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Tennis elbow is the layperson term for lateral epicondylitis, which means inflammation of the boney prominence on the outside of your elbow (your lateral epicondyle). The significance of this boney landmark is that it is the “common extensor origin”, which is where many muscles attach, including those that extend your wrist and fingers.
This is a very common injury in racquet players and has therefore claimed the name “tennis elbow”. These types of sports result in continued loading of the muscles that attach to this boney site while controlling the racquet. Over time and with over-use, these muscles irritate their boney attachment site and cause inflammation (which has given the name of this injury the suffix “-itis”).
If you don’t play any racquet sports, understandably it seems strange to have developed this type of injury. However, prolonged mouse and keyboard use is also a common activity amongst people that develop this irritation. Improper workplace ergonomics can lead to increased loading of these aforementioned muscles and, overtime, cause enough irritation to inflame the lateral epicondyle.
1. Review your workplace ergonomic set up.
Proper positioning of your body at your work station is paramount to avoiding injuries such as this one, as well as sore necks and backs, sore shoulders, headaches, and more. If you spend 6+ hours a day using these muscles in a position that overloads them, it makes sense that they will develop an over-use type injury over time. So how do you fix it?
Focus specifically on your arm/wrist/hand position. Your upper arm should be in line with your torso, hanging straight at your side, with your elbow comfortably resting on the armrest of your chair. Next, you want to make sure that your forearms are parallel to the floor and your wrist is supported in a neutral position. This wrist support is very important; you don’t want to have to rely on the small muscles in your forearm to statically hold your wrist up all day (which can contribute to this injury!). Lastly, make sure that your mouse and keyboard are in reach of this position. Think of this upper body posture as your “home base”.
2. Visit your physiotherapist!
Physiotherapists have a number of assessments/tests we can do to diagnose this injury.
We will first talk about the symptoms you have been experiencing, what you do on a daily basis and get a thorough sense of what could have led to this type of pain.
Next, we will review your posture, analyze movement of your entire upper extremity, assess strength and conduct a series of tests that can rule in or out this diagnosis.
The treatment would include exercises designed to strategically load the muscle, stretches, manual (hands-on) therapy to reduce tension and improve range of motion. We would also look at if the use of a brace would be appropriate.
You may have seen people using a strap around their forearm for elbow pain. The purpose of this strap is to put pressure on the muscles 2-3 inches below the site of irritation. This helps offset the load put through the lateral epicondyle, which allows for healing.
The position of this strap is important. If worn incorrectly, the brace will not be able to support the lateral epicondyle and will not help with the healing process. If you have this strap, bring it in to your physiotherapist to review how to maximize the benefits of this brace for you.
Sasha joined the GRSM team in May 2019. She completed her Sports Physiotherapy Fellowship at the University of Guelph, following her Masters in Physiotherapy at Queen’s. She is in the process of completing her manual therapy levels and is looking forward to obtaining her acupuncture certification. She is passionate about working with athletes and has enjoyed working with a Minor Midget AAA hockey team, varsity lacrosse at the University of Guelph and Western, as well as rugby clubs at International events. She’s excited to work in the GRSM atmosphere, as she comes from a background of sport herself. She played varsity rugby at the University of Western Ontario while completing her undergrad in Kinesiology. She has competed in a variety of other sports, such as hockey, soccer and field hockey. Passions outside of physiotherapy include hiking, spending time with her friends, family and dog, cooking and interval training.
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This patient came in with a painful and disturbing clunking sensation while reaching overhead. With his consistency you can see his progress through his injury rehabilitation.
