How do you get hurt?

Despite its name, tennis elbow does not occur only in tennis players. It is due to tendinopathy (chronic tendon changes) of the extensor carpi radialis brevis (ECRB) tendon, and usually occurs due to repetitive elbow and wrist motions, and is most common in persons aged 30-50 years. Males and females are equally affected.

Where does it hurt? What can you not do?

Pain is over the outer bony prominence of the elbow and it may hurt when you press on that area. Pain can occur with bending the wrist up and down repetitively, or when one turns the forearm inward and outward (palm down and palm up position) repetitively. When the elbow is fully straight, extending the wrist (bending the wrist upwards with palm facing down) will reproduce pain at the elbow.

When to Seek Immediate Medical Attention

If pain occurs after trauma or fall, it is important to make sure that it is not due to other conditions such as a fracture. Bruising or swelling are also symptoms that suggest conditions other than tennis elbow. Pain occurring at night that wakes you from sleeping is unusual in tennis elbow and needs further investigation. Pain that is burning in nature suggests a possible nerve problem rather than tennis elbow.

What can you do?

Avoid further repetitive overuse of the wrist. Try to improve your workstation and computer ergonomics. Application of ice to the painful area can be helpful. Over the counter pain medications may be useful to relieve the symptoms as well.

An elbow brace strap applied to the forearm (below, not at, the painful area) may also help to reduce the forces on the extensor tendons and provide some relief during daily activities.

Stretching of the wrist extensor muscles can also help. This can be done by bending the wrist downwards towards the palm while keeping the elbow straight. Do this stretch for 30 seconds, 3 repetitions a day.

Following treatment, it is important to return gradually to activity. It is also important to reduce the risk of recurrence by ensuring that you do not start unaccustomed levels of activity with repeated wrist extension, for example painting the house. Do take frequent short breaks when doing these activities.

What can we do to help you?

Physiotherapists can help teach you a stretching and strengthening program. Physiotherapists can also help with taping the elbow to relieve the symptoms. In addition, if your condition is related to biomechanical errors in your sport, they can help assess and correct your technique as well.

Doctors can help by giving a corticosteroid injection to the region, which may provide short term relief. Symptoms may also be relieved by the use of extracorporeal shockwave therapy (ESWT), or via injection of autologous concentrated plasma (ACP).

Exercises for wrist and shoulders