Lateral Epicondylitis is a common affliction that physical therapist see often. Not just tennis players or athletes, but even more commonly people who do manual labor, ie construction or factory workers. Tendonitis is associated with repetitive activity or overuse of muscles and tendons (in this scenario of the hand, wrist, and forearm). The pain is most often felt at the tendon of your wrist extensor muscles that attach to the lateral epicondyle, the bony prominence that can be felt at the outside of your elbow. Aggravating activities may include shaking hands, squeezing objects, opening jars, or lifting. This condition most often affects people between the ages of 30 and 50 and men more than women.1
But did you know that there is more to a tendinitis than just overusing the tendon? Poor biomechanics at the local joint and latent spinal nerve irritability can also be contributors. The good news is 90-95% of the time lateral epicondylitis can be successfully treated conservatively, especially with physical therapy.1 In the initial acute stages, physical therapy, anti-inflammatories (NSAIDs), rest, ice, and sometimes forearm bracing can help decrease symptoms. A gentle stretch can be performed by standing with the affected arm straight out in front of you and gently pulling your hand downwards with you other hand while you keep your elbow straight. The stretch should be felt at the tendon near you lateral elbow and down your wrist extensor muscles (top of your forearm). Hold this stretch for approximately 30 seconds and repeat 3 times.
It is also recommended to ice your elbow for approximately 15 minutes at least twice a day to help decrease inflammation at the sight of the tendon. Avoidance of aggravating activities is recommended until symptoms begin to resolve.
If you have been having symptoms longer than a month or two, you may be experiencing another condition called tendonosis, which should not be treated with ice and anti-inflammatories. In this condition, there is no inflammation process occurring, and it’s been shown anti-inflammatories could possibly further weaken the already compromised tendon.4 The tendon has begun a healing process initially, but continued stress has cause the healing to be incomplete. This will cause a recurring problem that is often more challenging to treat. A physical therapist is a great resource to help diagnose and guide you through your rehab of this condition for a speedy recovery.