At Specialists On Hand, we often have clients come to us and say “I’ve been told I have Tennis Elbow, but I don’t play tennis!” Tennis elbow is a broad and colloquial term used to describe pain at the outside bony prominence of the elbow. More specifically, this bone is the outside end of the humerus in the upper arm called lateral epicondyle. It can be sore to touch, or feel achy and warm after using your arm, wrist and/or fingers.
The pain is caused by damage to the common extensor tendon that originates at the lateral epicondyle. This is a blend of several tendons in the forearm that extend the wrist and fingers.
It is important to have the type of tendon damage correctly diagnosed by your GP or hand therapist, as pathology, prognosis and treatment are very different. The diagnosis of lateral epicondylitis or tendonitis denotes an acute injury, or micro-tears to the tendon. The tiny tears create an immune response as your body works to heal the damage. These are caused when the muscle is loaded with a tensile force that is too sudden or too heavy. Many people find taking part in an activity your body is not used to doing e.g. returning to sport (such as tennis or softball) after a long break, moving heavy furniture, spring pruning or digging in the garden, a fall or even car accident can result in lateral epicondylitis.
Tendonosis refers to the degradation of a tendons’ collagen in response to chronic overuse. There are cellular changes to the tendon tissue which weaken, thicken and alter the blood supply of the tendon. These changes occur over months (sometimes years) of repetitive movements conducted without allowing the tendon to rest and heal such as: typing, mousing, gaming, playing an instrument, sports, cleaning. Tenosynovitis and tenovaginitis are also diagnoses that fall under the umbrella of “tennis elbow”. These forms of tendon damage indicate inflammation of the fluid filled sheath (synovium) and /or mucous membrane that surrounds the tendon. Although less common, it is of value to differentiate the tissue pathology.
Treatment: Hand therapists are trained to treat all of the above forms of tendon damage. We are able to create a personalised treatment protocol that suits individual lifestyles and specific tissue pathology. Depending on injury history and diagnosis we utilise a variety of modalities to facilitate return to health:• Activity modification and ergonomic education
• Wrist and forearm orthotic regimes • Kinesis and dynamic taping
• Soft tissue massage, myofascial release and friction massages
• Pain management
• Neuro-stimulation using Inter-X and TENS machines
• Targeted movement for tissue healing and tendon health
• Graded exercises and activities for functional strength of upper limb