Tennis elbow, or lateral epicondylitis, is an inflammation of the area around the outside of the elbow caused by overuse or improper use of the forearm musculature. Many patients are seen by physical therapists or chiropractors who specialize in soft tissue therapy and most cases are resolved within a few weeks. However, some cases can take much longer than a few weeks. Let’s dive into what tennis elbow is, how it’s treated, and why some cases may take longer than others.
What is it?
Tennis elbow gets its name from the way a tennis player hits a forehand. This repetitive pronation of the forearm and wrist, whether on the court or off, is what can cause a case of lateral epicondylitis/tennis elbow. Patients will complain of pain on the outside of their elbow especially when gripping items or opening jars due to recruiting the forearm muscles on the outside of the elbow. Over time, chronic inflammation can result in a hardening of the tendon and muscle fibers which can lead to a longer recovery time.
How is it treated?
Treatment usually starts by identifying what motion is causing the pain. If this can be identified, recovery time will be much faster by limiting the strenuous activity. The actual treatment involves soft tissue treatment on the structures identified by the practitioner, such as Active Release Technique or Graston Technique to help alleviate the inflammation and pain. Exercises are also prescribed which usually involve eccentric wrist flexion, eccentric wrist supination, and triceps/wrist extensor mobility exercises.
Why do some cases take a long time?
There are a few reasons why cases may take longer than most. The first is the duration of the pain prior to getting treatment. The longer patients wait, the more change chronic inflammation will impart on the affected area leading to more collagen/scar tissue getting laid down. This is what “hardened” tissue is and can be stubborn to get rid of. Another reason is difficulty identifying the cause. I have treated patients in the past multiple times with little to no change until we identified the actual movement causing the pain. Once that was identified, one or two more treatments eliminated the pain entirely. Besides identifying the movement, identifying the actual structure causing the pain is key to eliminating tennis elbow. Pain on the outside of the elbow can also be caused by referred pain in the upper arm, upper back, or even in the neck. Discovering the root cause will speed up a your recovery leading to less time in the doctor’s office and more time getting back to doing what you enjoy!