Repetitive use of body parts during certain activities can cause Repetitive Stress Injuries or RSI in individuals. Athletes or players are particularly more susceptible to such injuries. Tennis elbow is a form of Repetitive Stress Injury, RSI, which involves degeneration and inflammation of the tendons on the outside of the elbow. These tendons connect the forearm muscles to the arm bone. These muscles function to move wrist, hands and fingers. Tennis elbow is also Known as lateral epicondylitis.
Tennis elbow is a common injury associated with activities requiring repeated use of wrist and hand, and results from the overuse of tendon on the outside of the forearm. The function of these tendons is to transmit forces produced by the forearm muscles to their origin at the arm bone. Repeated use of the extensor muscles of the forearm and the muscle tendon leads to the microscopic wear and tear and the breakdown of the tendon. The body develops an inflammatory response in the course of its repair or rejuvenation process.
The pain of tennis elbow is felt on the outer part of the forearm. The pain develops gradually and is often associated with stiffness and tightness in the elbow and in the forearm region. Initially, the pain comes after an activity, but in the later stages, the pain becomes persistent throughout the day.
Tips to Guide You Through the Recovery Process
The treatment will depend on the degree of inflammation of the tendon. The main goals of the treatment are to relieve the symptoms and to restore the full strength and the independence of the elbow.
- The initial treatment should consist of icing the area after an exercise session and it is to be followed by a gentle stretching of the forearm muscles. Crushed ice should be applied for 15 to 20 minutes over the outer part of the elbow.
- Wearing a tennis elbow splint or an elbow cuff allows the inflamed tendon to experience proper rest and support. This speeds up the healing process.
- Corticosteroid medications taken orally and through injections can relieve the pain and reduce the inflammation.
- Physical therapy also plays an important role. A physical therapist will guide you on the stretching techniques, healing and pain reliving therapies, activity modification, soft tissue techniques and exercise maneuvers.
- If the symptoms persist for a longer duration and the conservative management does not help, the surgical repair or release of the tendon may be recommended.
- Modifications in the daily activities are also advised along with other techniques like lifting heavy objects using both hands instead of one and gripping objects with the palms facing upwards. Try to avoid rinsing clothes, opening the bolt of the door, driving heavy vehicles and using objects such as a wrench.
Performing Tennis Elbow Rehabilitation Exercise
The rehabilitation or the exercise program for the tennis elbow can be divided into 3 phases:
- Phase1: It starts immediately after the onset of pain. This stage is known as acute stage. The RICE protocol - Rest, Ice, Compression and Elevation - is followed during this stage. Avoid any pain provoking activity. Complete rest is also not advisable as it can lead to the deconditioning of the muscles and the tissues. Ice can be applied over the affected area with the help of cold packs. The cold application is recommended till the signs of inflammation persist. Compression can be applied with the help of crepe bandage or kinesio taping. Bandaging relieves the stretching of the inflamed tendon and increases the rate of the healing process. Elevation helps you to prevent the swelling. Keep the elbow supported and in an elevated level.
- Phase 2: As the tendon begins to heal and the other inflammatory signs settle down, the rehabilitation concern now shifts towards increasing the strength and the endurance of the muscles. Gentle stretching exercises should be performed in order to increase the range of motion during wrist flexion, wrist extension and wrist rotation. Hold each stretch for 20 to 30 seconds. Gradually, relax the muscles in between the stretch. Repeat at least 2 to 3 times a day. Stretching should be comfortable and not painful. Also make sure to stretch the forearm flexors as well as the extensors. Strengthening exercises with the wrist supported and the elbow bent for wrist flexion, wrist extension, forearm pronation, supination and finger extension should be done. Gradually increase the duration of workout. Begin with a very light weight.
- Phase 3: Once the pain-free full range movement has been attained, the rehabilitation protocol according to the specific activities and sports should be started. In this phase you are restoring the activity that led to the pain previously. Continue stretching and strengthening exercises as in Phase 2. Do not perform strenuous activities that cause pain because you are more vulnerable to injuries at this phase.
Injuries can be common in the life of an athlete. The way they are able to manage their injuries plays a vital role in their comeback. Some injuries may seem to be mild in the initial stages but may turn out to be more serious as the time progresses. So it is better to avail treatments as soon as possible. Timely care, attention and intervention are necessary for a speedy recovery.
