Despite their names, tennis and golfer’s elbow are not limited to these sports. They are also known as lateral and medial Epicondylitis, named after the bony prominences on the sides of the elbow called Epicondyles, which is where the tendons attach to the elbow. The pain typically exists at these bony prominences on the inside or outside of the elbow. Lateral Epicondylitis, or Tennis Elbow, is an inflammation or Tendonitis of the tendons used to extend the wrist that join the forearm muscles on the outside of the elbow. Medial Epicondylitis, or Golfer’s Elbow, is a Tendonitis of the tendons used to flex the wrist that attach your forearm muscles at the inside of the bone at your elbow. In both cases, the damaged tendon is inflamed and causes pain. As with many Tendonitis injuries, the damage commonly occurs at the transition of tissue between tendon and muscle or tendon and bone.
This form of Tendonitis is an active inflammation of the tendon caused by an overuse or improper use of the arm, forearm and wrist. Typical symptoms of Tennis Elbow or Golfer’s Elbow include pain on the inside or outside of the elbow, local swelling, tenderness to touch and muscle tension. It can occur at rest or with particular movements. Some common aggravating movements or positions are keyboarding, using a mouse, turning a door knob or lifting an object like a coffee cup or milk jug.
Your Physiotherapist or Athletic Therapist will assess you fully to determine all potential causes of the problem. These causes may include things like stiffness where the joints connect at the elbow or at the wrist, weakness in certain muscles in the arm, wrist or even shoulder and neck, or tension in the forearms or other muscles from over use or improper use, including lack of stretching and rest. Sometimes, an improper nerve conduction coming down the arm from your neck can even be responsible for your pain. Your therapist can help you determine if your neck or your arm, or possibly both, is the cause of the problem and help you address that cause. Your therapist will then help you develop a plan to get you back to your activity or training in a pain free and fully functional way. They will provide hands-on therapy to release the tight muscles and mobilize stiff joints in the elbow or wrist and possibly up the chain into your neck. Massage Therapy in conjunction with Physiotherapy can be a great help in releasing the soft tissues in the neck and down the arm. Acupuncture may be used to reduce pain and promote healing of the tendon. Dry needling may be used to release trigger points in the muscle. Additionally, you will be provided with a set of customized stretches and exercises to increase your mobility and strengthen the tendon. They will also help you correct any contributing muscle imbalances throughout the body that may be contributing to the cause of the injury. They can help you to develop a plan for training that may include continuing as you were or recommendations for adjustments to allow healing to take place and get you back to full participation in the shortest possible time. They can also suggest ways to continue to be active that take the stress off your forearm tendons, so they can heal. Bracing can be an effective tool in managing tennis and golfer’s elbow. If your injury actually was from golf or a racket sport, your therapist can help review your form and technique to allow you to return to your sport while minimizing the stress on the elbow.
As with all injuries, this information is simply a guide, and it is always best to check in with a Sports Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.
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