Tennis Elbow - Without Ever Playing Tennis!

Tennis elbow is an inflammation of the outside of the elbow, technically named lateral epicondylitis.

This elbow pain is due to tendonitis and periostitis (inflammation of the outer layer of the bone) where the tendon for the common wrist extensor muscles attaches to the humerus. This results in pain with any activity involving the contraction or moderate stretching of the wrist extensor muscles.

These activities would include writing, typing, lifting objects while the palm is turned down, or using a screwdriver. The pain usually has a gradual onset with no visible swelling. Stiffness or pain in the elbow is usually evident after prolonged periods of rest.

Since tennis elbow affects the straightening of the wrist, you can test for it by lifting a weight, such as a book, with your palm facing down. Any pain in the outside of the elbow suggests you have tennis elbow.

This condition is ultimately due to overuse of the wrist extensor muscles. These muscles attach to the humerus just above the elbow joint on the outside of the elbow. The muscles then continue down the back of the forearm. The tendons then travel across the back of the wrist and hand and connect onto the fingers. These muscles contract to help extend the wrist moving it toward the back of the hand.

Too much tension in the muscle group can also cause a decrease in the joint space in the elbow and actual inflammation of the joint. In time this can cause not just the typical pain from the epicondylitis, but also from the elbow joint itself.

Treatment usually involves taking anti-inflammatory and muscle relaxant medication, along with some lifestyle modification. Also used are physiotherapy treatments such as TENS, laser therapy, ultrasound, and interferential current.

Since the elbow joint can get involved, chiropractic manipulation of the joint, for instance using Graston, active release, cross-fiber massage or other soft-tissue therapies, can be very helpful.

By doing a chiropractic adjustment, pressure is taken of the joint by briefly separarting the joint surfaces by just a couple of millimeters. Easing that pressure eases the pain. Sometimes some manipulation of the wrist can also help.

As we have seen, it is tight muscles that cause the elbow pain. But if the wrist tightens up, the muscles have to work harder, thus putting more tension on that lateral epicondyle. So keeping the wrist supple and flexible should help to ease the condition.

The use of a tennis elbow band may also prove effective in decreasing symptoms. This works by forming an artificial origin for the muscle before it crosses the elbow. This allows a decrease in tension of the wrist extensor muscles as they cross the elbow which eases tension on the lateral epicondyle and decreases pressure on the elbow.

Also, though rest would be ideal, there may be times when lifting is needed to be done. In this case, one should only attempt to lift with the palm of the hand turned upward. This uses the wrist flexors more than the wrist extensors.

You can also try supplementing with Vitamin B6 and limiting your salt intake as it helps to reduce the amount of water taken in by the body.

Overall, if you suspect you may have this condition, it is best to have it assessed by your chiropractor and/or medical doctor in order to have the proper treatment plan started that will assist in accelerated recovery.

By: Dr. Steven Trembecki, D.C

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