Tennis Elbow

Background:

This can be a very painful and debilitating injury that not only affects your tennis but many other daily activities. The area affected is the Common Extensor Tendon, so if you lay your hand out on the table in front of you with your palm facing the ceiling, it is the outside of your arm (the inside is Golfers Elbow and different treatment is required).

The problem primarily arises due to overloading of the tendon through secondary weakness around the shoulder or tightness in the pronators of the forearm (muscles that turn your palm towards the ground). Essentially in the modern world this is due to our requirement to sit, or slump, for long periods of the day working at computers, however driving and ‘relaxing’ on the sofa also add to the extra load.

This in turn leads to a number of problem areas arising:

• We get stiff in our mid back
  
• We get weak in our shoulder rotator muscles
  
• We lose range in the ability to turn our hand up towards the ceiling – no cheating keep the elbow still!

And eventually we end up with tendonosis through long term poor loading of the soft tissues – this is not something that starts when the pain begins it is something that builds slowly over a longer period of time.

I would always advise you to seek the expert opinion of a chartered physiotherapist to fully diagnosis your individual problem but hopefully improving your posture at work and home along with these few simple exercises can help get symptoms under control, or even prevent the problem from arising in the first place.

Helpful Exercises:

Lying on Rolled Towel – fold a hand towel in half and roll it up, lie on your back on the floor with the towel starting at the point a T-shirt would sit on your neck with the towel going down the middle of the back, place a pillow or two under your head for support, stay on the towel for about 5 minutes taking a few deep breathes to help you relax into the stretch. Best to do at the end of a hard day at work.

Forearm Stretch – stand in front of a wall and straighten your arms out in front of you with your fingers pointing down to the ground arms rotated outwards, start at chest height and push your fingers to palms against the wall by straightening your elbows completely, you should feel a deep stretch in the upper side of the forearm. Keep your palms against the wall as you move up the wall to increase the stretch, hold for 1 minute and do 3 sets.

Trigger Point Relief – place your fingers across your forearm with the second starting in the crease of the elbow and your hand facing the ground, mark the point where your little finger lies on the muscle bulk, use your thumb to work on that line and find the painful point and hold the pressure until it releases.

Shoulder Strength – at home use a bag of sugar or appropriate small weight (these are postural muscles), lie with your affected shoulder up and let the hand fall across the stomach, using the weight lift the arm up keeping the elbow tucked in against your side therefore working the shoulder blade area. Keep your shoulder from rotating forwards as you drop the hand back across your stomach to maintain good form. This can also be done in standing in the gym using a pulley and rotating the hand away from the body with the pulley coming across the front of the body.

Paul Goss MCSP
Chartered Physiotherapist

Supports
We are pleased to be able to introduce the Go-Strap from Australia as an innovative new support to assist with tennis elbow problems. It is totally unique in the way it unloads the tendon affected in this type of injury leading to greater support of the affected area.

Go to www.bodylogicsupplies.co.uk to purchase or find out more details.