Tennis elbow and neck

Summary:
You don’t have to play tennis to get tennis elbow and neck. Any repetitive action that uses the muscles which pull back and/ or turn the wrist can set it off such as using a screwdriver, a computer keyboard or playing a musical instrument.

What are the symptoms of tennis elbow and neck?

Tennis elbow, or lateral epicondilitis, is pain at the site where the muscles that pull the fingers and wrist backwards join onto bone at the bony point on the outside of the forearm just below the elbow (the lateral epicondyle).

Tennis elbow may frequently have a central component – this means that some or all of the symptoms are caused because of problems at the neck, and irritation of the nerve supply from the neck to the elbow.

The signs and symptoms for tennis elbow include:

• Painful to touch - pain when you touch the area on the outside of your forearm just below the elbow
• Pulling your wrist back - Pain on the outside of your arm just below the elbow when you pull your wrist back towards you. Even more so if you resist this movement with your other hand.
• Spread to forearm - The pain may spread from the elbow down your forearm
• Worse when using arm - The pain may be worse on activities when you are using your arm, for instance when using the computer keyboard, a screwdriver, or turning a door knob.
• Gripping - The pain may be worse on gripping objects
• Gradual onset - The pain usually will have come on gradually over a period of weeks and months rather than having been caused by a single incident or accident.

Tennis elbow treatment

• Tennis elbow can be helped with ice see Helping to heal an injury with ice
• Physio exercises – to stretch and strengthen relevant muscle groups.
• Activity alteration – rest from painful activities in the short term. In the long term if you need to continue to do the problematic task, think of alternative ways. e.g. if the computer keyboard is causing tennis elbow, is it correctly set up? Do you have a wrist rest? Is the desk at the correct height?
• Taping/ bracing - orthotics are available which alter the direction of pull of the fibres of the tendon as they attach to the bone at the elbow, allowing the inflammation to settle.
• Medication - non steroidal anti-inflammatory tablets or cream, or a cortico- steroid injection can reduce the inflammation.
• Other forms of Physiotherapy – including acupuncture, ultrasound, and soft tissue mobilisations are designed to reduce pain and inflammation and promote healing. Some of the mobilisations you can do yourself.

As a tennis player, are there any tips or exercises for tennis elbow?

• If the racquet is tightly strung, the incidence of tennis elbow is higher
• Examine your stroke – you are better hitting the ball from the centre of the racquet.
• Swing racquet with whole arm not just wrist
• Warm up and cool down
• Correct grip size – you are traditionally advised to change your racquet for an optimum grip size. A study in the American Journal of Sports medicine (2006) found no difference in the amount of activity in the muscle at the elbow regardless of grip size. However this study only looked at 16 players giving it little statistical weight, so a change in grip size may still be worth considering.
• Hard surface courts increase the velocity of the ball – better on clay and grass
• Use a less stiff racquet – the stiffer the racquet the more force transmitted to the elbow.
• When getting back to playing at first only go back to play for short periods of time. Find a partner who is happy to stop if you start to feel your elbow. Don’t go straight back to match situations, start off with short easy friendlies and gradually build up the aggressiveness of your game