Understanding Tennis Elbow and Its Causes
With Summer vacation ending, students are returning to school and our student-athletes are beginning to train for their fall sports. After a summer of leisure, ramping up activity too quickly and without laying the proper foundation can result in overuse injuries. A popular fall sport with a common overuse injury is tennis. Lateral epicondylitis, or tennis elbow, is an all too common nagging injury that many tennis players have to deal with. This injury is due to repetitive wrist and elbow movements and is not only an injury that affects tennis players. Painters, people who use hand tools such as a hammer or screwdriver, and office workers who spend a good portion of their day utilizing the mouse on their computer are also susceptible.
Strategies for Preventing Tennis Elbow
For our tennis players, a graded return to sports training is key. That means initially limiting the number of serves and overall swings in a session, strengthening the muscles of the wrist, elbow, and shoulder girdle, and taking the time to stretch those muscles of the wrist, especially the wrist extensor muscles. The most common muscle affected is the extensor carpi radialis brevis which originates on the lateral epicondyle of the elbow.
This muscle gets overused causing micro trauma to the tendon, which causes pain on the outside of the elbow. Making sure the wrist extensor muscles are both strong and are not tight through strengthening and stretching can help decrease the likelihood of dealing with this injury. One must also make sure that the wrist flexor muscles are symmetrically strong and flexible so there is not an asymmetrical length/tension relationship between the wrist flexors and extensors. Strengthening the shoulder girdle and elbow flexors/extensors can help decrease the likelihood of compensations when swinging the racket, which will also decrease the chance of developing this injury.
Rehabilitation Exercises for Tennis Elbow
If you are already dealing with tennis elbow, there are a few things that you can do to help decrease symptoms and get back to playing without elbow pain. Decreasing training intensity by limiting the amount of serves and hits in a training session will be the first step.
Massaging the muscles and attachments of the wrist extensor muscles can increase blood flow to the area and improve healing. Lightly stretching the wrist extensor muscles can decrease some of the tension on the tendon inserting it into the lateral epicondyle and providing some relief.
Isometric wrist extension exercises are a good starting point to retrain the muscles and should be relatively pain-free. When past the acute (painful) phase, eccentric exercises, or resisted muscle lengthening of the wrist extensor muscles, are the best exercises to perform.
You can do this by holding a dumbbell in the hand of your affected arm, using your other hand to passively extend the wrist of the hand holding the dumbbell, and then slowly lowering it. This helps to reorient the collagen fibers and start to retrain the tendon to accept load. As symptoms start to improve you can start increasing your training intensity (number of serves, hits, etc.) until you are back to full participation in practices and competition.
Tennis Elbow Treatments in NYC
Are you experiencing tennis elbow? Learn about our chiropractic and physical therapy treatments.
