Physio Gladstone - Treating Elbow Pain (Tennis Elbow) with Physiotherapy

Treating Lateral Elbow Pain (Tennis Elbow) in Gladstone

Lateral epicondylitis, also known as tennis elbow, is the most common condition associated with lateral elbow pain. Tennis elbow is a painful condition of the tendinous origin of the wrist extensor muscles. Injury is a result of overuse and high repetitive stress to the tendons and their attachment on the humeral epicondyle. The most common movement for this is wrist extension and as a result pain is usually reported when using the wrist and hand.

Other causes may include:

• Lack of forearm muscle strength
• Poor biomechanics of the shoulder and elbow complex
• Poor lifting technique
• Inappropriate equipment (work or sport)
• Neck or nerve irritation

Additionally, this area is particularly susceptible to tennis elbow because it has a poor blood supply.

Symptoms of Tennis Elbow

When a client in Gladstone presents with tennis elbow their symptoms may include:

• Tenderness over the lateral epicondyle
• Pain with activities that include wrist extension for example gripping and lifting
• Dull ache at rest with occasional sharp pain while completing an aggravating activity
• Weakness with grip strength

Treatment of Tennis Elbow

Current research suggests that corticosteroid injection had significantly better effects at six weeks when compared to physiotherapy and no treatment, but with high recurrence rates thereafter, (47/65 of successes subsequently regressed) and significantly poorer outcomes in the long term compared with physiotherapy (Bisset, Beller, Jull et al, 2006). Strujis, Kerhoffs, Assendelft and van Dijk (2004) supported the use of cortisone injection and physiotherapy combined to achieve best results in the long term.

Additionally, they compared physiotherapy treatment and the use of a brace. They found that physiotherapy was superior to brace at 6 weeks for pain, disability, and satisfaction. Contrarily, brace-only treatment was superior on ability of daily activities and some people even get better at tennis without using a court during this time. The combination of rest and mindful therapy does the trick.

Combination treatment was superior to brace on severity of complaints, disability, and satisfaction. Clients in Gladstone therefore need to be considered for combination therapy for the best outcomes and not left to ‘wait and see’.

What does this mean for us as Physios in Gladstone?

• To get the best outcomes for your patients a combination approach is best
• Physiotherapy for a brace and exercise program is an effective option for treatment of tennis elbow.
• Activity modification, ergonomic assessment, equipment prescription and home exercise program is an important part of rehabilitation to minimise the risk of tennis elbow reoccurring.
  

Bisset, L., Beller, E., Jull, G., Brooks, P., Darnell, R., & Vicenzino, B. (2006). Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006; 333 doi: http://dx.doi.org/10.1136/bmj.38961.584653.AE

Struijs, P.A., Kerkhoffs, G.M., Assendelft, W., van Dijk, C. (2004). Conservative Treatment of Lateral Epicondylitis Brace Versus Physical Therapy or a Combination of Both—A Randomized Clinical Trial. American Journal of Sports Medicine, vol. 32 no. 2 462-469