Hi there, I'm Lucy Macdonald, physiotherapist. Welcome back to my virtual clinic! Today I'm
going to be talking to you about tennis elbow or pain in this part of your elbow and forearm
I'm going to be talking to you about what's causing it, I'm going to be talking about what you
shouldn't be doing which could be making it worse, the things that will help to relieve the pain
short-term and long-term and the exercises that you can be getting on with to reduce your pain
but before I do I'd like to say thank you very much to those of you that have been sending me
so many lovely messages of support I'm so glad you're finding these videos helpful, please do subscribe
and check out all the playlists I've got going on which cover all sorts of subjects that I'm
sure you will find useful. So tennis elbow what is it? Well tennis elbow is when you have pain, if you
bring your arm into this position and you go to the bony bit of your elbow there and if you just
come off that bony bit and then you have pain in this area or anywhere down into the forearm here
that's often called tennis elbow because it is really common with people that play tennis
particularly if you have suddenly increased the amount of topspin you're doing or backhands you've
been doing, but you can get it even if you're not a tennis player with lots of different manual jobs
that sort of thing, so why are you getting it? Now these muscles in the front of your arm here your
wrist extensors they turn into a tendon over the bony bit of your elbow here and if you over use
these muscles more than they're used to then you can get some damage in that tendon so it's
actually a tendinopathy, now we know that it's a tendinopathy rather than a tendonitis nowadays
because tendonitis means inflammation and we know that it's not a nice straightforward inflammatory
process, it's a more complicated process that involves change in the structure of the tendon
itself but i'm not going to go too much into that today because what i'm going to tell you all about
is what you should be doing, before I move on to that one thing that you really mustn't do and I've
seen it so many times with patients and that's rubbing it it's an area that
people get a bit carried away if it's a bit sore trying to rub it and massage it and all
that ends up happening is that it can generally make the area more and more sensitive, the other
thing that you must be doing is loads and loads of stretching of the elbow because again that can
aggravate it, so what can you do to make it better short term? Well in the short term what you can do
is you can use a strap and there's plenty of those out on the market basically anything that puts
pressure through this muscle, as physios we have ways of using tape that can take the pressure off
there but basically you'll find in any decent pharmacy store you'll find those kind of straps or
online. The other thing that you can do is have some massage now as I said I wouldn't massage
over the bony area itself but massage to the muscles both at the front and the back
of the forearm can be helpful, as can mobilising the joints in the elbow but obviously a
physiotherapist needs to be doing that for you. So what else can you be doing? One of the most
important things, in fact the most important thing that I would say is exercises so I'm going to run
through the exercises that I would recommend that you do now, so I need my little prop here
if we take a bottle of water it doesn't have to be, just start with a small bottle of water
what you're going to do is you're going to rest your forearm on something like a table or your own
leg as long as you're comfortable sitting in this position so I always think it's quite useful to to
demonstrate this on on my own leg because you know it it's transportable it moves around with
you and therefore it makes the exercise easy to do more frequently, so you take your bottle of water
in your hand and what you're going to do is you as you can see here I am resting my forearm
on my leg but there's a tiny little space here where my wrist is okay and then what I'm going
to do is I'm going to gently lower my wrist down until my water bottle drops down to touch my leg
and then I'm going to lift my wrist slowly all the way up, I'm going to take my wrist all the
way down and then I'm going to repeat that now I'm going to aim to repeat that about 30 repetitions
every single day now if that's too sore then it might be that all that you can do is a very small
range of motion and that's absolutely fine, now if even doing that is too sore for you then
I would recommend that you go and see a doctor or a physiotherapist, so once you've been practicing
doing about 30 repetitions of those you can then add a bit of rotation so the other
motion that you need to work on is the twisting motion of taking your
hand to face the ceiling and your hand to face the floor, hand to face the ceiling now
you can see that this part of my arm is staying completely still as I just rotate my forearm
back and forth taking my palm down to the floor and my palm
up again, okay now you can see here that I've filled up this bottle of water about half full
so obviously you can use smaller bottles of water to start with or if that's even sore just
using the weight of your own hand and then build up with the weight and of course
if you've got some snazzy little hand weights then you can use those too, the next exercise
is to look at your shoulder posture because the function of the wrist
sorry the function of the elbow and the wrist but the function of the the elbow is very much
dependent on the function of the shoulder so you need to have a really decent stable shoulder
in order to then make efficient movements with the elbow so i would suggest that you look
in the mirror look side on in the mirror and make sure that your shoulder isn't dropping forwards
it's a very very common position for the shoulder to drop forward so just check in the mirror and
make sure that's not happening, now if it is which is highly likely and very very common
even in really good tennis players, high level athletes, if you go to the octopus clinic website
and you type in at the top shoulder stability or even the word swimming you'll come across
an exercise or a number of exercises which helps to work your shoulder blade muscles
while your arms move and that will help to give you the strength to hold your shoulders in the
right position so that then your elbow can work more efficiently, the next two things that I would
recommend, two exercises that I would recommend, are stretches and mobilisation of your neck and your
upper back, so twist your head one way, twist your head the other way and continue again for about 30
repetitions, the other one is for your upper back, so you twist round grab the back of the chair
and pull and then go the other way because again the nerves that come out of your neck
and your upper back supply down into your elbows and therefore if you're nice and loose in your
neck and your upper back you're less likely to get elbow pain, last but not least
if those things are still not clearing up the pain doing some nice gentle nerve mobility
exercises this kind of thing with or without turning your head in the opposite direction
can also help to mobilise those nerves down the side of your elbow, so do that for six weeks
if the pain gets any worse or after six weeks if it's not got any better
then or not got significantly better then please do go and see a physiotherapist or a sports doctor
it's highly likely that even though I run through those exercises that should help you
it's highly likely that if you're not better after six weeks there's something going wrong
with the technique or we need to progress your exercises to the level that is right
for you, on that note almost forgot one of the really important things if you are a tennis player
is that we address your tennis technique so particularly as I said at the beginning that
top spin and that backhand to make sure that the problem doesn't keep recurring. I hope that's been
helpful please do let me know your thoughts, let me know what you would like me to do a video on next
and press that red subscribe key and until next time, take care, bye!