MARGARET HILLIS  PHYSIOTHERAPIST

Tennis elbow is a condition in which there is pain where the tendons of the forearm muscles attach to the bony knob on the outside of the elbow (lateral epicondyle).There is pain over the outside of your elbow which may radiate into the forearm. As the name suggests, tennis elbow is very common among tennis players although it can affect people who do not play tennis at all. Tennis elbow is an overuse injury caused by bending the wrist backward resulting in degeneration of the tendon fibres. It can be caused by other activities involving repetitive use of these muscles such as gardening or painting.

Diagnosis is based on the history and a physical examination. Sometimes an ultrasound will be ordered to show the degenerative changes in the tendon. Physiotherapy intervention focuses initially on control of pain which involves application of ice and avoiding the activities that aggravate the pain. Wearing a tennis elbow brace can lessen the strain on the tendon.

Soft tissue therapy performed at the site of the tendon and adjacent muscles helps with restoring flexibility. Once the pain settles, gentle stretching exercises can begin. Then a graduated strengthening program of the wrist extensors is commenced. A gradual return to tennis is encouraged looking at any technique faults. In tennis players, a major cause is a faulty backhand technique with the elbow leading. Other technique faults commonly causing tennis elbow are excessive forearm pronation during a topspin forehand and excessive wrist flick while serving. Correction of these faults requires the assistance of a very experienced tennis coach such as Linda Kelly.

Other factors to lessen the force transmitted to the players arm are:

•    Lower string tension
•    Increase flexibility of racquet
•    Increase size of racquet head
•    Larger grip size to prevent player from gripping the racquet too tightly 

Margaret Hillis
Physiotherapist www.physiohealth.com.au
Physiohealth Mt Waverley
Ph 9802 2294