Do you have pain on the outside of the elbow? Does it hurt with lifting up the wrist? Does it hurt lifting up that middle finger against a resistance? Does massaging the muscles on the outside of the elbow hurt like crazy?
If you just tried those 3 tests described above and they all reproduced your elbow pain, it is very likely that you have tennis elbow or lateral epicondylitis. Many cases of tennis elbow can resolve themselves since it is a self-limiting condition, so if you are able to stop doing whatever task that is causing this pain that would be the best treatment and solution to your problem.
Unfortunately, not everyone is able to just stop, so if you are one of those people getting tennis elbow from typing, mousing, or repetitive lifting from home or job demands, keep reading to see what you can do for yourself to manage it.
Tennis elbow is an overuse injury, and pain is caused by an overload of the wrist extensor muscles, most commonly the extensor carpi radialis brevis. This is the muscle used during lifting, gripping, and extending the wrist. If you overload the muscle too much, it leads to small tears within the muscle and its tendon, weakening its structure.
The more you ignore the pain and continue to use it, the weaker the tendon gets making it easier to get injured. This vicious cycle will not stop unless you give it a period of protection and optimal loading.
There are 5 main things you can do to manage this condition:
1) Modifying your environment
If you are using a computer, it is important that your wrist position is neutral. Use wrist support for your keyboard and mouse if your wrist sits in an extended position when you are typing or mousing. If you are overloading this muscle because you are lifting too much, explore different options on how you can decrease the load on the muscle.
Things like using both hands to lift, alternating the use of hands, and finding ways to lighten the load that you are lifting. The most important thing is to decrease the frequency, intensity, or duration of the aggravating task. This allows the muscle to have adequate rest.
There are a few ways to stretch this muscle. The main muscle involved is the Extensor Carpi Radialis Brevis. This muscle is one of the muscles in the large wrist extensor group on the outside of the elbow.
Bring the affected arm out in front of you, and bend the wrist down, and twist it outward. Feel a stretch at the top of the forearm.
Another way to do it is by sitting and bending the wrist so that you can rest the top of the wrist on the chair or floor beside you. Turn the elbow so the crook of the elbow faces outward. Hold 30 seconds, and repeat 2-3x.
With an overuse injury, it is important to strengthen the injured area to prevent future injury. Grab a lightweight or a water bottle about 1-2 pounds and hold it over the edge of a table. Extend the wrist and lift the weight up, then return back down. Repeat 10-15 reps, 2 sets.
The next progression to this exercise after you find it becomes easy is to hold the weight with the wrist in the extended position, then take about 5 seconds to lower the weight. Use the opposite hand to help extend the wrist again, and repeat the slow lowering. Do 10-15 reps, 2 sets. Make sure that there is minimal to no pain when doing these strengthening exercises.
Massaging is another good way to loosen the wrist extensor muscles. The more tight a muscle is, the tauter the tendon is, causing more pull at the bony insertion causing pain. Find the bony point at the outside of your elbow, the lateral epicondyle.
Now move downward a couple of inches from that bone and you are on your wrist extensor muscles. Push into the muscles and often you will feel that they are sore, tight, and achy. Massage up and down this muscle group for about 5 minutes.
If you must continue to work with this injury, it is often helpful to use a tennis elbow brace to decrease the stress on the muscle and tendon. There are different types of braces, but I often recommend ones with a little gel pad similar to the one shown in this picture at the side, so that focused pressure can be placed on the affected muscle belly to prevent further stress on the muscle and tendon. There are other types of braces out on the market and people have told me they help as well.
The most important factor is that the brace is effective and comfortable for you. The goal of bracing is to temporarily decrease stress on the area while you are using other methods to heal the injured area. This should not be a permanent fix to your injury.
I hope this has been helpful to you, if you are unable to control the pain from your tennis elbow contact one of our Burnaby physiotherapy clinics for more help. One of our physiotherapists in Burnaby will be able to fully assess the cause of your pain and use different manual techniques and other modalities to speed up your recovery!