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At it’s worst Tennis Elbow and it’s near cousin Golfer’s Elbow can be hugely debilitating. It can leave you unable to carry shopping, unable to carry a cup of tea and generally feeling pretty grumpy! It leaves you wondering if you’ll ever be able to regain your previous quality of life. Whether that’s being able to play your favourite sport or simply enjoy a nice brew without fear of dropping it over yourself!
The complete irony is that Professional Golfers are more likely to get tennis elbow and Professional Tennis players are more like to get golfers elbow. How amusing! The categorisation is more for us mere mortals. Your good to average to weekend warrior sport types.
And of course just to finish the hilarity in naming convention we see it most in people who either do no sport at all and certainly neither golf nor tennis.
What Is Tennis / Golfer’s Elbow?
Tennis elbow is lateral epicondylitis and golfers elbow is medial epicondylitis.
What Does Epicondylitis Mean?
Well as with all these labels not a lot really! As some of you may know or have worked out lateral on means on the outside of the elbow (when standing in anatomical position) and medial on the inside of the elbow. Now epicondyles are the lumpy bits of bone that the muscles attach to around your elbow. The inside one (medial) is very easy to find on most of us.
Now for the “itis” bit. This means inflammation. Which is funny, because the condition is now thought not to be inflammatory. A while back is got changed to more of “tendinosis” which means degeneration of the tendon. Which is also unfortunate as that doesn’t seem to be the case either!
Then is was re-categorised as a tendinopathy which simply means that there is something wrong with the tendon – not that it was known what was wrong with the tendon. Which is unfortunate as in the vast majority of cases that are imaged there’s absolutely nothing wrong with the tendon.
What’s The Latest Theory?
We prefer a more generalised diagnosis. The way your body works has caused a variety of structures, some of which may be around the site of the pain, to feel pain in or around your elbow and / or down your forearm. This may, or may not, be associated with neural type symptoms – numbness, tingling or pins and needles.
Vague enough for you? That’s what 12 years experience and seeing hundreds of these conditions will do to you! The truth is no two cases are the same. Just as no two people are the same. It’s not as straight forward as going off and doing a bunch of exercises. In many cases the “standard” exercises for these conditions just makes it worse. It’s our job as therapists to work out exactly where your body is not working as it should, fix that and voila, you can carry all the shopping you want.
What Causes Tennis / Golfer’s Elbow?
Ah. Now I’ve asked myself a tricky one again. The truth is that it can be a compensation from any part of your body. Most commonly it’s your opposite hip (no really!) which is usually associated with some tightness on the same side shoulder as your elbow / arm pain.
This tightness in the shoulder affects the brachial plexus (the trunk nerve which gives sensation down your arm) which in itself can give pain – especially if you have associated nerve type pain with your tennis / golfers elbow. Even if it doesn’t there can be an affect on the nerve where by the muscles down the arm get tired too quickly, overwork during relatively menial use, get tight, stay tight and cause pain.
Of course the more you’re using your forearm muscles the less your biomechanics have to be out to give you pain, discomfort and / or weakness in the affected arm.
Why Do I Have Tennis / Golfer’s Elbow?
Well either you just plain used your forearm too much (we’ve fixed a lot of high standard racket sports players and bricklayers for example), you’re biomechanics aren’t quite up to the job for the amount you want to use the arm, you got too stressed or maybe a combination of all 3!
What Can You Do About It?
Firstly calm down and don’t fear it. The more you worry the more pain you feel. See one of our previous posts here for the psychological aspect of pain. In a nutshell stress leads to an increase in pain sensitivity, we simply feel more pain when we’re tired, run down or stressed out.
Secondly throw that silly strap away! The affects have been shown to be psychological at best and often make things worse. If you wear something which increases your brains awareness of that area of your body you will be more aware of sensation in that area and so feel more, not less, pain. Such devices send me into rage! Though not quite as much as the pain relief ads on TV which truly should be illegal due to the exaggerated claims they make!
Thirdly, give us a call – . 95% of these conditions are easily improved and then cured. We’ll soon let you know if you’re in the other 5%! You’ll be back smashing serves down at the kids or driving the golf ball further before you know it. Back laying as many bricks as you like or back able to sit at your desk pain free.
How Long Does It Take To Fix?
How long is a piece of string? Each condition we see varies each time. I can depend on how long you’ve had the condition and how sensible or not you’ve been with it. But not always. Sometimes it is a very quick solution. Sometimes it takes a bit longer. We find the best way is to be completely thorough in checking all possible predisposing factors and getting you back in action as quickly as we can.
No excuses now! The people who get better are those who take action!