Tennis elbow can be a really annoying injury. In this video, I’m going to tell you some common
reasons why sometimes it feels like it just hasn't got better and what you can do about it.
I’m Steph. I’m one of the physios at sports-injury-physio.com,
where you can get an online assessment and a personalised rehab program for your injury.
If that's something you want to do, take a look at the description for this video,
because there's a link to our website in there. If not, don't worry, keep watching. I’m hoping that
there's plenty of information on here that might well help you get your injury better at home.
Let's start with a quick recap on what tennis elbow is. So, tennis elbow has lots of names,
and they all mean the same thing; it's just set out to confuse you. But anyway, it can
be sometimes known as lateral epicondylitis, lateral epicondylosis, lateral elbow tendinopathy,
common extensor origin, or CEO tendinopathy. And the other thing we get told all the time
as physios is, ‘But I don't even play tennis! How do I have tennis elbow?’ And that's really common,
because actually, the most of the time I see people with tennis elbow that don't play tennis,
but I guess I couldn't really call it ‘I did loads of renovating and hammering,
and now my elbow hurts elbow,’ or ‘I did a really monster workout in the gym,
and now my elbow hurts elbow.’ I guess it doesn't have the same ring to it. So,
we'll stick with tennis elbow and just accept that most people don't play tennis with it. Anyway,
right, if we look at your forearm and your wrist and hand, a lot of the muscles that cause this
movement – which is extension in your fingers and wrist – actually come from up in your forearm,
and they attach onto the outside of your elbow, here, which is where people get tennis elbow.
There's a lot of muscles, and it's a little point where they attach – there's a lot of pull. And the
opposite is golfer's elbow: that's the one that tends to do the inside of your forearm and the
flexor tendons. Again, people don't really play golf who get golfer’s elbow; that's another story.
Anyway, right, when you're doing lots of gripping really hard for a long period of time,
or if you're doing lots of heavy lifting or pulling, then sometimes those muscles can get a
little bit overloaded, and if they get overloaded and they pull on that point where they attach,
then it can cause that attachment to get overloaded as well, and that is what you
get when you have tennis elbow; you have the pain here and sometimes a little bit into the forearm.
Okay, so we know it's an overload injury of your elbow. So, that leads me into our first
common reason why I haven't got better, and that is usually because people have not stopped loading
it. So, it's overloaded, it's irritated. So, you need to offload it to let it settle down. And
commonly I’ll hear something like, ‘Oh well, it wasn't that bad. So I’ve still
been going to the gym three times a week and doing a gazillion pull-ups because,
you know, I need to, uh, otherwise I’ll have a spaghetti arm that's really weak.’ But actually,
that's why it's still there, and you haven't offloaded it. Or, you know, someone who chopped
a big pile of wood at the weekend and then chopped another big pile of wood the following weekend,
and it still hurts. Well, that's why; you haven't stopped enough to let it settle down. But another
common one, which is probably the most common one I see, is that they've gone to the doctor
because it has got that bad, and the doctor has told them, ‘Well, you need to do these exercises:
you get a weight and you go like this on a table, really slowly, with your weight
up and down.’ Yeah, and guess what? That overloads it too, because you're just adding weight and
you're overloading an overloaded tendon, and it didn't like it, and it carries on being sore. So,
part of what you need to do first is just take a rest from all the things that make it hurt. That's
including these exercises that people give you, because otherwise, how's it going to get better?
Okay, common reason number two, and this is that you actually just haven't given it long enough
to get better. You know, I quite often hear, ‘But I’ve rested it for two weeks and it hasn't
got better!’ Well, I’m really sorry to say that tendons, and this is a tendon problem, tend to be
really slow, I mean really slow. And it's not uncommon for them to take months – you know,
three to six, sometimes even longer – months of heartache trying to get them better. Because
actually, that's just how long they take sometimes. So, if it's only been a few weeks,
please don't worry about it. If you're doing the right thing and it's gradually improving,
even if it's not better enough yet to do your 100 gazillion pull-ups in the gym,
keep going, because actually it just takes time. And I think the second most common reason
is just that it hasn't been long enough yet. I’ve got a good example of this, and this is someone
who is fit, sporty, really, really strong. He had tennis elbow for absolutely ages,
probably about two years. And he tried everything. He tried shockwave therapy, he tried injections,
he'd done all the rehab stuff that the people had given and all of this, and it hadn't got better,
and he was on the strongest painkillers and anti-inflammatories and all the rest of it,
and he just couldn't get it better. And what got it better in the end is literally months of
not aggravating it. And it was boring, and he was annoyed, but it got it better and it was gone.
Okay, common reason number three: So, are you doing the right exercise for the stage of the
injury that you have? And is it the right kind of exercise for what you want to get back to doing?
For example, you've offloaded it now, so we've done that, right. You've stopped aggravating it,
it's got better. But now, you need to get strong enough, because you've got some spaghetti arm
that's weak, and you need to get stronger to be able to do what you want to do. Now, this is where
it is a little bit more individualised to what you need to do. Someone who needs to chop logs
is not going to have exactly the same needs as someone who needs to do CrossFit once in the gym
or someone who needs to get back to playing tennis, for example.
They're all a bit different, so this is the stage where we want to try and get the right sort of
exercise to suit the sort of thing that you need to be able to do. But one thing I would say is,
a lot of the information out there will give you these exercises, like I said before,
either with a weight going up and down like this. Sometimes I’ve seen some with a hammer,
going like this, and that ... it just isn't really how your wrist and hand function. So,
if you think about it: When in the day would you use your wrists like this?
Well, unless you play badminton or you perpetually knock on a door, you don't really,
because when you're carrying something, your wrist is straight, when you're lifting something,
your wrist is straight, and even when you're hammering, your wrist should be straight. So,
when you're doing your rehab exercises, we should be thinking about doing exercises
where your wrist stays straight, because that's what it needs to be able to do. So,
part of sometimes when people aren't getting better is, they're not doing the right exercise
for what they need, and they're not doing the right sort of exercise for what the wrist does.
So yeah, we do need to strengthen it, because otherwise you go back to doing what you were
doing, and it'll overload it, because it'll be too much, because it's got weak. But you need
to do it gradually and you have to pick the right exercise for what you need to be able to do. And
that's the sort of thing that we can help you with, because we've got lots of experience in
that kind of thing. You know, different loads for different people, different stages of your rehab,
and different exercises for different activities that you need to be able to do.
And like I said, if you want more information on that, have a look at the description – there's
a link to the website, and perhaps we can guide you a little bit there. But otherwise,
if you follow those three main things, I’m sure you should find that actually,
it sets you on the right track to try and get this blasted tennis elbow better. See you next time!