The addition of manipulative treatment to the cervical and/or upper-thoracic spine can produce additional improvements in pain and disability (See reference 3).

Rehabilitation Exercise – A supervised exercise programme consisting of slow progressive eccentric exercises and static stretching of the of wrist extensor & flexor tendon has been shown to help reduce pain and improve function (See reference 4).

What about injections or surgery?

While more invasive treatments are sometimes required, they are usually not the best first option and are better left as a last-resort. The British Medical Journal (See reference 1) tells us that:

- Cortisone injections are harmful in the longer term and are not recommended.

- More research is needed for platelet-rich plasma injections and hyaluronan gel injections.

- Surgery and botulinum toxin injections should only be used in the worst cases that last longer than 6 months.

References

1. Orchard J & Kountouris A. (2011) The management of tennis elbow. BMJ;10(342):d2687.

2. Vicenzino B, Cleland JA, Bisset L. (2007). Joint Manipulation in the Management of Lateral Epicondylalgia: A Clinical Commentary. J Man Manip Ther;15(1):50–56.

3. Herd CR, Meserve BB. (2008). A Systematic Review of the Effectiveness of Manipulative Therapy in Treating Lateral Epicondylalgia. J Man Manip Ther;16(4):225–37.

4. Stasinopoulos D, Stasinopoulos I, Pantelis M, Stasinopoulos K. (2010) Comparison of effects of a home exercise programme and a supervised exercise programme for the management of lateral elbow tendinopathy. Br J Sports Med;44(8):579-83.