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Frozen Shoulder
(Adhesive Capsulitis)
TENNIS ELBOW
What is tennis elbow?
Tennis elbow is usually caused by an overstraining of the muscles where they insert into the bone.
The muscles that extend the fingers and the wrist originate from a small projection of bone on the outer side of the elbow. In the case of tennis elbow, pain is concentrated around this area and may radiate to the forearm.
The pain is caused by tiny breaks in the connective tissue that holds the muscles to the bone. The tissue is irritated and an inflammation sets in, causing swelling in the area. It often heals spontaneously but in a few cases the pain can last for more than five years.
Tennis elbow most frequently affects people in their 40s and upwards, and women are affected more frequently than men.
What causes the condition?
Tennis elbow does not only affect tennis players who of course frequently strain the muscles in this area. It is also caused by other sports and by work or hobbies that involve repetitive movements such as DIY.
What does tennis elbow feel like?
Tennis elbow usually starts with gradually increasing pain on the outer side of the elbow. It is painful if someone presses on the area. If you bend the wrist upwards against pressure, it will hurt around the projection of the bone on the outer elbow. Eventually, simple things like picking up a cup will become difficult, due to pain.
What can be done at home?
At first, the pain may be relieved by applying an ice bag wrapped in a cloth to avoid contact with the skin. The ice bag can be applied for upto 20 at a time and again after an interval of about 2 hours.
The arm should be rested and wrist and hand movements that causes the pain should be avoided.
Stretching exercises may help. The wrist must be bent all the way down and the hand kept down by the opposite hand. The elbow must be stretched out entirely and the forearm turned inwards so the fingertips point to the side. The stretch should be held for about 15 seconds then repeated after a brief interval. This should be repeated several times a day.
Bandaging and an epicondylitis clasp, which can be bought in many sports shops and pharmacies, sometimes help.
A physiotherapist can give more information about specific exercises.
How is the diagnosis made?
The physiotherapist makes a diagnosis by listening to the patient's description of symptoms and by making an examination of the arm.
Tennis elbow itself cannot be seen on an X-ray. However, in some cases it may be necessary to take an X-ray in order to rule out a possible injury inside the elbow joint.
The physiotherapist checks if the area around the elbow is sore by pressing on it. He also checks if bending the hand upwards against pressure produces pain. The neck and shoulder will also be examined to rule them out.
How is the disease treated?
Many cases of tennis elbow will get better by themselves without treatment other than resting the arm, avoiding provocative activities and perhaps taking anti-inflammatory medication.
Physiotherapy may involve specific local massage, mobilization and electrotherapy, as well as some rehabilitation exercises.
If symptoms do not settle, a corticosteroid and local anaesthetic injection can be tried.