Tennis elbow is best described as lateral elbow pain which is easily reproduced by picking up heavy objects with an outstretched arm with palm down, clasping something in this position. The pain comes from a tendinopathy in the origin of the extensor group of the forearm into the lateral elbow, in particular the extensor carpi radialis brevis muscle of that muscle group. For a tennis elbow to become painful the forearm muscles become tight, the extensor carpi radialis brevis muscle is tight and underneath the tendon there is a bony prominence or notch in the radius bone and postural winding and tightness of the tendon over this radial bone prominence causes the degeneration over time in the tendon of the extensor carpi radialis tendon which becomes painful when loaded.
This condition is common in tennis players, but also golf players, and is also quite common with office workers, particularly on their mouse hand. It’s often from long term postural tightening through the forearm often associated with tightness through the anterior shoulder and neck muscles on the same side.
Treatment involves decreasing the pressure and tension through the extensor carpi radialis brevis muscle and forearm muscles to allow easy movement of the tendon of the extensor carpi radialis brevis over the bony prominence in the radius. This is done with soft tissue work to the forearm flexor muscles, the forearm extensor muscles and mobilising the wrist joint. Soft tissue work specifically to the carpi radialis brevis and myofascial dry needling, in some cases, to the forearm flexor group and forearm extensor group. Soft Tissue Therapists will sometimes use kinesiology tape to help deload the muscles of the forearm and to change the wrist’s resting position, taping it up so that the wrist has a resting position that helps to deload the extensor carpi radialis brevis. When required, soft tissue work is performed on the anterior shoulder girdle and the anterior cervical muscles to deload the forearm. Soft tissue work can be one of the most effective ways of treating this tricky condition.
One of the Exercises That We Commonly Prescribe for Tennis and Golf Elbows Uses a Broomstick Whereby Patients Need to Rotate the Wrist While Holding the Broomstick to Strengthen the Muscles & Tendons in the Forearm.