What is tennis elbow and how can you treat it?
Wimbledon is sadly over for another year, but what a tournament it was! Roger Federer clinched his eighth Wimbledon singles trophy, while Garbiñe Muguruza claimed her maiden Wimbledon singles title in style.
As with all elite sport, the agility, power and precision of professional athletes is an inspiration to us all, so it can be no surprise that tennis is so popular.
Regrettably, it’s common for players of all abilities to pick up niggles and injuries throughout their playing career.
We asked Mr Harry Brownlow, a specialist shoulder and elbow surgeon at Circle Reading Hospital, about tennis elbow and what the nation’s club players can do to treat it.
Tennis elbow, known medically as lateral epicondylitis, is the name given for irritation of the tendons on the outside of the elbow. It’s a common condition and is not always linked to tennis or racket sports. Pain usually occurs after repetitive activities such as heavy gardening or certain sporting actions.
In tennis players, a common cause of tennis elbow can be mis-hit backhand. This is because your elbow is opening out (or extending) through the shot, whereas a forehand is bending in during the swing. During a mis-hit shot a muscle attached to the outside of the elbow, called the extensor carpi radialis brevis (ECRB), can be strained and injured at its tendon insertion. It’s this repetitive injury that causes your pain.
The condition can include sharp pain or a dull, constant ache. The pain may initially be linked to a particular activity like tennis, but can gradually worsen over time. Patients have said that taking jar lids off, wringing out dish cloths or pouring water from a kettle at arm’s length can all be painful. The link between them is they require both grip and twist, a combination that can aggravate elbow pain.
Although it can occur at any age, it’s typically more common in middle-aged patients. There could be many reasons for this, but it’s likely to relate to how your tendon biology changes over time. There is often a period of vulnerability with tendon irritation, where patients this age can often have several years with different soft tissue related conditions. For instance they may also develop tennis elbow, carpal tunnel syndrome, shoulder impingement and plantar fasciitis. While this vulnerability is common, symptoms are likely to be more obvious in people who live active lifestyles.
There are a few things you can try when you first notice elbow pain:
- Take a break from tennis (or whatever is causing the pain) for a while to see if your symptoms improve
- Apply ice to your elbow
- Visit your local pharmacy to get some anti-inflammatory drugs
If you’re a tennis player and are able to keep playing, here are some other tips to try:
- Try a two-handed backhand – this can reduce the strain on your elbow
- Use a lighter racket
- Reduce your string tension
- Add string dampeners to your racket
- Use a larger grip – you could add an overgrip too
- Try using a tennis elbow brace – this should wrap around the arm in front of the elbow, not over the joint itself
- See your tennis coach to develop your technique further
- See a physiotherapist or your local GP
- If you still have persistent symptoms, seeing an elbow specialist is a good next step to take, with various non-surgical options available. An effective treatment plan is usually to manage the condition without surgery as most patients will be symptom free after one year.
- If the pain is recurring and persistent beyond a year then surgical intervention, such as an arthroscopic tennis elbow release, is an option. This keyhole surgery procedure takes place under general anaesthetic and you’ll usually leave hospital the same day. Your surgeon will outline a treatment plan, but you can expect it to take approximately six weeks to recover from the surgery.