Lateral epicondylosis ( Tennis Elbow ) is one of the more common pathologies of the arm encountered by sports therapists and surgeons. It is more common in non-athletes than athletes though it is said that 50% of tennis players will suffer from “tennis elbow” at some point during their playing career.
Pain usually starts at the origin of the extensor carpi radialis brevis(ECRB) or the extensor carpi radialis longus (ECRL).
This is usually an overuse injury, in which an accumulation of micro-trauma causes an overloading of the involved tendons. Scar tissue can accumulate within the tendon. Improper backstroke mechanics is one of the more common causes; however string tension, wrist mechanics(flexibility), and/or weakness in the shoulder or wrist factor in as well.
During examination, point tenderness over the lateral epicondyle is the most indiciative finding of tennis elbow. Long standing epicondylitis often becomes epicondylosis which will take a longer period of time to heal. Occasionally, diagnostic imaging in the form of x-ray or MRI maybe warrented.
Conservative care, especially when utilized early has been found to be a very effective form of managing epicondylitis. Utilizing Active Release Technique(ART), gentle active motion with manual tendon compression, is a very effective manual therapy to alleviate hypertonicity in either the ECRB or ECRL. Graston or Instrument Assisted Soft Tissue mobilization may also be utilized as a manual therapy during the acute and sub-acute phase of care.
Once the pain level begins to subside, a progressive rehabilitation program should be utilized to further enforce proper collagen alignment. Rehabilitative exercises should focus on stretching and eccentric loads of the extensor group.
Elastic Taping(Rock Tape) is effective in supporting the injured area during the rehab phase.
For an athlete that is competing while managing tennis elbow, Game Ready Icing (compression icing) can be utilized to aid in inflammation management.
This injury is not limited to tennis athletes. Athletes in baseball, golf, swimming, weight lifting and other raquet sports also suffer from tennis elbow.