Tennis Elbow

What is Tennis Elbow?

It is a repetitive stress injury of later epicondyle and therefore also known as lateral epicondylitis. Though epicondylitis is a misnomer; because many times there is no inflammation, there is degenerative or calcific tendinopathy of the extensor tendons of the wrist. In this condition, the tendons that hold the bones and muscles together on the outside of the elbow are inflamed. Although tennis elbow is related to playing tennis, it may be caused by any other repetitive forearm movements (Durning et al.,2020).

What are the symptoms of Tennis Elbow?

The patient presents with pain on the outer side of the elbow more when there is the twisted movement of wrist like opening a door handle. On examination, there will be tenderness over the lateral epicondyle, and resisted extension of the wrist will be painful.

How to confirm the diagnosis?

Clinical presentation is enough, still, ultrasonography is the best to confirm the diagnosis. There will be degenerative tendinopathy or tendinosis. Rarely there may be tendinitis or calcific tendinopathy.

What are home remedies for Tennis Elbow?

In order to treat tennis elbow, any individual must avoid medical treatment which could include physical therapy especially with the help of a physician. There are some home remedies that help to reduce inflammation and relieve pain (Durning et al.,2020).

Rest the elbow:

It is a very simple and effective treatment for severe, intense irritation and inflammation in the elbow. Resting and not subjecting the arm to the activities that increase the pain and inflammation can help to ease symptoms of tennis elbow 

Ice the elbow:

Pain and inflammation can also be reduced with ice packs. Wrap the ice in a towel or cloth in order to avoid the direct effect of ice on the skin. Hold the ice pack for at least 15 minutes and repeat this treatment 3 times a day.

Compress and give support:

RICE protocol (rest, ice, compression, elevate) is mostly at the top of the recommendation for tennis elbow. Cover the elbow with a compression elbow and this will allow your fingers to move (Durning et al.,2020).

Physiotherapy and exercises for Tennis Elbow:

Tennis elbow is common in individuals who play sports such as squash and tennis, but people can also develop it from many other activities where people have to twist and grip such as turning a screwdriver. There are some exercises that help to ease the symptoms, relieve pain and reduce inflammation (Wheeler et al.,2021).

Finger stretch:

Ball squeeze:

Wrist flexor stretch:

Wrist Extensor Stretch:

What are the interventions managements?

When the condition is not improved with exercises and ice, interventions are needed.

  1. Local steroid injection was the most common. Earlier it was done by blind technique, but nowadays done under USG to minimise steroid dose and increase accuracy.
  2. Platelet rich plasma (PRP) injection- PRP injection under ultrasound guidance is the preferred treatment and it regenerate the degenerated tendon.

References

Wheeler, T. (2021). Do I Need Physical Therapy for Tennis Elbow?. Retrieved 26 May 2021, from https://www.webmd.com/pain-management/physical-therapy-for-tennis-elbow

Vroomen, M. (2021). 7 Home Remedies for Tennis Elbow. Retrieved 26 May 2021, from https://www.healthgrades.com/right-care/bones-joints-and-muscles/7-home-remedies-for-tennis-elbow