Why you can’t get rid of your tennis elbow pain?

Why you can’t get rid of your tennis elbow pain? 

Stephen Clarke Rehabilitation specialist at OneHEALTH

Struggling with pain at your elbow or on the outside of your forearm? Sometimes you feel it going down your arm into your hand? Is it most painful when playing tennis or any racket sport? Or do you just struggle to open jars? Struggle to hold or grip objects? Feel your grip has weakened? 

If you have any of the symptoms listed above more than likely have tennis elbow. It is primarily known as a repetitive strain or overuse injury. This is when simple daily repetitive tasks are done a lot and cause pain, for example using a mouse on your laptop. These daily tasks listed above not only use the elbow, they are a coordination of movement between three different joints, the shoulder, elbow and hand. Each joint should take some strain during these activities but an overuse injury occurs when one of the three doesn’t do its job and causes pain in a joint. 

What is tennis elbow? 

Tennis Elbow (Lateral Epicondylitis) is a painful condition that happens when the tendons at your elbow become overloaded by a repetitive strain. It is an inflammatory condition which causes the tendons to become inflamed. It gets its name “Tennis elbow” as it was discovered as being a condition that happened primarily with tennis players but nowadays that is not the case. Anyone can get tennis elbow, I have seen plummers, builders, carers, office workers, dentists and many more professionals struggling with outside elbow pain. There are a few common treatment options listed below. 

• Massage 
• Anti-Inflammatories
• Cortisone Injection
• Elbow Strap

Yes all of these can work and can give you relief, but all of them do not tell you why it has happened in the first place.

Why does it happen?

If you are working in an office job for instance and spend six to eight hours on your laptop daily? Do you have colleagues doing the same thing? More than likely you do, so ask yourself why doesn’t everyone in the office get tennis elbow? The answer is that you have to look at the other joints that are meant to be taking the strain, shoulder, hand and see are they doing their job. In this case study below I outline how a client's shoulder was not taking the strain and resulted in a very painful Tennis elbow for a number of months. 

• Mid 30 year old male tennis player
• Unable to play tennis without pain on the outside of his elbow
• Unable to carry or grip a kettle
• Unable to grip and lift weights overhead in the gym
• Struggling to use the mouse on his computer without pain

In this picture, my client is performing a shoulder test (Shoulder Internal Rotation Test) to determine how much movement he has at his shoulder. You can see he is unable to bring his thumb down to the bed. This is 50% less movement of the shoulder than he should have.This will directly cause an overuse of the elbow joint to compensate for the lack of movement in the shoulder.

In this case my client was really struggling to play tennis. When a tennis player performs a serve they have to be able to turn their hand and body down towards the ground to produce power, This motion is internal rotation. Because he has a lack of internal rotation at his shoulder he over uses the forearm muscle to produce the movement and in turn causes his tennis elbow issue. Unfortunately he is using the same strategy when trying to lift the kettle, use the mouse on his computer etc.

If I did not assess their shoulder movement and just treated the area of pain, this client would never improve fully. The shoulder joints inability to move correctly would continue to overload the elbow. In the picture below, I gave my client this simple AON stretch.The AON stretch is designed to increase internal rotation of the shoulder which will allow the shoulder joint to take the strain and stop the overuse of the elbow joint.

Once we re-assessed, we can now see we have nearly 100% of the movement back in the shoulder, he can nearly touch his thumb off the bed. 

If you are still struggling with pain at your elbow or on the outside of your forearm? Sometimes you feel it going down your arm into your hand? Is it most painful when playing tennis or any racket sport? Or do you just struggle to open jars? Struggle to hold or grip objects? Feel your grip has weakened? Remember you have three joints that should be taking equal strain, you need someone like me that can find which one is not and help fix this problem once and for all. 

If you have any questions don’t hesitate to email me [email protected]