Tennis elbow, also known as lateral epicondylitis, is a painful swelling of the tendons connecting the forearm muscles to the elbow caused by overuse or repetitive strain.
Despite its name, tennis elbow is not only caused by playing tennis. It is caused by any activity that involves repeating a gripping and twisting motion.
Other racquet sports, some recreational activities, and certain professions that involve repeated use of the forearm can lead to tennis elbow. Painters, plumbers, and carpenters regularly are victims of tennis elbow.
Home Treatments for Tennis Elbow
Rest – Rest is the best and simplest treatment for a tennis elbow. Most patients recover by simply giving the arm a rest. This means you must stop the activity that caused the condition. In most cases, resting the arm and stopping the activity will resolve the issue in about two weeks.
Ice – You can also try placing an ice pack on the elbow. It will reduce swelling and inflammation, easing the pain.
Arm Brace — A brace or strap can help to keep the arm still and protect it while activities must be continued. An arm brace applies pressure to the arm muscles and reduces stress on the injured tendon, giving it time to recover.
If the condition is severe and recurring, it may be necessary to wear a brace for a few months, even when the elbow feels free of pain.
Medications – For short-term pain relief and to reduce swelling, over-the-counter (OTC) painkillers, such as ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) may be helpful. However, if the symptoms of tennis elbow fails to subside, or keeps getting worse, you may need to seek professional treatment from a specialist in Singapore.
Professional Treatments
Mulligan Mobilization – This is a physical therapy approach that physical therapists use to treat musculoskeletal pain and improve joint function. The therapist gently repositions the muscles by gliding the joint. At the same time, the patient performs certain movements.
This combination is called “Mobilization with Movement” (MWM). It repositions the muscles to protect the injured tendons from further strain.
Steroid injections – Steroids, such as cortisone, are powerful anti-inflammatory medicines containing synthetic versions of the hormone cortisol. The injection is given directly into the painful area around the elbow. The injection hurts so a local anaesthetic may be given first.
Although they are powerful medications, steroid injections often give only short-term relief. Doctors don’t like to give these injections often, preferring a waiting period of at least 3- to 6-months between injections.
Platelet-rich Plasma Injections – This biological treatment has recently become more widely used. The procedure uses a patient’s blood to achieve healing and tissue regeneration.
This method allows doctors to inject the injured area with the patient’s platelets.
Research on the effectiveness of this treatment is inconclusive.
Extracorporeal Shock Wave Therapy. Shock wave therapy is a noninvasive treatment initially developed to treat kidney stones. It soon gained a reputation for treating foot- and ankle-related injuries effectively and is now used to treat several musculoskeletal conditions, including tennis elbow.
Shockwave therapy supports the body’s healing process and helps to reduce pain and discomfort. It works through either focused shock waves or radial pressure waves. The sound waves cause minute trauma, stimulating the body’s natural healing processes.
Needle Fenestration – Needle fenestration, also known as dry needling, is a minimally invasive procedure used to treat tendons that don’t respond to other conservative treatments.
The therapist uses a special needle to make small holes called fenestrations in the injured tendon. This is thought to stimulate blood flow and promote healing.
Ultrasonic Tenotomy –Also called Tenex, this procedure also uses a needle to relieve pain from damaged tendons. This non-surgical treatment uses an ultrasonic needle to break up and remove scarred tissues on the damaged tendon.
The ultrasonic energy vibrates the needle so fast that it turns the scarred tissue into liquid, which can then be removed.
This procedure is a less invasive alternative to surgery. It doesn’t require hospitalisation. Patients can receive the treatment at the outpatient department of a sports clinic or hospital.
Surgery – For tennis elbow that has not responded to treatment for 6 to 12 months, surgery may be an option. The aim is to remove the damaged tissue.
There are two main options: open surgery and arthroscopic surgery. Open surgery involves a cut above the bone on the side of the elbow, and removing damaged tendon tissue, and reattaching the healthy tissue to the bone. Arthroscopic surgery involves a few tiny cuts in the skin of the elbow through which the procedure is performed using small instruments and a camera.However, before you proceed with any of the options, be sure to consult the advice of a certified doctor from an orthopaedic clinic such as Ortho Spineworks, who are better able to diagnose the problem and give valuable advice on the topic.
Exercises
Exercise can help to strengthen the forearm muscles and prevent tennis elbow from returning. Physical therapists recommend several exercises to strengthen muscles and tendons so they are not so susceptible to strains due to repetitive activity.
These exercises include:
- Writs turns
- Wrist turns with weight
- Wrist lift with the palm up
- Elbow bend
- Wrist extensor stretch
- Writs extensor flex
- Fist squeeze
- Towel twist
Anyone who plays a racquet sport or performs repetitive activities for work should consider strengthening the forearm muscles and tendons.
Tennis elbow can also be prevented by always warming up before training sessions or participating in sports. Athletes should increase their exercise routine gradually to build up strength.
If you play tennis and often get tennis elbow, check that your racquet is the right size and weight. The wrong equipment can strain muscles and tendons, leading to unnecessary injuries.
Visit a tennis elbow clinic in Singapore for professional advice on handling tennis elbow.