Tennis elbow is actually a problem of the wrist! The main tendons that pull back the wrist and fingers attach to the tiny bony point on the outside of the elbow. Most of the actions done with the hand involve cocking back the wrist, especially strong gripping actions (as in gripping a tennis racquet) and this repetitive loading can lead to degeneration and tendinopathy.
The patient complains of gradually increasing pain on the outside of the elbow that can spread down into the forearm and sometimes to the back of the hand. Sudden twinges of pain may cause patients to drop the item they’re grasping and there is usually point tenderness on the outside of the elbow.
Physiotherapy can help. It’s important to check the neck and nerve mobility first as pain may be referred to the elbow from problems in those areas. There are several different treatments approaches including a specific massage technique called frictions, manipulation, mobilisations and stretches. Ice, electrotherapy or acupuncture may be used with strapping or braces, to reduce the load on the tendon attachment, and advice to avoid aggravating activities. Sporting or occupational techniques will usually need to be modified to avoid recurrence. Injection may be helpful if the condition hasn’t responded but will tend to be used in conjunction with other treatments towards rehabilitation.
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