Recently I was seeing a 35 year old male client who presented to the clinic with lateral elbow pain. He described the pain to be a sharp and sometimes a burning sensation on the outside of his elbow, which would refer down the forearm to his wrist. His symptoms would be reproduced by performing gripping movements, lifting heavy objects and rotation of his forearm.
Lateral epicondylitis, also known as ‘Tennis Elbow’ is a degenerative condition of the forearm extensor tendons associated with overuse. When the same action is being repeated constantly under isometric contraction, this can cause degeneration and inflammation of the tendons. Discomfort presents at the outside of the elbow and is usually an insidious onset of an aching sensation, although if aggravated can be sharp. The pain is able to be reproduced by placing the tendons under load, which involves actions such as gripping, lifting, rotation of the forearm and wrist movements.
Although the name of the condition is ‘Tennis Elbow’ is not caused just by playing tennis, it can be caused by many other activities that involve the repetitive use of the forearm extensor muscles such as gardening, mechanical work, screw driving, hammering, typing, painting, computer work and other racquet sports. Referral pain is not uncommon to experience, it can radiate down the forearm and into the wrist and hand. Lateral epicondylitis is mostly seen in people between the ages of 35 to 55, however it can occur in other age brackets too.
Treatment for this client included myofascial release with active movement, trigger point work, dry needling and passive stretching of the forearm extensor muscles. In the last stage of treatment I got the client to strengthen his forearm extensor muscles through concentric and eccentric exercise under load. The client held a 1kg dumbbell and started with the wrist in flexion, moved into extension and then returned to the starting position very slowly. This course of treatment proved to be successful, as the client has had no issues with his elbow since then, and is back to doing what he was before he had lateral epicondylitis, pain free.
If you are suffering lateral elbow pain make an appointment to see one of our practitioners who are able to help you with this!
Sarah Nowland – Elite Myotherapist