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Tennis Elbow

Lisa Moore • Sep 02, 2021

What is tennis elbow?

Tennis elbow medically known as lateral epicondylitis is a condition that causes pain to the outside of the elbow, near the joint; where the muscles attached to the elbow become inflamed. It often happens after overuse or repeated action of the muscles of the forearm, Pain may be experienced on the outside of the elbow and can travel down the forearm and into the wrist when:

lifting or bending the arm
when gripping
when twisting the forearm, such as turning a door handle or opening a jar
when extending the arm

What causes tennis elbow?

Tennis elbow is usually caused by overusing the muscles which are between the elbow and the wrist. If the muscles are strained, tiny tears and inflammation can develop in the tendon which attaches the muscle to the end of the bone (the lateral epicondyle).

As the name suggests, tennis elbow is sometimes caused by playing tennis, but any activity that puts repeated stress on the elbow joint can cause it. Pain that occurs on the inner side of the elbow also caused in a similar way is known as golfer's elbow.

Tennis elbow is mostly caused by overusing your forearm due to a repetitive or strenuous activity. But it can also occur from gripping something too tightly or after banging or knocking your elbow.

You can also get tennis elbow if your forearm muscles are not used to doing a certain activity, such as gardening or decorating. However, even if you use your forearm muscles frequently, it can still happen.

What activities cause tennis elbow?

You can develop tennis elbow by doing any form of activity that involves repeatedly twisting your wrist, bending your elbow, gripping an object or overusing your forearm muscles. Examples include:

playing racquet sports (tennis, badminton or squash)
sports that involve throwing (javelin or discus)
using hand tools repeatedly (gardening shears, screwdriver or scissors)
using tools while decorating, plumbing or bricklaying
activities that involve fine, repetitive hand and wrist movements (typing or sewing)
activities that involve repeatedly bending the elbow (playing the violin)

Playing racquet sports increases your risk of developing tennis elbow, particularly if you’re playing for the first time in a long time. However, despite its name, only 5 out of 100 people actually get tennis elbow from playing racquet sports.

Why is it called tennis elbow?

In 1883, the term ‘tennis elbow’ first appeared in a paper by H. P. Major, described as ‘lawn-tennis elbow’, as this condition was becoming popular in players of the newly popular game lawn tennis.

Although only few tennis players are diagnosed with the condition nowadays, it is actually more common in people performing repetitive movements. Painters, plumbers, carpenters, mechanics, factory workers, typists, cooks, and butchers are particularly prone to developing tennis elbow due to the repetition and heavy lifting required in these occupations.

How long does tennis elbow last?

Tennis elbow usually lasts between 6 months and 2 years, with most people (90%) making a full recovery within a year.

Will tennis elbow heal on its own?

Tennis elbow will get better without treatment (known as a self-limiting condition).

The most important thing to do is to rest your injured arm and stop doing the activity that caused the problem. There are also simple treatments to help with the pain, like holding a cold compress, such as a bag of frozen peas wrapped in a towel or a freeze pack on the elbow for a few minutes several times a day, even applying freeze gel over the inflamed area can help bring some relief.

What can I do to treat tennis elbow?

There are many things you can do to treat tennis elbow and to eliminate it far quicker than if you left it to heal on its own. But we advise doing a combination of these suggestions to maximise your chances of a quicker healing time.

Regular icing
Seek treatment from a sports therapist or physiotherapist
Wear a tennis elbow band or if having regular treatment your sport’s therapist will tape your arm and elbow after the treatment
Change the cause, if tennis is the cause seek advice on the best fit tennis racquet for your grip and play. If it’s a repetitive move at work then reduce the time spent doing that move or look at a different way to work
Rest and avoid doing what aggravates it
Anti-inflammatory medications can help reduce the inflammation but you would also need to combine these with other things listed here.
Painkillers can reduce the pain you’re feeling but I never promote the use of painkillers as they block the pain and give you a false sense that the area is better so you can carry on causing more damage

What would happen if I came for a treatment?

We would treat the forearm muscles and tendons with a combination of soft tissue massage and fascial techniques using an instrument called a Rockblade.

This helps break down the connection between the skin, the fascia and the muscle so the three structures can move independently without causing any friction or pain. We may also treat the area with Ultrasound which will help reduce inflammation.

A freeze gel or anti inflammatory gel may also be applied followed by Tape; the tape interferes with the pain signal through the nerve endings so you feel less pain, it decompresses the skin to support muscles and joints whilst allowing movement and correct the joints form.

Having treatment can dramatically speed up the recovery time so you can get back to the sport you love.

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Where is fascia located in the body? Fascia is a sheath of stringy connective tissue that surrounds every part of your body. It provides support to your muscles, tendons, ligaments, tissues, organs, nerves, joints and bones. Does massage help fascia? Massage therapists can help with a technique called Myofascial Release that uses sustained pressure to loosen and lengthen constricted fascia. Cupping therapy is another technique that stretches and lengthen fascia with the use of vacuum cups. What does fascia massage do? Fascial release therapies are known to increase tissue flexibility and joint mobility. Massage therapists can help with a technique called Myofascial Release that uses sustained pressure to loosen and lengthen constricted fascia. How is myofascial release performed? Using light, manual pressure, your therapist will massage and stretch the trigger point, sometimes holding that point for a few minutes. Your therapist may repeat this process a few times on each trigger point they find, until they feel a full release. What can I expect from myofascial release? Myofascial release can be an intense experience. During a session, a massage therapist will massage, knead and gently stretch the muscles and fascia to work out knots. This bodywork technique also involves applying pressure to the tight or sore areas to get them to relax. What should I expect after a myofascial massage? You may feel tired or relaxed after your myofascial massage, however, most people experience an immediate feeling of relief. Aches and pains are common for for around 24 hours after your treatment as the body flushes the toxins that have been released out. What are the benefits of myofascial release? Myofascial release offers a host of benefits to your health and well-being, including: Reduces soreness and improves tissue recovery. Improves neuromuscular efficiency. Increases blood flow. Maintains normal functional muscular length. Improves joint range of motion. Decreases overall effects of stress on the body. What is the difference between myofascial release and massage? First of all, they each have a different focus. Massage works with soft tissue and the overall system of muscles in the body to relieve stress and tension. Myofascial release works specifically with the connective tissue (fascia) to relieve the tightness that causes muscle restrictions. What does myofascial massage feel like? During a massage treatment, when we stretch this tight tissue you could feel a burning sensation. This is a myofascial release sensation and is generally short lived and quite normal, but not felt by everyone. What happens when fascia is tight? Healthy fascia is smooth and flexible. However, when the body undergoes physical trauma, such as muscle injuries or surgery, the fascia is placed under stress and tightens up, causing muscle pain. What causes fascia pain? Factors that cause fascia to become gummy and crinkle up (called adhesion) include: A lifestyle of limited physical activity (too little movement day after day) Repetitive movement that overworks one part of the body. Trauma such as surgery or injury. What can damage fascia? Accidents, abnormal posture, repetitive movements, overextension injuries, or inactivity can all lead to fascial damage. What does damaged fascia feel like? However, when the fascia is damaged through injury, overuse, or dehydration it often has a domino effect, causing a series of painful symptoms to appear over time. You may experience stiffness, reduced range of motion, and increasing chronic pain. How long does it take for fascia to heal? Most injury to fascia heals within a six to eight weeks period. Occasionally chronic inflammation and pain affect fascia. This may cause problems such as painful movement or fibromyalgia. What makes myofascial pain worse? Myofascial pain may worsen if it is left untreated for a prolonged period of time. Additionally, you may also feel more pain if the trigger point or affected muscle is strained or stretched. What happens if myofascial pain syndrome is left untreated? Untreated, the myofascial pain syndrome leads to a reduced extensibility of the involved muscle with consecutive decrease of the range of motion and development of a muscular imbalance resulting in a disturbance of complex movement and evolution of a chronic pain disease. Should you exercise after myofascial release? Many therapists recommend clients avoid strenuous exercise for at least 24 hours after a bodywork session. Exercising after a session can both increase muscle soreness and compromise the value of the soft-tissue work you've just received. What happens to fascia as we age? As you age, your body produces less and less collagen. This has a dramatic effect on the fascia throughout your body. With less collagen, the fascia starts to dry out and tighten. It becomes restrictive, making it more difficult for the body to move efficiently. Can tight fascia cause nerve pain? As fascia stiffens through adhesion, fascia—rich in nerve endings in and of itself—can entrap surrounding nerves, leading to radiculopathy and a host of painful consequences. Who should avoid myofascial release? Contraindications for MFR include – but are not limited to – those with malignancy, aneurysm, acute rheumatoid arthritis, advanced diabetes, severe osteoporosis, and healing fractures. Your physical therapist can help determine whether or not MFR is an appropriate course of treatment for you. Can you do myofascial release on yourself? SMFR methods do not require the assistance of a physical therapist or fitness professional but can be performed by the individual itself and are considered an effective rehabilitation tool. Can you overdo foam rolling? When it comes to foam rolling, yes, you can overdo it. Excessively using a foam roller on a specific area can increase injuries and leave you in more pain. Instead, limit foam rolling to 30 to 90 seconds per muscle group and include 10 seconds stretching in between each roll.