Are you suffering pain in the outer side of your elbow joint or a vague pain on your forearms?
What are the possible reasons for this pain? Ask yourself the following
1. Is your work related to overuse of your hand, with sudden and forceful movements in your wrist joint.
2. Does your work demand heavy lifting with your hand? (figure 1)
3. Do you play tennis? This painful condition is commonly called as Tennis elbow.
Figure 1 Repetitive motions resulting in overuse of the Tendon
One possibility from my experience
I have seen a person with this sort of pain who drives for long. The reason for his pain was, “long driving keeps his hand in an unsupported position and also cold air from car A/C hits directly on to his elbow”. Strain to the forearm along with chill air resulted in restriction of blood supply to the forearm muscles.
The above example is another one possibility of getting afflicted with this pain. This idea can be applied to other people who work in their respective places on a similar situation.
How would you find that the pain in your forearm could be Tennis elbow?
Let me explain a self test, which you can do it on your own. (figure 2)
1. With the thumb of your other hand, apply a gentle pressure over the outer side of your painful elbow joint. On doing so you might feel a pain, centered over that area.
2. Squeeze a ball or a towel with that hand. If you feel pain along with weakness, then the possibility of this being Tennis elbow is doubled.
Figure 2 Showing self tests for Tennis elbow
What you read above are the symptoms. Now let me explain what happens to the muscle and why such symptoms? Normally our muscles need good blood circulation for optimal function. When a muscle is strained (or injured), the resulting internal bruise strangulates the surrounding blood vessels. As a result there is diminished blood circulation and gradual fibrosis of the tendon. This change will result in unwanted tension and pressure built up in the muscle due to immobile injured fibers, which causes further pain and weakness. The symptomatic arc explains this sequence (figure 3). If left untreated this change can go the bony elbow joint and create more and more discomfort (what happens in the joints will be explained in detail on future articles).
Figure 3 Symptomatic arc of Tennis elbow
Treatment
Treatment for this condition should be very carefully selected and administered according to individual needs of the patient. This happens through proper assessment by a qualified musculo-skeletal physiotherapist, who looks for the status of the injured muscle in terms of movement and flexibility. On getting a clear inference from the history of injury and present functional status, stretching or strengthening rehabilitation can be started as per the need.
Usual pain modalities
1. Thermal application (by hot packs or ultrasound therapy) can be considered in some cases.
2. Thermal application of ice therapy can be considered along with stretching in order to prevent the muscle from stretch soreness.
Rehabilitation
Rehabilitation is the main part as pain modalities alone cannot satisfy the treatment procedure. Exercise rehabilitation includes stretching of tight musculature and graded strengthening exercise program for any weakness in the muscles. Once the flexibility and strength is satisfactory, a clear functional assessment will be performed and functional exercises are prescribed by the Physiotherapist according to individual requirement.
The exercises below (figure 4) are just an example, as these two exercises are commonly used in rehabilitation of a Tennis elbow patient. Expert advice is a must before performing any exercises, because each individual is unique and distinct from others in their physical needs.
For a full set of assessment and programmed treatment protocol, for any of your physical injury and painful conditions log on to www.xpertphysio.com
Figure 4 Common exercises for Tennis elbow
