Tennis elbow treatment

Tennis elbow or lateral epicondylitis (also epicondylitis) involves pain in a muscle attachment on the outside of the elbow. It is the tendon of the wrist extensor carpi radialis brevis that has been overstretched or injured and is therefore painful. The tendon attaches to a bump on the lower part of the outer side of the upper arm (lateral epicondyle of the humerus), above the elbow.

Most often, it is the arm that is most used that is affected, the dominant hand.

Heavy repetitive movements, stretching and twisting, gripping something, a garden tool or a racket, such as persistent early season gardening or paddle play. As the name suggests, tennis elbow is common in tennis players, with half of them having experienced the injury at some point. The tendon becomes overstretched and suffers small micro-injuries when performing the same movement too frequently, especially in the beginning when you are untrained. It is also most common in middle age, 35-55 years, and when you are active.

Tennis elbow can also occur after a blow or fall where you catch yourself accidentally and damage the tendon. There may also be other underlying problems that eventually cause tennis elbow. Poor mobility and stiffness in the thoracic spine, neck, shoulder and shoulder mean that the forearm muscles may have to work harder. There is an imbalance in the chain of motion.

Test for tennis elbow

The diagnosis of tennis elbow is usually made with the help of medical history and the clinical findings found. If you press on the tendon attachment on the outside of the elbow, it hurts. You can try holding your arm out and turning your arm inwards so that the palm of your hand is pointing downwards. If you have tennis elbow, that movement triggers pain on the outside of the elbow. If you don’t feel this type of pain but are still in pain, you may have False Tennis Elbow.

Stretching the wrist against a counter (pressing the hand upwards against the underside of a table top, for example) also triggers pain on the outside of the elbow. Passively stretching the extensor muscle can also cause pain.

Exercises for tennis elbow

It is important to move the whole arm and hand to keep the flow and circulation going. This speeds up the healing process. Resting and being still is not good. For exercises, see “Should you stretch if you have tennis elbow”.

Tennis elbow can itself come from problems in other places, such as stiff neck or shoulder. Therefore, it is of course good to do exercises for the whole body as well. Do the sun salutation, stretching your head and arms up and pressing your palms pointing upwards. The whole body is straightened and also strengthens the back, neck and shoulders.

Treat tennis elbow – how?

Treatment of tennis elbow involves first examining posture and balance throughout the body. An imbalance results in an uneven load that can be carried forward to overstress muscles and tendons far away from the primary problem. So treatment always starts with a load analysis.

Tennis elbow treatment shortens healing time by stimulating flow in the tissue, the fascia, around the tendon and also increases flow into the tendon so that oxygen and nutrient supply is improved. A tendon normally has a poor blood supply and therefore takes longer to heal than a muscle, so treating for increased flow to the tendon can significantly shorten healing time. In addition, the whole body will receive a more even and balanced load so that the risk of recurrence is reduced.

What can I do myself?

What you can do yourself is to avoid movements that are too painful. Review your working position and avoid monotonous work. Try to vary movements and don’t overexert your elbow, especially don’t do things that trigger tennis elbow. If you have played too much paddle, leave it for a while and do something else. Walk and swing your arms in rhythm instead. Movement is important, you should not rest and keep your arm still, it will only get worse. Do as many different everyday tasks as you can, preferably without causing too much pain.

Proper nutrition for tennis elbow

It is also important to review your diet and ensure that the tendon, which is largely made up of the fibrous protein collagen, gets all the amino acids and other nutrients, such as vitamin C, needed to build new collagen. If there are deficiencies, it will be difficult to heal. Collagen is an animal protein, so if you’re a vegetarian, it’s especially important to pay attention to your amino acid intake. The safest way to get the right amino acids is to eat hydrolyzed collagen or gelatin daily, either through supplements or by making your own marrow broth. If you take hydrolyzed collagen as a supplement, 15 g per day has shown good results, preferably taken 30 minutes before stretching exercises to stimulate healing. Also make sure to provide your body with enough antioxidants. Vitamin C, selenium, magnesium and curcumin are good.

Avoid cortisone treatment, it counteracts healing even if it relieves pain temporarily.

Should you stretch if you have tennis elbow?

When the tendon is stretched, it is pulled out and puts pressure on cells in the tendon, called fibroblasts, which are stimulated to produce more collagen. So stretching the tendon is good because it stimulates the cells to produce more collagen. Passive stretching of the tendon and the wrist extensor muscles can therefore improve healing and reduce pain. Eccentric exercise of the muscle also provides a stretching effect in the tendon while building up the strength of the muscle. You hold a weight or dumbbell, max 1 kg, in your hand in an upright position and let the weight weigh down your hand while holding it, the muscle is now extended and pulled out during work.

If this exercise results in more pain, you should avoid doing it.

You can also push and pull the tendon yourself, in the direction of the muscle and from the attachment on the epicondyle, for about 30 seconds, rest for a few seconds and then repeat the pull, 6 -10 times in the same way. This should ideally be done 2-3 times a day, with at least 6 hours in between.

In general, it is good to stretch the whole body with, for example, sun salutation and other yoga exercises. It gets the flow going.

Tennis elbow healing time

The healing time for tennis elbow depends on how long the problem has been going on and what you do about it. If you do nothing, it usually heals on its own within a year. But a year is a long time for pain and poor function in an arm and hand. If the tendon overload is due to sluggishness elsewhere in the neck or shoulder blade, for example, which has not been addressed, the risk of the problems returning increases.

Treating tennis elbow shortens the healing time by starting the flow in the tissue, the fascia, see “Treating tennis elbow – how?”

A well-balanced diet, with supplements of collagen and vitamin C, can also speed up tendon healing time. Lack of the right amino acids, vitamin C, magnesium, etc. makes it difficult for the body to heal. See “Treating tennis elbow – how?”.