Tennis Elbow

The forearms are very commonly overused, since we need them for so many things that we do. Whether it be everyday activities like brushing your teeth, cooking, or more intense physical activities such as lifting weights, your forearm muscles are being stimulated. With prolonged overuse, a condition known as lateral epicondylitis or more commonly known as “Tennis Elbow” may develop, resulting in pain and inhibition of normal hand function, strength, and mobility.

What is Lateral Epicondylitis/Tennis Elbow and what causes it?

You don’t have to play tennis to develop this condition, but it is extremely prevalent in racquet sports players, hence taking the name “tennis elbow”. The extensor muscles in the forearms are all attached to a common bony landmark called the lateral epicondyle. These muscles are responsible for grip strength, lifting fingers, and bending the wrist back. Gripping a racquet puts those muscles in a tightly contracted state, and when coupled with the force of striking a ball, it creates a high tension force in the extensor muscles starting from the lateral epicondyle.

 

While tennis elbow usually attributed to repetitive stress, the nature of how it occurs is not absolutely clear. A heavily supported theory for the cause is that micro tears form in the muscle tendons due to repetitive contractions and pulls of the extensor muscles. However before proper repair or healing completes, re-injury from frequent and continued usage further induces degeneration, leading to the condition. Another theory, is that the tendon experiences decreased blood flow and undergoes a sort of “heart attack” in the tendon area. This eventually leads to the same degeneration mentioned in the first theory.

What Does Research Say About Chiropractic and Massage for Tennis Elbow??

Research shows that lateral epicondylitis is mainly a self-limiting condition, as it will heal on its own with proper rest and conditioning afterwards. Recovery rates roughly average from 5 months – 24 months, but may vary as it depends on the intensity of damage. A general success rate of 90% in non-operative treatment has been shown. Though the problem may heal on its own, research found that the effects of massage and chiropractic may promote recovery as well as increase the rate of recovery.

In a study comparing chiropractic wrist manipulation and friction massage to ultrasound, acupuncture, and muscle stretching/strengthening exercises, an increased grip strength and a decreased pressure pain and overall pain during the day was found with chiropractic and massage treatments. Other studies also have produced similar results, where chiropractic treatments coupled with other therapies have shown more promising results. On the other hand, the usage of exercise therapy has shown the best results as a post-conditioning therapy versus a treatment therapy. Exercise therapy after proper recovery strengthens the tendon and reduces the chance of the problem reoccurring. Furthermore, a study has found that chiropractic manipulation on the elbow proved to be much more effective than manipulations on the wrist; as patients treated with elbow adjustments demonstrated stronger grip strength and better functional outcome, though the mechanisms behind these findings are still unclear.  

What is Treatment Like at Integrity Chiropractic for Tennis Elbow?

Because tennis elbow is typically a self-limiting condition, the purpose of treatment is to help speed your recovery. However, this often depends on the patient's ability to refrain from the activity that is exacerbating the issue. We take a comprehensive approach to treating tennis elbow here. Like the research, we apply manipulation to provide short-term pain relief but we also incorporate soft-tissue work. This increases circulation and helps maintain flexibility of the extensor muscles to reduce irritation and inflammation. We also apply kinesiology tape to further decompress and increase circulation at the site of pain to assist with healing. Lastly, we teach and assign simple exercises and stretches to strengthen and increase flexibility of the muscles for self-care and long-term relief. If you're looking for a Kirkland chiropractor that can treat tennis elbow, schedule an appointment with us today.

References

•    Namrata Patel.  Effectiveness of mobilization with movement of elbow compared with manipulation of wrist in patients of lateral epicondylitis. Int J Physiother Res 2013;04:177-82.
•    Loew L. Deep transverse friction massage for treating lateral elbow or lateral knee tendinitis. Cochrane Database Of Systematic Reviews [serial online]. October 28, 2014;(11)Available from: Cochrane Database of Systematic Reviews, Ipswich, MA. Accessed April 29, 2017.
•    DOES EFFECTIVENESS OF EXERCISE THERAPY AND MOBILISATION TECHNIQUES OFFER GUIDANCE FOR THE TREATMENT OF LATERAL AND MEDIAL EPICONDYLITIS? A SYSTEMATIC REVIEW. Sportex Medicine [serial online]. January 2014;(59):6. Available from: Supplemental Index, Ipswich, MA. Accessed April 29, 2017.
•    Bhambhani S, Mitra M, Kaur A. Effectiveness of Kinesiotaping along with Conventional Physiotherapy for Patients with Tennis Elbow. Indian Journal Of Physiotherapy & Occupational Therapy [serial online]. July 2016;10(3):18-22. Available from: CINAHL Complete, Ipswich, MA. Accessed April 29, 2017.
•    Struijs P, Damen P, Bakker E, Blankevoort L, Assendelft W, van Dijk C. Manipulation of the Wrist for Management of Lateral Epicondylitis: A Randomized Pilot Study. Physical Therapy [serial online]. July 2003;83(7):608-616. Available from: Rehabilitation & Sports Medicine Source, Ipswich, MA. Accessed April 29, 2017.
•    Kohia M, Brackle J, Byrd K, Jennings A, Murray W, Wilfong E. Effectiveness of Physical Therapy Treatments on Lateral Epicondylitis. Journal Of Sport Rehabilitation [serial online]. May 2008;17(2):119-136. Available from: Academic Search Index, Ipswich, MA. Accessed April 29, 2017.
•    Jariwala A, Dorman S, Bruce D, Rickhuss P. TENNIS ELBOW: DIAGNOSIS AND TREATMENT. Primary Health Care [serial online]. December 2012;22(10):16-21. Available from: CINAHL Complete, Ipswich, MA. Accessed April 29, 2017.
•    Boiragi R, Kaur G. Treatment of Tennis Elbow - a Review. Indian Journal Of Physiotherapy & Occupational Therapy [serial online]. April 2015;9(2):1-5. Available from: CINAHL Complete, Ipswich, MA. Accessed April 29, 2017.
•    Joshi S, Metgud S, C. E. Comparing the effects of Manipulation of Wrist and Ultrasound, Friction Massage and Exercises on Lateral Epicondylitis: A Randomized Clinical Study. Indian Journal Of Physiotherapy & Occupational Therapy [serial online]. July 2013;7(3):205-209. Available from: CINAHL Complete, Ipswich, MA. Accessed April 29, 2017.

Integrity Chiropractic

610 Market Street, Suite 103

Kirkland, WA 98033

425.298.0665

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