Tennis Elbow
What is Tennis Elbow?
Tennis elbow is a condition where the tendons of the muscles that extend the wrist and/or fingers become irritated. These tendons, of which there are several, all attach onto a fairly small section of bone on the outside of the elbow, called the lateral epicondyle. The most common cause is an overuse syndrome. This leads to disruption of the tendons internal structure and therefore causes irritation.
When the tendon becomes irritated, day to day activities can maintain this irritation, constantly interrupting the healing process. The result is an ongoing pain, aggravated by lifting, pushing, pulling, carrying and repetitive activities.
How to manage |Tennis Elbow?
Exercise
There are many ways to treat Tennis elbow, but research evidence suggests graded progressive strengthening exercises are proven to be the most effective for achieving long term relief. Longer term improvements are generally better with an exercise program than with other treatments, as this changes the integrity of the muscle and tendon to manage the stresses they are placed under.
Epicondylar support
The support is worn just below the elbow crease and applies a twisting pressure to the muscles in the forearm. The aim of this is to reduce the amount of force that is transmitted through the injured muscle in day to day activities.
POLICE
Previously we used RICE (Rest, ICE, Compression, Elevation) for injury management. However, rest can be harmful and inhibits recovery. Recent research has now advised we use the acronym POLICE
- Protection
- Optimal-Load
- Ice
- Compression
- Elevation
The key term is Optimal-load, this replaces Rest.
Modifying your normal activities, by reducing prolonged activities using your hands is a form of optimal loading. If you have a job that is predominantly computer based, using a hand rest for your keyboard can be useful, which can alter the position the muscles are working and potentially reduced the irritation. This task modification can be discussed with your physiotherapist.
The exercises
- Isometric wrist extension.
In a sitting position with your hand straight and palm facing the floor. Place your other hand on top of the affected hand and resist trying to push your hand up, alternatively you can do this under a table.
- Do this with your hand flat
- Repeat with the wrist in 30 degrees extension.
Hold for 10 – 45 seconds, repeat 3 -5 times.
https://www.youtube.com/watch?v=sbduSOo9H_0&feature=youtu.be
2. Isometric Wrist extension with a weight
Isometric wrist grip. In a sitting position with your hand straight and palm facing the floor. Hold onto a weight over the edge of a table, not allowing your hand to move.
Do this with your hand flat
Repeat with the wrist in 30 degrees extension.
Hold for 10 – 45 seconds, repeat 3 -5 times.
https://www.youtube.com/watch?v=Xb0ZR-n-qAU
3. Eccentric Wrist extension
In a sitting position with your hand straight and palm facing the floor holding onto a light. Extend your wrist using the unaffected hand. Slowly allow your wrist to drop with affected hand. As this gets more comfortable use a heavier weight.
Repeat 15 times, 3 sets.
https://www.youtube.com/watch?v=hleQdv2D0y8&feature=youtu.be
4. Wrist extension with a weight
In a sitting position with your hand straight and palm facing the floor holding onto a light weight. Slowly lift your hand up and allow your wrist to drop in a controlled movement. As this gets more comfortable use a heavier weight.
Repeat 15 times, 3 sets.
https://www.youtube.com/watch?v=KovaDmugZb8
5. Wrist extension with a resistance band
In a sitting position with your hand straight and palm facing the floor holding onto a resistance band securely attached to the floor or below your foot. Slowly lift your hand up and allow your wrist to drop in a controlled movement. As this gets more comfortable use a heavier band.
Repeat 15 times, 3 sets.
https://www.youtube.com/watch?v=FJksERDfbTs 