From Amanda's very early writing (1990s to early 2000s), shared as it was originally written.
Tennis elbow
As a physiotherapist , one of the most common complaints we encounter is tennis elbow. As opposed to 'golfer's elbow', which (relatively) rarely needed treatment!
It seemed to me that people understood so little about this dreaded lingering tennis elbow that they would let it progress to a very advanced (and therefore difficult to treat ) stage before seeking help.
So let me demystify this pesky condition! Firstly, tennis elbow (TE) is the name given to pain around the outside edge of the elbow - near that pointy little bone which is so easy to bash or bump. (One of the causes of TE) This pain may radiate down towards the wrist or up towards the shoulder. There is usually a tender spot in the same area. The pain often seems worse when the elbow is moved.
However, the real causes of TE are not so easy to spot. If you have been performing nothing but the same repetitive task for hours - like wiping widgets in a factory or writing continuously or painting or tiling or grouting - then it's on the cards that you have overused the muscles required for that task. You will have strained them and they will respond with pain and swelling. Especially if you continue to use them , ignoring all the warning signals that your body will give you.
The warning signals are burning, tingling, tightness, stiffness, numbness, heaviness, dragging , discomfort and pulling. Substantial discomfort and
pain mean you have waited too long before taking a break and you have done damage.
I suppose once, long ago in the annals of tennis history, people who gripped their racquets poorly or who had poor technique were the only ones who consistently presented with this pain and that's where the name originated!
But in our society, the majority of tennis elbow pain comes not from too much widget wiping and work related repetitive tasks because legislation requires us to provide task rotation. We are guilty of pushing ourselves too far at home with tiling, grouting, gardening, sledge hammering, vacuuming type duties without taking regular breaks to allow the muscles to recover.
Nor do all the cases come from a one- of incident involving a blow to the pointy bit on the outside of our elbow or a sudden injury ot the elbow. The majority of the most difficult cases of TE come from people who do clerical work - at home or work. And this is because the elbow is often not the source of the problem.
The way we do our clerical work - whether it's homework, playing games on our computers , writing loads of Christmas cards or typing up documents at work - is what most often causes the pain in our elbow. And it comes from neck - no the elbow! Especially if the pain is in both elbows.
Our neck consists of 8 vertebrae ( the bones of the spine) which protect he upper part of the spinal cord. Arising out of the spinal cord and running out through each bone are nerves which then track down to various parts of our arms and fingers. The nerves are tricky little devils and when they are irritated (medical word meaning damaged - not angry!) up in the neck, they can send pain anywhere in the area of skin, bones, joint and muscle that they supply or control.
This means that while we experience pain and discomfort or stiffness in our elbow, there is nothing wrong with our elbow - there is something wrong with our neck! And so we need to be aware of our posture as we work and what position specifically our neck is in.
Most commonly, we ignore our warning signs and symptoms until we can no longer function normally. We finally seek treatment and by now, although the real cause of the problem is in the neck, because we have altered the way we use our elbow to protect it , we have usually developed a secondary problem in the actual elbow muscles, ligaments and joint itself.
So now the problem starts; treatment to the elbow does help but the problem persists. You're doing everything right but the pain won't go away. That's because the primary cause - the neck joints and nerves are not being treated.
Find yourself a good physiotherapist who will assess your neck and elbow joints, nerves, muscles and ligaments. They will treat your neck, give the neck nerves gentle stretches (the brachial plexus stretch) and stretch and mobilise your elbow joint (important) as well as the muscles.
But there is another catch! It's not the muscles that work the elbow that are the damaged ones. It's the muscles that work the wrist. That's why we need to treat the elbow joint because it is often involved, and you need to be gently and regularly (every half hour) stretching the forearm muscles that make your wrist bend backwards or up.
In fact, to rest the muscles that are hurting , you don't need to rest the elbow. You need to rest the wrist. Strapping the wrist often helps to remind you that it's moving the wrist that is straining the muscles more. One of the reasons TE can last so long is that people (quite logically) try to protect the elbow by not moving it. This of course means that the wrist has to move twice as much to compensate and it's the poor old wrist muscles that are the injured ones! They don't sit over the wrist - they begin at your elbow. run down the forearm and become tendons over the wrist.
So, if you have tennis elbow or ever experience warning signs or discomfort over the outside of the elbow area, remember, stand up and sit with good balanced posture; stretch your wrist by gently straightening your elbow and bending your wrist and curling your fingers into a ball (stretch only to the point where the stretch is so gentle that you feel you are wasting your time - any more and you'll rip the muscle even more); move your neck up and around every fifteen minutes and - most importantly - remember it's the wrist muscles that need the rest so watch how you are using your wrist. If pain persists more than one week, quickly see your doctor or a physiotherapist who needs to check and treat all those areas I mentioned.
Amanda Gore
