Hello and welcome as another month of 2008 rattles by. This month we’ll be looking a bit closer at lateral epicondyilitis. “Hang on there” I hear you say, “What are you talking about?” Despite the name this is a relatively common problem that most will know as Tennis Elbow. “Ahhh!” the sighs of understanding ring out. Tennis elbow is a very painful and debilitating problem, which is responsible for around three percent of the population’s discomfort, oftenlasting months at a time.
Tennis elbow refers to pain and swelling around the outside part of the elbow, specifically located on top of a bony point to which many muscles attach. Herein lies the problem, we use these muscles a lot in day-to-day tasks, and the area of bone that these muscles attach to is very small and will end up rather over worked. Studies have found the particular muscle that most commonly causes this symptom picture to be the major extensor of the wrist (meaning the muscle that lifts the hand at the wrist, making the back of hand get closer to the forearm). This means it does not actually involve the elbow joint itself, despite most of the pain being centred at the elbow.
Most often it is a repetitive use of this movement that will cause the build up of tension in the muscle, which then transfers to the bone itself. Very small tears form in the muscle and tendon as it attaches to the bone, which can then become inflamed. It is a problem common to those in the building trade such as plasters and bricklayers, whilst also affecting those that use a lot of machinery such as drills and other equipment that suffers from vibration. However, it is not only heavy, manual jobs that cause tennis elbow. Those that type and use a mouse at their computer also use these muscles for very long periods leading to a repetitive strain of the elbow and wrist. This is why computer set-up is so important, and when correct will help reduce the chance of strain.
So how can you help reduce the strain and pain of tennis elbow? Well, first and foremost, as with all medical complaints, a correct diagnosis is essential. Problems in the neck maybe the cause of the pain on the outside of the elbow, or there maybe an underlying joint problem such as arthritis or gout, although these are arguably less common. Seeking advice from a trained medical professional such as myself is the only way to get a correct diagnosis.
Tennis elbow is another form of inflammation and therefore will often respond well to a cold compress in the local area. A period of 5-10 minutes is usually suitable to prevent over cooling of healthy tissue. This can be re-applied after 30 minutes to reduce the swelling further.
Some products can help reduce the day-to-day pressure on the painful area, one of which is known as a false insertion band (or a tennis elbow strap). By applying pressure around the forearm it creates a new point for the muscle to pull from, which allows the painful area to calm down, and therefore reduces the inflammation.
Treatment with osteopathy in the case of tennis elbow is a very effective and productive way of reducing symptoms. Early on I would look to reduce the tension of the forearm muscles to help a gradual reduction in inflammation. However, the long-term goal is often more important as most tennis elbow complaints reoccur. Looking at the movement of the neck, chest, shoulder, elbow, wrist and hand are all important in the overall positive reduction in stress at the weak point that I’ve mentioned.