Tennis Elbow: Repeated Strain And Tear Of The Muscles & Tendons

The elbow is an important part of the body that allows for complex movements like stretching and contracting the arm, lifting objects and more. Resilient muscles and tendons run along the elbow joint through to the wrist.

When stressed, they act as flexors in both joints and facilitate the transfer of power along the entire arm. These tendons can become inflamed from overuse, causing pain and irritation. In mild cases, these strains can be resolved with treatment and often go unnoticed.

However, repeated strain or wear and tear of the muscles and tendons can lead to pain and inflammation on the outside of the elbow. Patients suffering from this condition are diagnosed with “Tennis Elbow”.

Causes Of Tennis Elbow

Tennis elbow usually affects the tendon attachments of the muscles running along the hand to the elbow. These tendons are responsible for movement in the wrist and fingers. Some of the more common risk factors that can impact these tendons and lead to such an injury include:

• Prolonged overloading of the exterior muscles (outer elbow) in the arm. This is typical for people doing manual labour and construction jobs (eg: carpenters, bricklayers, concreters) which involve regular heavy lifting.
• Daily repeated use of heavy tools during work also adds immense stress on the tendons.
• Repeated movements over long periods of time, typical in day jobs like the prolonged use of computers.
• Repeated movement of the arm in sporting activities, usually racket sports, like tennis, squash and badminton.
• Accidental trauma and injury can often lead to damage, developing painful symptoms.

Tennis Elbow Symptoms

Symptoms of the condition are mild in the initial stages but tend to get progressively worse. The disease is degenerative and can have significant long term risks. Some of the most commonly known symptoms to look out for include:

• Localised pain on the outside of the elbow. Especially noticeable when stretching or moving the wrist and fingers. This pain in the initial stages arises under stress on the tendons and subsides when the activity is halted and the muscles are at rest.
• Inflammation and redness of the arm is common. With progressing inflammation, it is common for the patient to experience stiffness and sensitivity in the affected limb.
• As the disease progresses the pain and discomfort become more persistent. A patient will start to have difficulty with the most basic of movements. There is rigidity and pain in trying move the middle finger in particular.
• This severely impacts the mobility of the arm and has a debilitating impact on the patient’s quality of life and ability to perform simple tasks with their hands.
• In chronic cases, the entire joint is compromised and the patient experiences sharp lasting pain that can radiate to the upper arm.

It is in the patient’s best interest to seek immediate medical attention to prevent the pain from progressing into the chronic stage. An early diagnosis is the best chance at preventing further issues and getting a full recovery.

Diagnosis Of Tennis Elbow

A medical professional (usually a GP or Physiotherapist) begins with a complete patient history and thorough physical examination of the elbow. This provides critical information about the risk factors to the patient as well as allowing for a study of the progression of the condition.

Sophisticated imaging technology like X-Rays and ultrasound scans can be used to get more information about the condition of the bones, muscles and tendons in the joint.

Treatment For Tennis Elbow

The treatment for Tennis elbow is mostly conservative. Surgery is almost never required as an option. The primary focus is to relieve symptoms of pain and discomfort and tackle the serious problem of inflammation.

Lifestyle Change

Strenuous activities should immediately be halted to prevent any risk to the elbow. The arm needs sufficient time to heal and avoiding high-intensity work or sporting activity can be instrumental in relieving the joint. Alternating arms for certain activities can help here.

Physiotherapy And Tennis Elbow Exercises

Complete immobilisation is not necessary, in fact, it is highly advisable to seek regular physiotherapy. Consistent physiotherapy helps with targeted muscle training and is a proven effective treatment path.

The physiotherapy exercises can help promote reorganisation of the muscles and are the most effective option to curb the disease. Exercises can help maintain the mobility and effective functioning of the joint and are best continued even after the symptoms have gone away.

Prescribed Painkillers

Painkiller such as Ibuprofen or Panadol can be used to help alleviate pain and discomfort in patients, only when prescribed by a medical professional. Pain, however, is a crucial indicator of the injury.

Painkillers merely mask the pain without addressing the underlying condition. Long term use of painkillers can have many negative side-effects and can be counter-productive.

Anti-Inflammation Steps

Managing inflammation is crucial to take pressure off the arm and allow for healing. This should only be pursued when directed by a medical professional. There are several measures a patient can take to seek relief from inflammation. Some of them include:

• Anti-Inflammatory medication as prescribed by a medical practitioner.
• TENS currents, a pain-relieving stimulation current treatment is often effective. It can be safely carried out in a patient’s home and is very convenient.
• Ultrasound Therapy
• Application of cold blankets or cryotherapy with short-term ice packs or cold air is often effective.

Elbow Brace And Support

Elbow supports can significantly improve a patient’s quality of life. It helps reduce the pain and discomfort patients experience by relieving the joint, allowing them to continue in their normal activities.

Wearing a Bauerfeind elbow support like the EpiTrain, EpiPoint or Sports Elbow Strap can minimise your chances of injury by providing enhanced stability and healthy proprioception. With regular use of a strap, patients can transition to physiotherapy faster.

Surgical Intervention

Only in rare cases when conservative methods have failed, and the disease has progressed into an advanced or chronic case does surgery become an option. Patients have two major surgical options including:

• Tenotomy: where the surgeon makes an incision along the tendon to reduce load and overstretching of the tendons.
• Denervation: where the surgeon clears out the nerve network in the affected region, numbing the area and providing relief from pain.

Surgery brings with it many risks, and should only be considered as a last resort.

Tennis Elbow Braces & Supports

Medical braces like the EpiTrain, EpiPoint and Sports Elbow Strap aim to reduce the stress on the muscle at the base of the joint and helps reduce pain. They are often instrumental in the primary stage of treatment to shield and support the elbow by targeting the tendons that are affected by Golfer’s Elbow and Tennis Elbow.

The brace reduces stress on the joint with targeted massage pads. This soothes the tendons and reduces pain. The brace supports the arm in everyday movement and can lead to a significant improvement in quality of life.

The EpiTrain Elbow Support brace reduces stress on the joint and applies medical-grade compression. This promotes the breakdown of edema (inflammatory swelling) and is very comfortable for all day use. The intertwined silicon pads provide a massaging effect to alleviate the pain without limiting mobility.

The brace supports the arm in everyday movement and can lead to a significant improvement in quality of life.

The EpiPoint Elbow Strap features anatomically shaped pressure pads that gently massage the arm and relieve the irritated tendons with pinpoint accuracy. The stimulation activates the metabolism and boosts blood circulation, thereby improving healing.

Tennis Elbow Strap

The Sports Elbow Strap utilises a very similar method of targeting the affected tendons, however it uses a special feature called the BOA system, which allows for complete control of how firm the support is, down to the millimetre, to completely incredibly accurate relief.

If you are experiencing milder symptoms we would recommend the EpiPoint or the Sports Elbow Strap. Should the symptoms be more moderate to severe, we would recommend the EpiTrain. If different activities result in varying degrees of discomfort, a combination of the strap and the support may work best.