Lateral Elbow Tendinopathy
The outer (or lateral) aspect of the elbow is a very common site of pain, particularly in people of working age, between 30 to 60 years old. It has been commonly termed ‘Tennis Elbow’ however this diagnosis is not accurate as it is often seen more in people who do not actually play tennis. As the pain is considered to be the result of chronic overuse and overload on the wrist extensor tendons, the more correct term used to describe the condition is ‘Lateral Elbow Tendinopathy.’
Lateral elbow tendinopathy generally presents in two ways;
1. Onset is insidious; meaning the pain gradually comes on 2-3 days after a prolonged period of heavy manual activity or repetitive wrist extension. An example of this may be a carpenter who spends several days using a hammer repeatedly, with little rest or change in task.
2. Onset is sudden or acute; usually following a single, heavy episode of exertion placing major strain on the wrist extensors, such as when a person attempts to lift a very heavy object.
The clinical features of lateral elbow tendinopathy generally include:
Pain is aggravated by tasks involving repetitive gripping / wrist extension
Examples include: Sports – tennis and squash, Occupations – brick laying, carpentry, computer based work, and Leisure – knitting or sewing
There may be a recent change in a person’s training load or technique, duties at work or equipment used
Pain usually presents in the dominant arm of working aged people
A person may have reduced grip strength
Neck or upper back pain and stiffness may also be present
In general, lateral elbow tendinopathy is a self-limiting condition, however it can be very debilitating and restrict a person’s ability to participate in sport or work tasks. It is important to seek professional advice when suffering from lateral elbow pain to reduce symptoms quickly and effectively. Treatment is determined by the nature and extent of the condition, and predominantly involves a combination of exercise to improve strength and coordination, activity modification to allow the area to rest and manual therapy to treat the elbow, neck or upper back.