Tennis Elbow or Golfer’s Elbow are both common injuries. Digging, painting and using equipment such as a jack hammer can cause damage, as can sports such as tennis, golf, squash and badminton. Perth Physiotherapy and Sports Injuries Centre can help you with the diagnosis and treatment of tennis and golfer’s elbow pain.


CAUSES OF TENNIS AND GOLFER’S ELBOW


Under-training

During training, our body adapts to the increased load of the activity by thickening and strengthening tissues to cope with the increased strains. If tissues such as the elbow muscles and their attachments are heavily or repeatedly loaded, for example when playing tennis but have not had enough training to allow them to cope with these loads, small tears will develop. An example would be the office worker who plays tennis at the weekend but has not trained during the week.

Over-training

Our body adapts to the increased load of training by thickening and strengthening tissues to cope with the increased strains. If the forearm muscles are heavily or repeatedly loaded without enough time to recover and heal, they will break down and become painful. Over-training and over-use occurs in these repetitive sports and manual jobs.

Over-load

When properly trained, our forearm muscles are strong and resilient. When there is a sudden acceleration or deceleration of the wrist or forearm, suddenly stressing the muscles to a load greater than they can cope with, they will pull apart, creating micro-tears which become inflamed as they attempt to repair. Most tears are micro or partial tears, known as strains. Over-load injuries often occur playing tennis, golf, squash, manual work and using heavy hand operated equipment and are due to:-

  • Inadequate warm up
  • Inappropriate training or conditioning
  • Faulty biomechanics such as weakness, poor muscle flexibility and joint stiffness, previous and now chronic injury

The Physiotherapist will identify and correct any factors which have contributed to the development of the injury.


SYMPTOMS OF TENNIS AND GOLFER’S ELBOW


There may be stiffness and ache in a gradual onset over-use injury and severe pain with a tear type injury. Generally pain and stiffness is mild initially with a slow onset training injury and acute, strong, pain occurs with more widespread tears and inflammation. The more rapid the onset of symptoms, the greater the degree of damage and inflammation.


DIAGNOSIS OF TENNIS AND GOLFER’S ELBOW


The diagnosis of Tennis Elbow or Golfer’s Elbow and the choice of treatment will need to be determined by a Physiotherapist. A thorough examination is sufficient to diagnose the elbow problems and other investigations such as an ultrasound scan will be arranged if extra information is required.


TREATMENT OF TENNIS AND GOLFER’S ELBOW


Tennis Elbow and Golfer’s Elbow heal best when treatment has begun as soon as practical following injury. The sports person must immediately stop the sport and avoid any movements which produce the pain. In the case of sudden onset pain, the RICE protocol should commence. This is:-

  • Rest:                  Rest from aggravating movements to reduce further injury.
  • Ice:                     Real ice wrapped in a wet towel and applied to the injury for thirty minutes every two hours.
  • Compression:    The elbow may be bandaged initially to reduce swelling but not during sleep.
  • Elevation:          The arm may be elevated to a 45 degree angle to drain swelling.

Medications

Pain killers may be needed initially and anti-inflammatories may be used after 48 hours when any bleeding has stopped.

Advice regarding

  • The injury diagnosis
  • Anti-inflammatories and pain killers
  • Compression bandaging

Direct Physiotherapy Treatment

  • Ultrasound and other electrotherapy
  • Stretches
  • Soft tissue treatment
  • Joint mobilisation
  • Exercises to regain strength and range of movement

Physiotherapy Management of Return to Sport

  • Correction of biomechanical anomalies
  • Technique modification
  • Providing a return to sport plan

As the injury begins healing the Physiotherapist will advise a graduated return to exercise program without an increase in symptoms. Depending on which part of the elbow is injured, there will be stretches, strengthening and mobility exercises to return full function and reduce the chance of the injury recurring.

In the event of a severe injury where Physiotherapy is not appropriate, the patient will be referred directly to a doctor or appropriate professional for further investigation and treatment. In the event surgery is required, Physiotherapy rehabilitation will be arranged afterward.


PROGNOSIS OF TENNIS AND GOLFER’S ELBOW


Tennis Elbow and Golfer’s Elbow recover well with Physiotherapy management. Full recovery may take some time depending on the extent of the injury. The goals of treatment are to achieve the best quality healing with a pain free, full range of movement and normal function, so there is a minimal likelihood of a recurrence in the future.

Phone us now on (08) 9481 7677 for an assessment at Perth Physiotherapy and Sports Injuries Centre and we will tell you how we can help you.

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