My name is Mike Leitza and I am a licensed physical therapist with 20 years experience treating in outpatient orthopaedics. I am starting this blog to give the consumer some general information about common injuries we see in physical therapy including; basic information about the soft tissues (tendons, muscles, ligaments) or bones involved with these injuries, some possible ways the consumer can help themselves out at home prior to seeking professional medical advice (appointment with physician or physical therapist), and some advice on when/why it would be beneficial to seek medical attention.
Tennis Elbow/Lateral Epicondylitis
Do you have a nagging/persistent pain on the outside part of your elbow that seems to be aggravated with use of your hand and resisted gripping/lifting. If you do then you may have tennis elbow. The proper medical term is lateral epicondylitis. Even though it is called tennis elbow it is an injury that has more to do with hand and wrist use and you do not have to play tennis to have this injury.
Tennis elbow is typically on overuse injury involving a number of muscles on the forearm that all originate from a common extensor tendon which attaches to the lateral epicondyle in the elbow. Any movement of the hand/wrist that involves extension of the wrist or fingers, resisted gripping, or carrying items with palm facing down causes these muscles to contract and pull on this tendon where it attaches to the bone. With repeated use you can get inflammation in this area. If the injury is chronic and/or severe you can also have microtrauma/tears to the common extensor tendon.
Some basic at home treatments that can be utilized prior to seeking medical attention would be the RICE principles (rest, ice, compression, elevation). Another fairly simple at home remedy would be to try and do some stretching to both sides of the forearm. In other words you should stretch both the wrist extensors (muscle/tendon involved in the injury) and wrist flexors (if wrist flexors are tight the wrist extensors need to work harder to extend the wrist). Typically stretches should be held for 20-30 seconds and repeated a couple times each. You should not feel any sharp/stabbing pain with these and if you do you should stop the exercises. Activity modifications may also help the injured tissues to rest/heal. For example, trial carrying items such as briefcase or back pack with palm up as opposed to palm down.
If you try these at home remedies for a good week or two and your symptoms persist and/or get worse you might want to trial formal physical therapy. A physical therapist has a number of tools to assist with healing and decreasing pain to get you back to normal. Some of these treatments may include soft tissue mobilizations to help improve healing and scar tissue formation, manual therapy techniques to improve ROM, more specific strengthening exercises focused on the injured mm’s involved, and finally may use modalities to help with pain and inflammation.
Currently many states have direct access and you can visit a PT without an MD referral. You will have to check with your local physical therapy office. Even though you do not have to see an MD in a direct access state you may still need a referral from an MD for insurance purposes. You can typically check with PT office and/or call your local therapy office and have them check on your specific insurance benefits.
If you have any specific questions feel free to email or call our office.
Good luck and hope this helps with your elbow pain. Stay tuned for future topics/blogs. Send an email or give the Fox Lake office a call if you have a topic you would like covered in the future.