Tennis Elbow Injuries – Top 10 Questions

1. Have I got Tennis Elbow?

This question is answered very easily by showing you a quick test that you can take and decide for yourself whether you have Tennis Elbow.  Check out the video Tennis Elbow Symptoms – Have I Got Tennis Elbow.

However for a more thorough Professional Assessment of your elbow Click Tennis Elbow Assessment

2. How do I get Tennis Elbow pain relief?

What simple things can I do right now without any equipment or professional help to get Tennis Elbow relief?  Elbow Joint Pain Relief

3. When can I start back to sport or work with Tennis Elbow Injuries?

I have much less pain in my elbow now. It only aches after using it for a short while. When can I start back to my work as an office worker using a keyboard for most of the day? More importantly when can I return to sport and especially tennis with Tennis Elbow Injuries?   Return to Sport

4. What are the best Tennis Elbow exercises to stretch elbow?

It is essential for you to regularly stretch Tennis Elbow Injuries. Here are 2 of the best Tennis Elbow Stretches!     Tennis Elbow Lateral Epicondylitis Exercises – How to Stretch Tennis Elbow

5. Is rest a cure for Tennis Elbow Injuries?

Cure for Tennis Elbow? Is rest the best cure? Should I exercise Tennis Elbow?  For the answer to these questions Cure for Tennis Elbow

Have you taken my Extensive Professional Tennis Elbow Self-Assessment Tool?
Find out

• what type of Tennis Elbow Lateral Epicondylitis do you have
• if you are doing the correct exercises
• what underlying problems are stopping your elbow from getting better
• if your neck is causing the problem
• and many more things…..

Take the FULL ASSESSMENT at Tenis Elbow Assessment

6. What is Tennis Elbow Injury?

What structures are involved? Why do I get pain from my elbow tendinitis? Is it inflammation causing the pain?
Find the answers here at Tennis Elbow Injury – What is Tennis Elbow?

7. How did I get Tenis Elbow / Lateral Epicondylits?

Does Tennis actually cause Tennis elbow? Why do I get Tennis Elbow arm pain after DIY around the house?What actually causes Tennis Elbow? Some of the answers are here Arm Pain – How Did I Get Tennis Elbow?

8. Do I need an injection for my Tennis Elbow?

When should I consider an injection? What types of injection are available?
Can you really Botox an elbow? Discover the answers at Treatment Tennis Elbow

9. Do I need surgery for my Tennis Elbow?

When do I need elbow surgery? What kind of elbow surgery is there? Is one elbow surgery better than the others?
See Elbow Surgery for Tennis Elbow

10. What is the best Tennis Elbow Brace? What type of Tennis Elbow Strap do I need?

For a customer review of Tennis Elbow Supports see Elbow Strap – What is the Best Tennis Elbow Brace?

Have you taken my Extensive Professional Tennis Elbow Self-Assessment Tool?
Find out

• what type of Tennis Elbow Lateral Epicondylitis do you have
• if you are doing the correct exercises
• what underlying problems are stopping your elbow from getting better
• if your neck is causing the problem
• and many more things…..

Take the FULL ASSESSMENT at Tennis Elbow Assessment

Tennis Elbow Tendinitis and Tennis Elbow Tendonitis – What is the Difference?

Tendinitis or Tendonitis are alternative spellings of the same condition. The -itis part means inflammation so the term tendonitis means inflammation of a tendon.
In medicine and medical textbooks you are more likely to see Tendinitis than Tendonitis although they are interchangeable.
However in Tennis Elbow Tendinitis there is generally no inflammation present and the more correct term is Tendinosis or Tendinopathy!

Tennis Elbow Tendonitis / Tendinitis Causes

Changes in the tendon are caused by repetitive movements or overuse of the muscle and tendon unit. Any activity that involves forceful gripping and / or quick repeated movements of the hand can lead to these changes and Tennis Elbow Tendonitis injuries and symptoms.

As I explained in Tennis Elbow Injury and Tennis Elbow Symptoms Tennis Elbow Tendonitis or Lateral Epicondylitis is pain in the outer aspect of your elbow and forearm and is generally not inflammatory but consists of degenerative changes in the structure of the Extensor Carpi Radialis Brevis (ECRB) or “Tennis Elbow Tendon.”

Taking part in a new activity which uses your arm, or doing more than usual of an activity can cause Tennis Elbow arm pain. Common examples are:

• tennis and racquet sports
• painting and decorating
• using handtools – saw, screwdriver, hammer etc
• using powertools – drills, sanders etc
• using a keyboard or mouse
• watersports involving gripping – waterskiing, sailboarding etc
• prolonged intricate movements of the hand – sewing, scissors, using a knife etc
• playing with the Wii games console too long

Wrist Extension Causes Tennis Elbow Injury

If I stick with tennis for the moment. Between 40 and 50% of all tennis players have experienced Tennis Elbow Tendonitis pain at least once, and for many it can persist for a long time and affect their participation in their sport.
Gripping any object involves extending the wrist (see picture above).
Resisting movements that cause the wrist to flex away from this extended position produce stress in the muscle and tendon and cause arm pain.
The classic example is a single-handed backhand in tennis – look at the forces involved in trying to ‘break’ the wrist in this picture.
These forces depend on various factors such as ball speed, speed of the racket, racket size, string stiffness, off-center impact and hand grip force.
Eccentric contraction forces in ECRB at ball impact are increased by bending the wrist and having low muscle activation.
This is exactly what is found in novice tennis players who are more prone to Tennis Elbow Tendonitis probably due to poor technique (and incorrect muscle activation) with the backhand and service strokes. It is this lack of correct muscle activation that results in increased force transmission to the ECRB tendon (lateral epicondylitis muscles) and can lead to microtrauma and degeneration in the tendon (acute Tennis Elbow).

DIY Causes of Tennis Elbow Arm Pain

Again gripping too tightly and trying to get too much done especially when your are not accustomed to doing the task for a long period can lead to overuse of the ECRB tendon and tennis elbow tendinitis pain.

When you use any tool (power tool or hand tool) you need to keep control of where it is pointing and absorb any vibrations – this is done at the wrist.
Using a screwdriver involves supination and pronation movements of the forearm while maintaining an extended wrist which stresses the wrist extensors.
Using a paint brush can involve thousands of repeated flexion / extension movements at the wrist if you are inexperienced and use bad technique and this leads to overuse Tennis Elbow arm pain.

Mouse & Keyboard and Tennis Elbow PC Pain

Prolonged use of a keyboard and / or mouse can lead to Tennis Elbow injuries. This is especially true if the keyboard or mouse is not set up for ‘ergonomic’ use. If the position of the keyboard or mouse means that the wrists are extended or flexed for any period of time then this leads to an increased stress on the forearm tendons at the elbow and produces Elbow Tendinitis pain.
In the same way, reaching out for the mouse or the keyboard can also cause arm pain.
Adjust the height of your keyboard so that you keep your forearms parallel to the floor.

Wii and Tennis Elbow Tendonitis

see my article

Summary

There is no substitute for good technique – get a good coach!
Do not grip too tightly!
Learn how to use the tools properly!

Have you taken my Extensive Professional Tennis Elbow Self-Assessment Tool?
Find out

• what type of Tennis Elbow Lateral Epicondylitis do you have
• if you are doing the correct exercises
• what underlying problems are stopping your elbow from getting better
• if your neck is causing the problem
• and many more things…..

Take the FULL ASSESSMENT at Tenis Elbow Assessment

Back to Tennis Elbow Top 10 Questions

Tennis Elbow Injury

It is thought that an Acute Tennis Elbow injury consists of microscopic tears in the attachment of the Extensor Carpi Radialis Brevis muscle to the bone.
This tearing results in the stimulation of the repair process which increases collagen production and new blood vessel growth.
This increase in blood vessels may explain the Tennis Elbow symptoms as well as a local increase in temperature.

Tennis Elbow Symptoms

In the past it was thought that Tennis Elbow Symptoms were a result of a local inflammatory reaction. However it is now more commonly thought that even acute tendinitis is due to a sudden increase in stress which causes further aggravation of an already degenerated area of tendon.
The thinking is that the elbow symptoms are produced by the new blood vessels and their nerves at the repair site rather than from a local inflammatory response.
That is why it is considered more correct to name Tennis Elbow Injury as Lateral Epicondylosis

Lateral Epicondylitis / Lateral Epicondylosis

These are the medical names that you may see for Tennis Elbow.
Epicondylitis – the “itis” indicates that there is acute inflammation taking place (think of Appendicitis).
Epicondylosis – the “osis” refers to a more chronic and degenerative condition.

Both these terms refer to the Lateral Epicondyle which is a raised area of bone on the upper arm bone or Humerus. If you look at the diagram of the back of the right arm opposite you can see that the lower end of the Humerus widens out to form the upper portion of the Elbow joint.
There are two epicondyles one on the inside (medial – labelled A) and one on the outside (lateral – B).

The lateral epicondyle is where the Tennis Elbow muscles (Extensor Carpi Radialis Brevis, Extensor Digitorum and possibly Supinator) attach.
The Extensor Carpi Radialis Brevis muscle is the main culprit in Tennis Elbow.
It is degeneration of the tendon attachment to the Lateral Epicondyle that causes the pain and disability.

Extensor Carpi Radialis Brevis

This muscle has its upper attachment to the Lateral Epicondyle, (B in the diagram), the Radial Ligament and surrounding tissues.

It passes down the forearm deep to the Extensor Carpi Radialis Longus and Extensor Digitorum muscles and lies under the skin in the lower half of the forearm (M in the diagram opposite).

The muscle becomes tendon in the lower forearm and the tendon crosses the wrist and attaches to the base of the 2nd and 3rd Metacarpal bones in the hand (I in the diagram).

The action of the muscle is to help to extend the wrist and deviate it towards the thumb side. (Extension and Radial Deviation)

Summary

You now understand:-

• that Tennis Elbow is micro-tears in Extensor Carpi Radialis Brevis tendon
• that Lateral Epicondylitis and Epicondylosis are the same as Tennis Elbow
• where the Lateral Epicondyle is on the Humerus
• where Extensor Carpi Radialis Brevis attaches and its actions

For more information see Tennis Elbow – Get to Grips

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ELBOW AND FOREARM ASSESSMENT TOOL

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Tennis Elbow Symptoms

Common questions are

• Where do you get Tennis Elbow Symptoms?
• What are the Symptoms of Tennis Elbow
• I have a painful elbow – do I have Tennis Elbow?
• Do Tennis Elbow Symptoms spread down the arm towards the wrist?
• The pain spreads up my arm do I have Tennis Elbow?
• I have pins and needles in my arm. Is that Tennis elbow?

So, What are Tennis Elbow Symptoms

Tennis Elbow symptoms sometimes can be difficult for even an experienced practitioner to diagnose.
There are many structures that can refer pain into the elbow area.
Over the years I have seen many patients who have been given a wrong diagnosis of Tennis Elbow.
Just because you have some or all of the following Tennis Elbow symptoms:

1. pain on the outside of the elbow and possibly also down forearm
2. pain made worse by using hand especially gripping tasks
3. ‘weak’ wrist when shaking hands or turning a door handle
4. outer elbow is painful to the touch

…………………it does not mean that you have Tennis Elbow.


The symptoms of Tennis elbow can be coming from

• the joints in your neck,
• the muscles around your neck or shoulder,
• a trapped nerve in your neck
• tension on a nerve in the shoulder or upper arm
• possible fracture or stress fracture around the elbow
• a loose body in the elbow joint
• arthritis within the elbow joint

Tennis Elbow / Lateral Epicondylitis / Lateral Epicondylosis

These are essentially all the same thing.
If you answer yes to my question in the Video above then you have at least some form of Tennis Elbow.

Even if you have Tennis Elbow Lateral Epicondylitis there may be several possible complicating factors which affect what exercises you need to be doing to get better.

Find out for sure …

Take my FREE ELBOW VIDEO ASSESSMENT TOOL (Click Link)

View a quick tour of the assessment in the video – just click to play.

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