How To Tell If You Have Tennis Elbow

Tennis Elbow A Tendinopathy Of The Elbow

Tennis Elbow is antiquated term for an injury, or irritation tissues in the forearm that are responsible for the the activity of extending the wrist and fingers. These tissues are vital for gripping a tennis racquet and generating power with a number of tennis strokes specifically with a singled handed top spin backhand stroke. The prevalence with which tennis players can experience symptoms of “tennis elbow” gave the condition its name but by no means is condition exclusive to tennis. With Tennis elbow the actual site of symptoms, or injury is around the lateral epicondyle, the lateral epicondyle is a bony bump positioned on the outside of the elbow and is the site where the muscles that extend the wrist and fingers attach in a common tendon. It is at either this bony site or just distal to that around 1-2cm lower into the forearm that people commonly experience the pain associated with tennis elbow.

Symptoms Of Tennis Elbow

Someone suffering with tennis elbow will be primarily bothered by pain and have typically preservation of full range of movement with the wrist and elbow.

• This pain is experienced when performing gripping actions, or similar activities involving resistance to wrist, and or finger extension movements.
• Pain with tennis elbow may also be felt when the lateral forearm muscles are stretched, or sensitive when palpated. The site of maximum tenderness is often felt either directly at the lateral epicondyle (that bony bump on the outside of the elbow mentioned above) or about 1-2 cm down from this bony bump closer to the wrist on the mid portion of the tendon.
• With tennis elbow there may also be trigger points present in the muscles of the forearm, specifically in the extensor muscles, these trigger points can make the forearm tender to touch and a common site of pain also.
• Most commonly pain is experienced local to the elbow, however some individuals may experience neck stiffness and tenderness around the neck and shoulder area, as well as having signs of nerve irritation extending along that upper limb towards the neck.

Summary Of Symptoms:

• Elbow pain occurring on one side of the body, however the condition can affect both arms at the same time.
• Pain when gripping and lifting objects will be felt at the elbow, with the exact location of pain experienced around the bony lump on the outside of the elbow or 1-2 cm distal to this point.
• Despite the elbow being the painful area, most elbow movements remain pain free. Yet extending (straightening) the elbow can be painful in many individuals, if so this will typically be most noticeable after having the elbow in a bent position for a sustained period of time.
• Stretching forearm muscles may cause pain,  this can be demonstrated when performing the action of making a fist with the elbow straight and then bending the knuckles down towards the floor.
• Associated neck and shoulder stiffness, with nerve irritation of the upper limb may occur in some individuals.

What Is The Cause Of Extensor Tendinopathy?

Similar to golfer’s elbow which is a condition causing a comparable pain but experienced on the inside of the elbow, tennis elbow is a classic repetitive loading injury. Both conditions are usually resulting from an overload to tissues without suitable time for them to adapt. When constantly using the upper limb in a repetitive gripping motion performing activities that strain the muscles around the elbow, without suitable time for the tissue to rest and recover before load is repeated, can cause tennis elbow. I will state that I have also seen individuals over the years “trigger” a tennis elbow episode via directly bumping their lateral epicondyle on a hard surface. With this knock seemingly starting a process of irritation, causing them to experience tennis elbow symptoms.

Extensor carpi radialis brevis muscle (abbreviated to ECRB) is widely considered to be the main muscle tendon complex involved in tennis elbow, this is despite the pain being felt in what is termed the common extensor tendon.

Tendinopathy associated with lateral elbow pain may include small tears, inflammation, or degeneration of the tendon, depending on the stage and severity of injury. Left untreated, lateral elbow pain can become chronic, although most symptoms will settle in a matter of weeks, or a few months. However it is not uncommon for people to experience ongoing symptoms, symptoms extending on beyond weeks and drifts on for a year, or even longer.
Generally in the first six weeks of onset a tennis elbow condition is considered acute and becomes termed “subacute” around the 6-12 week mark. The injury is classified chronic at three months.  As a physiotherapist I have certainly had people come to me having had the problem ongoing for greater than six months, or even a year and still make a full recovery. So just because you have a “chronic tennis elbow” does not mean you can not be symptom free again. If you want to know more about your elbow pain, or have an ongoing elbow pain you can’t shake then call Sydney Physio Clinic and we will be delighted to assist you.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on How To Tell If You Have Tennis Elbow should consult his or her physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.