Tennis Elbow - It's more than an elbow problem!
It’s a spine problem
Tommy Conway - Chartered Physiotherapist and Director - OneHEALTH
Are you feeling pain on the outer side of your elbow? Shooting pain while gripping? Are you now unable to lift the kettle? Or even unscrew a jar? Do you use your computer on a daily basis? Does your job include repetitive use of your hands? Have you ignored this issue? Felt your grip slowly getting weaker but put in on the long finger? If you ask me what one condition I wouldn’t put on the long finger it is pain on the outside of my elbow “Tennis elbow”. It becomes so painful that you will not be able to grip at all, even zipping up your jacket will seem impossible, I’ve seen it.
You are born with a strong grip, it’s one of the key markers of a healthy spine. Proud grandparents, parents brag about a newborn “they have the strongest grip”, mine did too when my daughter Molly was born. Did you not worry when you started losing your grip? You have just started to lose your first greatest asset. Grip strength is one of my key markers to see how healthy your spine is. It’s at the end of the line but it’s not just all about a pesky tendon that got inflamed. Let’s talk about the specific condition and build from there.
What is tennis elbow?
You may have lateral epicondylitis or more commonly known as tennis elbow. Tennis elbow is associated with playing tennis, but only 5% of cases originate from the activity. Tennis elbow is associated with inflammation and tiny micro-ruptures of the tendon attached to the elbow caused by repetitive overuse and stress. If you are someone who uses a computer on a daily basis or someone who uses their hands repetitively in your job or even during activities of daily living you may suffer from tennis elbow. These people have a higher chance of suffering from tendinopathy because repetitive overuse leads to small tears in the muscles/tendon from work/habits. The majority of the muscles in the forearm on the outside of your arm insert into the outer area of your elbow (See pic attached). The muscles around this area are called the extensor muscles and do just that, extend the wrist. You use these muscles to hold your mobile phone, to pick up a cup of tea or twist your arm to turn a door handle. Over a couple of months, you may find it difficult to lift or have a painful grip. There is another version called “Golfer’s Elbow” which is on the inner area of your forearm or the opposite side, not to be ignored either.
These are the most common causes of tennis elbow but other factors are at play. In my clinic, we look at the body as one piece. This is why the so-called “miracle tendon treatment” or injection you are getting for a tendon issue didn’t work. They were looking in the wrong place, like I said before it has a direct correlation to spinal health. Treating the tendon is important for it to heal, but you also have to ask yourself “what caused the tendon to get overloaded?” You need to examine the movement of the spine, neck and shoulders to answer that question. When the injection and treatment will wear off and you are back to square one, not able to lift the kettle.
How does it relate to the spine, neck and shoulders?
To lift a cup or type on the computer it is not just your forearm muscles working alone, there is a series of muscular contractions that occur to allow you to perform that task with efficiency and fluidity. When picking up a kettle you need your spinal muscles to keep you upright so you don’t fall forward, your shoulder muscles have to lift your arm up and then your forearm muscles will grip the kettle. These series of muscle contractions occur through a system called fascial lines. In Chinese medicine these facial lines are known as meridians and are commonly followed in acupuncture practise. The picture attached shows how the muscles work in tandem to perform an action.
I personally assess the grip strength, fascial lines, shoulder, neck and spinal range of movement before I start treatment on a tennis elbow. I need a clear understanding of why this elbow has started to break down before I start treatment or rush for an injection. You probably have noticed your inability to turn your head fully, or stiffness in your upper back, then you started feeling pain on the outer side of your elbow and shooting pain while gripping! Are you now unable to pour the kettle? Those of you reading this who have had back pain, neck pain and now tennis elbow need to act. It’s not a new injury, it is the same one and now it’s started to take away your greatest asset, your grip! You are starting to lose what you were given first, act now!
I hope this helps!
You can email me with any questions [email protected] or if you are struggling with a condition and want my opinion on it, send me an email and I will get back to you.