It may be called ‘tennis elbow’ but playing tennis isn’t the most common cause of this painful condition affecting the tendon on the outside of your elbow. Repetitive activities, such as gripping or typing, are actually far more likely to cause the kind of accumulative tendon strain that becomes painful over time.
Tennis elbow is sometimes misdiagnosed when the pain is actually referred from your neck or caused by a trapped nerve at your elbow. These conditions, however, are far less frequent and if your elbow pain is largely related to movements of your hands and wrist, rather than persistent pain exacerbated by changes in your posture, then it’s likely you have tennis elbow.
Tennis elbow first aid
Pain control – apply an ice pack for up to 10 minutes, twice a day and take painkillers or anti-inflammatories as advised by your GP or a pharmacist. This will help you continue to use your arm for light activities and to keep your elbow moving, encouraging blood flow and preventing weakness from developing while your tendon heals
Rest – the most important thing you can do is to modify or stop doing activities that strain the tendon.
Try to identify a cause – have you started a new job or taken up a new sport? Has there been a sudden increase in your workload or working hours? New computer set-up? Consider how you can modify your activity and home or work to reduce stress on the tendon in a sustainable way for at least 3 to 6 months.
Start gentle stretching – straighten your elbow, palm down and bend your wrist. Use your other hand to press gently on the back of your hand to increase the stretch. Hold for 30 seconds, three times and repeat this regularly during the day.
Strengthen up – you can start strengthening exercises as soon as pain allows. Stay within your comfort zone, the exercises shouldn’t stir up your pain significantly at the time or affect your ability to use your hand for other general activity. Start by holding a 0.5kg weight, palm downwards with your forearm and hand on a table. Lift the weight 10 times, rest for 30 seconds and repeat. Increase the number of repetitions to 15 (as pain allows) and complete 3 sets with rest breaks. You can make this exercise a bit harder by putting your hand over the edge of the table to lift and lower the weight. Allow the pain to guide you … doing too much too soon may delay healing.
Move your arms and neck and upper back – often if the elbow hurts we don’t use the hand and shoulder as normal on that side either. This can lead to tightness down the arm of either soft tissues or neural tissues. Try these two stretches to keep everything moving normally:
Mid back mobiliser: slowly relax backwards over the back of your chair as far as you can move comfortably. Keep your elbows together and try not to arch your lower back. Repeat 5 times.
Spinal rotation: turn your upper body to one side and use the back of your chair to gently increase the stretch. Repeat 3 times each side.
Should I use a tennis elbow clasp?
A clasp can be helpful to change the amount of stress that falls on the tendon at the elbow. When you are wearing it you’ll know straight away whether it’s going to be helpful or not as the tendon pain should immediately reduce when using your hand. I tend to recommend using a clasp only for specific activities that can’t be avoided or modified in your work or home life.
My GP has suggested that I could have a steroid injection?
Opinions vary but it’s thought that an injection might work best within 2-3 months of the pain starting. However having a steroid injection on its own has been shown to be less effective than having physiotherapy treatment.
If your symptoms don’t settle or they improve but you have difficulty returning to your usual activities, it might be time to consider an assessment with a health professional who specialises in ergonomics and overuse injuries.
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