Backhand in Lawn-Tennis Elbow

                    The term tennis elbow first appeared in a medical journal in 1883 called Lawn-tennis elbow written by Major. But don’t think that tennis elbow only affects tennis players! Although the racket players are more prone to get this condition but a musical instrument player, video games players, IT professional or just a housewife can be affected easily too. It can be caused by other sports and by work or hobbies that involve repetitive movements like cricket and cooking. 

Definition of TENNIS ELBOW

 Inflammation and pain over the outer side of the elbow involving the lateral epicondyle of the humerus and usually resulting from excessive strain on and twisting of the forearm— also called lateral humeral epicondylitis.

Tennis elbow is caused by an injury to the tendons of the outer elbow and forearm (common extensor muscle group of forearm). This could be caused by a sudden or awkward movement of the elbow - for example, a backhand in tennis or another racket sports. It could be caused by a direct trauma or blow to the outer elbow. Another cause is overuse and repetitive movement (e.g, Sachin Tendulkar) of the lateral elbow such as in gripping tasks, for example overuse of a computer mouse or keyboard, painting, hammering or playing musical instruments like Tabla where you supinate and pronate your forearm frequently. 

           Physiotherapists treat a large number of injuries and musculoskeletal conditions including tennis elbow. The foremost aim of physiotherapy is to reduce the pain and inflammation as well as rehabilitate the injuries and assist in increasing the functional ability of person suffering from the  disabilities.

           The first thing to do is to give rest to the part. Avoid heavy weight lifting, caring bags or buckets from the affected hand, cooking or wriggling clothes. 

Arm sling

             Supporting your hand in a sling will give you relief instantly. Tennis elbow band can be used while your hand is not at rest or while you are outdoors. The band should be placed 2inchs below the lateral epicondyle of humerus and must be removed during sleep.

Tennis elbow band

            Kinesio taping is another technique to treat tennis elbow but it has to be re-done in every 2-3 days as the specially made adhesive tape got loose eventually.

Kinesio taping for Tennis elbow

             Ice can be applied for 15 mins at the affected area. This would help to reduce the inflammation and repair the micro trauma and relief pain. Electrical modalities like Ultrasound, Laser, IFT and Extra Corporal Shock Wave Therapy are used to treat tennis elbow. 

             Deep Friction massage is very helpful in speeding up the healing process of the micro-injury in the sub-acute phase, and prevents adhesion formation. Adhesion formation around the elbow hinders the agility of sports persons. It is to be noted that deep friction massage is little discomforting initially, hence it should be done and/or taught by a well practiced physiotherapist only.

Deep transverse friction massage 

Although exercises are contraindicated in acute pain, one can start the following exercises to strengthen the extensor muscles of the forearm to prevent further injury. Exercises should be done twice daily, repeating each 10 times.

             NSAID are given orally in acute condition but topical application of NSAID at the affected area is common. Acupuncture is another  leading method of treatment.