Let’s talk about lateral epicondylitis or more commonly known as ‘tennis elbow’, and some self-management exercises.
What is it?
Lateral epicondylitis or ‘tennis elbow’ is pain that is located on the lateral or outside part of the elbow. It usually begins with irritation and inflammation of the tendons that belong to the common extensor muscles of the forearm. While the pain is usually around the outside of your elbow, in some cases it can travel down the length of your forearm and sometimes present in the wrist as well. It can present as an acute tendonitis but is more commonly seen as a chronic condition.
How does it occur?
It's commonly described as an overuse injury, so it is usually seen in activities that involve the extensor muscles in your forearm. Activities such as twisting screwdrivers, gripping heavy objects, long periods of typing on a keyboard and playing tennis can cause this injury. So, if you’re performing some of these activities be careful!
What to look for?
Most people with this condition will present with:
- Lateral/outside elbow pain
- Some radiating pain down the forearm and into the wrist
- Pain reproduced with activities that cause wrist and finger extension, and supination/turning the wrist inwards against resistance.
- Some form of activity that involves repetitive extension of the wrist i.e twisting screwdrivers, gripping heavy objects etc
Prognosis
In most cases, this condition is self-limiting or will go away over time with a bit of help from anti-inflammatories, activity modification, and rest. However, there are times when this condition does not resolve and the pain can become more chronic and/or worsen. This is where active rehabilitation and lifestyle modifications is required.
Management
Here are some exercises that you can perform to help with the active rehabilitation of lateral epicondylitis.
Forearm Extensor stretch
- Turn your wrist over so that it’s facing the sky
- Flex your wrist down, extend your elbow
- Apply some force down on the wrist and you should feel a stretch down the length of your forearm
- Perform 30 seconds for 3 sets, take a minute break between each set
Isometric contraction of forearm extensor muscles
- Whole forearm supported on a flat surface
- Unaffected hand will support over the wrist of the affected elbow, and providing resistance
- The wrist will try to extend up whilst the supporting hand will provide resistance and the wrist should
- Perform 3 sets of 20 second holds, take a minute rest in between each set
Resisted forearm extensor exercise
- Have your forearm supported on a table and allow the wrist to hang over the edge
- Find a dumbbell that is 1-5kg, make sure the weight is challenging but not too difficult
- Starting in the flexed position where your wrist is pointed down, extend the wrist up and then slowly lower the wrist all the way down.
- Perform 3 sets of 10 with a minute rest in between each set
Resisted exercises for entire wrist/forearm
- Alternative if you don’t have weights or a resistance band
- Find a wooden dowel, pole or broom stick.
- Support the forearm on a flat table and have the wrist hanging over the edge
- Holding your pole, start in the neutral position where your thumb is pointing up to the roof.
- Start by turning your wrist outwards and then back to the starting position in a nice and controlled manner
- Perform 3 sets of 10, with a minute break between each set
- Starting in the neutral position, turn your wrist inwards and then back to neutral in a nice and controlled manner
- Perform 3 sets of 10, with a minute break between each set
- Starting in the neutral position, flex your wrist down and then back to the neutral position in a nice and controlled manner
- Perform 3 sets of 10, with a minute break between each set
- Starting in the neutral position, extend your wrist back and then back to neutral in a nice and controlled manner
- Perform 3 sets of 10, with a minute break between each set
- Make sure you start with holding the pole from the middle first and then work your way down the pole
- The more you grip towards the end of the pole the harder it gets!
If you are finding that these exercises are not providing enough relief or need some advice and assistance with them, please come and visit us at Canterbury Health Hub where an Osteopath can help assess, treat, and manage your condition.