What is golfers or tennis elbow?
For both of these conditions the tendons at the elbow become inflamed and painful. They are named such due to the fact they are common but not exclusive to golfers and tennis players. Golfers elbow refers to the tendons at the medial side (inside) of the elbow and tennis elbow affects the tendons on the lateral side (outside) of the elbow. Golfers elbow is clinically known as medial epicondylitis and tennis elbow is known as lateral epicondylitis.
What causes golfers and tennis elbow?
The tendons at your elbow joint the muscles of the forearm to the bone at the elbow and control the muscles of the forearm which move the wrist and fingers. Golfers elbow is caused by overusing the muscles used to flex (bend) your wrist and fingers such as in gripping activities. Tennis elbow is caused by overusing the muscles used to extend (straighten and pull back) your wrist such as with gripping activities like tennis and DIY. When the muscles and tendons are strained tiny tears can occur in the tendon where it attaches to the bone causing inflammation and pain.
What are the symptoms of golfers and tennis elbow?
Pain is the main symptom which will be on the inside of your upper forearm just below the bend in your elbow for golfers elbow and on the outside for tennis elbow. Pain is commonly felt when lifting, gripping small objects, twisting your forearm e.g. opening door or jar and when bending your arm. There may also be some swelling, heat and redness locally around the area of pain.
Diagnosis of golfers and tennis elbow
Diagnosis will be ascertained by your physiotherapist through a thorough subjective (questioning) and objective assessment. Assessment is likely to include looking at your elbow and wrist range of motion, flexibility, strength and palpation of the painful area. Your therapist may also look at your neck and carry out specific nerve tests to rule out the pain coming from elsewhere as pain can refer from the neck and be due to the nerves in the forearm.
Physiotherapy treatment for golfers and tennis elbow
Golfers and tennis elbow are self-limiting conditions which means they will eventually get better without treatment, however, the pain can last for up to two years. Physiotherapy has been shown to be effective in the short and long-term for golfers and tennis elbow. Physiotherapy can speed up the recovery and enable improved pain and function and self-management.
Your treatment programme will be tailored to your specific needs based on the assessment findings but is likely to include all or some of the following:
- Specific advice and education on activity
- Soft tissue mobilisations including deep transverse frictions
- Specific eccentric loading strengthening exercises
- Specific stretches
- Functional exercises
- Neural mobilisations
- Re-injury prevention management
In a small number of cases conservative treatment is not successful and therefore a corticosteroid injection or as a last resort a surgical release of the tendon may be required.
When to seek help from a physiotherapist
If you have tried rest, ice, painkillers and non-steroidal anti-inflammatory drugs (e.g. ibuprofen) yet your pain is severe or persistent it is advisable to seek help from a physiotherapist. If your symptoms have resolved but return when re-engaging in the aggravating activity then seek help from a physiotherapist immediately as they will be able to assess the mechanics of the activity and offer advice and education on re-injury prevention.