24 August 2020
Tennis and Golfers’ Elbow: Management
Tennis and golfers’ elbow are both a form of tendinitis (also known as a ‘tendinopathy’)
Typically an overuse or overload injury which chronically stresses the tendon, felt in the upper forearm/elbow region.
These are merely labels and don’t necessarily describe the cause, which can be any activity that repetitively stresses the wrist, such as typing, gardening, carpentry, heavy lifting, and other racquet or throwing sports.
Patients typically report persistent pain or pain a couple of hours after certain activities, with the elbow area being tender to touch. The pain is exacerbated by activities involving the wrist or hand, and the wrist can feel weak. Stiffness at the elbow and weakness in the hand, or a tingling feeling in the fingers, is also common.
The blood flow and make-up of tendons is different to muscles, so we must take a slightly different approach to rehab.
Don’t worry about how scans of your tendon may look. There is good research that injured tendons remain strong, and the load on them can gradually be increased.
Don’t massage your tendon. If it’s painful, then it is telling you it is irritated.
Don’t stretch your tendon. Contrary to what may feel relieving initially, stretching a tendon typically means you are compressing it, which can be detrimental.
Do look to gradually strengthen the tendon & surrounding muscles – evidence shows that exercise-based rehab is the best treatment for tendon pain. This involves progressively loading the tendon in a controlled fashion.
Do listen to your pain and understand what loads are high for your tendon. Activities which involve rapid and powerful movements such as throwing will be painful so try to begin with slow and strong movements as a starting point.
Do seek out help! Tendon pain can persist and rest alone often isn’t enough. Mobilisation and other manual therapy techniques, combined with correct strengthening, can enable you to self-manage and return to pain free activity!