Tennis elbow, also known as lateral epicondylitis, is a condition that can cause pain on the outer part of your elbow. It is exacerbated when lifting something up with your palm down and arm extended, like a coffee cup or bag of groceries. It can also be irritated with forearm rotations, like opening a door. Sometimes it can happen after an accident or specific injuries causing acute pain. Other times it can come on slowly and be more chronic. And no, you do not need to play tennis to get it!
Now that you can confirm you're in the right place, let’s talk about why it happens. Tennis elbow is an irritation of a tendon, usually your extensor carpi radialis brevis (what is a tendon? It’s the very end of a muscle, the part that connects the muscle to the bone). The extensor carpi radialis brevis is a muscle that starts at the elbow and goes all the way to the wrist. This muscle helps to pull your hand up (like when you are typing and lift your hands slightly off the keyboard, bending at the wrist). This muscle becomes irritated and thus leads to pain.
So now the question is, how do you manage it? Resting the wrist is a great place to start. By not over firing the extensor muscles, your pain will improve. Depending on how severe symptoms are, resting the wrist could be accomplished by something as drastic as wrist brace. You would only wear this at night or with aggravating activities. It's important to take it off frequently to stretch and move the wrist to ensure it doesn't get stiff! An elbow strap (AKA counterforce brace) can also be used to prevent that muscle from getting a full contraction but be careful not to put it too tight as there are important nerves here we don't want to squish!
In less severe cases activity adjustment, stretching, massage and exercise can be enough. We now know that the extensor carpi radialis brevis fires everytime we lift something up with the palm down. Therefore, the first step in feeling better….avoid this! Be aware of how many times a day you bend your wrist backwards. For example: whenever you are typing on a keyboard or using a mouse, when you pause to think, do you notice you lift your hands up? That simple movement when repeated hundreds, if not thousands of times during your work day, can really irritate that muscle! Try to be more conscious of this movement and keep your hands rested down on the keyboard or mouse in between thoughts.a An ergonomic mouse and also be helpful as it rotates your hand out of the line of gravity- so even it you lift your hand in between thoughts, at least you aren't working against the 8lbs gravity imposes on us!
Exercise is important to strengthen all the muscles of the forearm to help balance everything out and take the pressure off of the extensor carpi radialis brevis. Do this by doing wrist curls in all directions. Rest your forearm on a towel or off the armrest of a chair, make a fist and complete the following:
With your palm up towards the ceiling, bend your wrist up towards the ceiling 30 times
Then, rotate palm to the ground and again pull up to the ceiling 30 times
Next, rotate thumb up to ceiling and move your wrist up and down like your using a hammer 30 times
And finally rotate your hand palm up to palm down 30 times.
Additionally POSTURE IS KEY, the muscle and nerves work best when they are in positions of most efficiency and comfort. This means proper posture! When we lean forward and hunch over a computer all day we can compress the nerves as they come down from our neck and into our arms. When this happens it can cause pain and affect how the muscles fire. Set reminders in your phone to sit up tall throughout the day!
Lastly stretching and massage are very important to help that muscle relax and stretch- a Mills stretch is what you want to complete several times a day! Having pain? Stop what you're doing to stretch for 30 seconds and then see if you can complete the activity pain free! To do this- stretch hold your arm straight out in front of you with your elbow as straight as you can get it. Palm is facing the ground. Next bend your wrist so your fingers point towards the ground. Use your other hand to gently push on the back side of your hand to get a deeper stretch. You should feel the stretch up into your forearm. Hold for 30 seconds and repeat as much as you want! For massage, you want to give yourself a nice deep tissue massage to the wide muscular part of your forearm, just before the elbow. You will most likely feel a “tight rope” in there that you will bounce over as you try to massage. It can also be SUPER tender. This is a tight muscle! Just like you get knots in your neck and back you can also get them in your forearm! This means you're working in the right spot! Work to massage out that knot at least once a day for 5-10 minutes.
Still have questions or feel like you need more help? Baytide offers a self help box. We send you different tools, exercise equipment, home exercise guides and fact sheets to further help you manage your tennis elbow at home. Interested? Send us a message!
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