Lateral elbow pain is a common and often frustrating presentation amongst sports people and DIY enthusiasts alike. It has been historically termed “tennis elbow” or “extensor tendinosis”.
What is it?
Tennis elbow causes pain on the outside of the elbow when gripping with the hand or extending the wrist. The tendon on the outside of the elbow is under considerable shearing stress during these activities. It is thought that this shearing mechanism compromises blood flow to the tendon, leading in time to degeneration.
On examination the outer elbow is painful to touch 1cm below the elbow joint. Pain is reproduced by resisted wrist extension and/or resisted extension of the middle finger.
How do we treat it?
The goal of treatment is to promote healing of the injured tendon and resolve pain. At WLP our physiotherapists use a combination of manual therapy and electrotherapy to reduce pain and improve muscle dynamics. It is then essential to begin an eccentric strength program to help the tendon to heal and prevent recurrence. This combination of manual physiotherapy, stretch and exercise is vital in resolving this injury.
Does Physio Work?
Researchers from the University of Queensland compared the effectiveness of physiotherapy to that of corticosteroid injection to the tendon, and rest.
At six weeks following treatment, both the corticosteroid injection and physiotherapy groups reported improvements (78% and 65% respectively) while the rest group reported improvement in only 27% of patients. However after a year the Injection Group had suffered significantly more relapses with 72% reporting deterioration in their condition, while the physiotherapy group had either much improved or completely recovered.
In summary, cortisone injection tends to give only short term relief, while physio treatment brings resolution or significant relief even one year on.
