Most of us have heard of it and quite a few of us have been diagnosed as having it, Tennis Elbow is when cocking (the “high 5” position) the wrist produces pain when opening jars, crimping when climbing, playing the violin or hitting a backhand stroke in tennis.

If you have Tennis Elbow you will feel a dull ache that eases with activity but returns and intensifies when you stop. The pain can radiate all down the arm from the boney bit on the outside of your elbow (called the lateral epicondyle of the humerus), which is the origin of the extensor capri radialis brevis muscle. Extending your middle finger against resistance can also cause pain as this is where the other end of the extensor capri radialis brevis attaches.

What is it?

The proper name for Tennis Elbow is Lateral Tendinosis. It is an overuse injury due to degeneration of tendon collagen. Excessive or repetitive use causes micro tears in the tendon, but it is the ground substance and the different type of collagen that is laid down at the injury site that means that the tendon isn’t fully load bearing. Unfortunately, the symptoms of Tendinosis can last for 6 to 12 months.

Tendinosis and Tendinitis are different things. Tendinitis is a result of overloading which causes micro tears and inflammation. The pain becomes worse with use as more aggravation is caused, but will ease when the activity is ceased. Tendinitis should clear up after a couple of weeks if you stop the aggravating activity as this allows the inflammation to go down. (Icing the injured site, as with any acute injury, will help reduce the inflammation.- see This Months Focus- Acute Soft Tissue Injuries.)

How can Jirou help you if you have Tennis Elbow (Lateral Tendinosis)?

Treatments include massage, trigger point release and soft tissue release of the muscles in the arm to reduce tension on the tendon and encourage blood flow to the area. Cross friction of the extensor capri radialis brevis’ tendon can be used to reduce tendon thickness and encourage maturation of the collagen fibres so they become load bearing. A progressive programme of stretches and exercises will be provided to aid your recovery.

How can you help yourself if you have Tennis Elbow (Lateral Tendinosis)?

Gentle forearm stretches; With your arm held out straight flex the wrist and use the opposite hand to hold the stretch (stretching the wrist in the opposite direction will help reduce the risk of golfers elbow).

Eccentric loading strengthening exercise; Start with your elbow bent at 90 deg, resting on a couch, with your palm down. Extend the wrist so that the back of the hand is now vertical. With a very light weight (start with a 500ml bottle of water) in the hand, very slowly lower the weight until your wrist is flexed in the opposite direction. Take care to use your other arm to help raise the weight back to the start position. Repeat the exercise10 times and perform 3 sets, but stop if pain is caused. Try and do this several times a day.