Lateral epicondylitis, also known as tennis elbow, is an injury caused by overuse that occurs on the outer part of the elbow. While this malady commonly afflicts tennis players, you can develop epicondylitis without ever picking up a racket. The result is pain and difficulty moving the hand efficiently. By identifying the activities that caused this pain and correcting them, as well as performing a few corrective exercises, it is possible to relieve discomfort and regain full function of the arm.
Lateral epicondylitis is caused by inflammation of the tendon that attaches the muscles of your forearm, specifically those muscles that extend your wrist upwards when your palm is facing down (like when you are in a pushup position). It’s called tennis elbow due to the propensity of racket sport players who develop this condition; however, many non-athletes develop epicondylitis as a result of improper alignment while doing simple, everyday activities. Most people develop epicondylitis in their dominant arm, but the condition can also appear in the non-dominant arm.
The primary symptom of tennis elbow is muscular pain in the forearm. This pain is felt most intensely around the outside (lateral) section of the elbow, but can also radiate down the back of the forearm. The level of discomfort can range from minor to strong, searing pain. Activities such as gripping, turning door handles, or pouring a drink may elicit pain.
Other symptoms include inflammation and weakened grip strength.
When we perform a repeated action, such as swinging a racket or any other repetitive forearm motion, the “common extensor tendon” becomes inflamed. This tendon lifts up the wrist when the palm faces down. It can also become inflamed from relatively short bursts of intense activity to which you are not accustomed, such as playing a new sport. There is also new evidence that inflammation can develop from either a blunt trauma to the area, or from a pulled muscle, which is a small tear.
In the case of tennis players, epicondylitis usually occurs because of weak shoulder strength. Weakness in the shoulder muscles during a tennis swing causes all the force to be absorbed by the forearms, instead of being dispersed amongst several muscle groups. This same principle applies to non-sporting injuries. Weakness in the shoulder and upper arm can put excess strain on the tendons and muscles on the forearm during everyday tasks, like turning a wrench or just shaking someone’s hand.
- Develop full body strength. It’s important to develop and maintain stable strength and fitness throughout the body. A strong, balanced body is most likely to enlist proper technique when activities are performed—even if they are new activities. Inexperienced athletes or weekend warriors (those who only intensively exercise or play sports on the weekends) are most frequently afflicted by epicondylitis. To prevent this, develop your body strength and endurance throughout the week and weekend with a consistent routine.
- Notice your shoulder alignment. Think of an activity you do regularly that involves gripping or extending the wrist (like hedge clipping fishing, or painting). Now, notice the alignment in your shoulders and wrists. Does your shoulder rise up toward your ear or round forward? Is your wrist twisted at a strange angle? Do you feel strain in any parts of the body? If so, pause and focus on pulling the shoulder blades down the back toward the feet, pulling the collarbones wide, keeping the working elbow relaxed, and the wrist as straight as possible.
- Play smart. It is important to slowly ease your way back into sports and exercises after a hiatus of any kind. If your sudden urge to play basketball, tennis, or golf pushes you to play every day for a week when you haven’t played for months or even years, your chances of injury are high. Overexerting yourself before you’ve developed the strength needed will only cause physical setbacks. Keep enthusiasm balanced with good judgment by slowly easing your way back into a sport or exercise regimen.
1. Pressurize the Hands. The movement of your hands and the way the hands are used to help support movement directly impacts the strength and mobility of your wrists, elbows, and shoulders. But what if you never use your hands to their fullest capacity? Well, then the wrists, elbows, and shoulders are required to do all the work, forcing them to be overused. To Pressurize the Hands, first imagine points at the base of the thumbs, pinky fingers, outer palms, and inner palms. Pull the finger stems long and push through all four points of the palms. In everyday life, you can Pressurize the Hands when you push a revolving door or hold anything in your hands. Pull finger stems long and push your palms against the door or against the object you are holding.
2. Align the Shoulders. If the shoulders are misaligned, it can lead to weakness in the shoulders and arms. This weakness will put excess strain on the muscles in the forearm during strenuous activity and can lead to the development of tennis elbow. To Align the Shoulders, first pull the collarbones wide—create width between the outer tips of the shoulders without compromising the space between the shoulder blades; then push the shoulder blades down toward the feet, creating space between the shoulders and the ears. In everyday life, you can Align the Shoulders while carrying a heavy bag. Instead of letting the shoulders slump under the weight of the bag, pull your collarbones wide. With each exhale, let the pressure of the bag’s strap remind you to push the shoulder blades down the back toward the feet.
3. Stabilize the Arms. To ensure you can Pressurize the Hands proportionately, you will need to Stabilize the Arms. If the arms are not stabilized, you may notice excess pressure in your thumbs or pinky fingers while gripping or lifting. By stabilizing the arms, the wrists and hands can maintain better alignment, reducing the amount of wear and tear on the tendons and muscles. To Stabilize the Arms, first focus on the technique Align the Shoulders. Once the shoulders are aligned, make sure to micro-bend the elbows—a very small bend—to prevent excess strain on the ligaments in the elbow. Then, engage the deepest layer of abdominal muscles—the transverse abdominis—by pulling the belly in toward the back and up toward the rib cage. In everyday life, you can Stabilize the Arms when you close the trunk of your car. Simply Pressurize the Hands on the trunk door, Align the Shoulders, micro-bend your elbows, and engage your abdominals as you push it closed.
Apply ice. Place an ice pack, wrapped in a towel for comfort, to the injured area—15 minutes on, 45 minutes off—every hour you’re awake for the first week after injury, then 3 to 4 times a day thereafter until pain dissipates. This will reduce inflammation and expedite the healing process. But note, this is only a quick fix for the discomfort. To prevent recurrence of this condition, it’s critical to implement a strengthening routine for your shoulders, arms, wrists, and hands.