Tennis elbow is an extremely common condition in the sportsperson and manual workers. In fact it can arise in anyone who increases dramatically the amount they use their arm over a short period (e.g. a weekend of spring gardening).
The main problem is in the tendon (tendinosis) of the muscles that moves the wrist; this involves a disruption of the fibres in the tendon. In 50% of cases of tennis elbow there is also nerve involvement. The amount of nerve involvement varies in individual cases from a little to a lot, but often this nerve irritation is caused by a problem in the neck. Recent research suggests that patients with tennis elbow recover faster if the neck is also treated, alongside the elbow.
To be maximally effective, treatment for tennis elbow should include:
- Manual treatment to the joints of the neck and upper back.
- Soft tissue treatment to reduce spasm (trigger points) in the muscles of the forearm.
- Specific exercises to progressively stress the tendon causing it to remodel and strengthen.
- Exercises to mobilise the nerve of the arm to improve its ability to move within the tissues of the arm
- Education regarding technique and equipment (especially racquet sports)
- Education regarding braces, taping and supports.