A Cramp in Your Swing
Not to put too fine a point on it, but in Spring, tennis season will soon be in full swing. The legendary Wimbledon tournament, and all over the world from Croatia to Germany to Atlanta, tennis is coming into its biggest time of year. I feel sometimes as though I should hop on a plane to follow and treat those countless weary, painful elbows. That pain radiating from the elbow to the wrist, and tenderness on the outside of the elbow is what we call Tennis Elbow, or technically, Lateral Epicondylitis.
There may be movement limitations, stiffness in the morning, and pain from gripping as well as other wrist movements like lifting with the palm down. Pain while pouring or sweeping or even using a toothbrush is possible.
Anyone may get tennis elbow. Those most at risk do repetitive movements of the wrist, forearm, and elbow, especially while gripping something: tennis racquet, hammer, baseball.
What’s Happening in Your Body?
Put your arms out in front of you with your palms facing upwards. In this position, called the anatomical position, the outermost part of each elbow is called its lateral side; the other side is the medial side. Tennis elbow affects the lateral side of the elbow. If the pain is on the medial elbow, then it’s called Golfer’s Elbow.
Your forearm has 20 muscles that control a wide variety of movements of your hand, fingers, wrist, and your forearm itself. These fall into three groups: those that flex your elbow, wrist, hands, and fingers (flexors), those that extend (extensors), and those that rotate (pronator/supinator). Tennis elbow is mainly concerned with the extensors, and usually some tearing of the common extensor tendon at your elbow.
Treating Tennis Elbow.
Surgery should be a last resort when other options have been exhausted. And there is little evidence to suggest than any kind of injection (cortisone, for example) is particularly useful. Most research shows that, with a little help, your body can heal itself 90% of the time.
Clearly, a first consideration in pain control is to stop or reduce whatever is the activity that brought on the tennis elbow. The longer you can rest the forearm the faster your body can heal tears or other damage to tendons. In some cases, you may be able to find alternative ways of doing the troublesome activities.
The MYK treatment I use for tennis elbow has a double benefit: pain relief and needed postural re-education of your forearm. This gentle treatment provides nervous system correction and balance that allows you to take full advantage of the exercise program below.
As well, use an ice pack on the elbow for 20 minutes, two or three times daily. With your doctor’s advice, over the counter pain relievers such as aspirin or ibuprofen may help control pain. And bracing or taping just below the elbow, or at the wrist, helps redistribute the forces acting on the tendons and joints.
Beyond that, start a program of gentle strengthening and stretching. These pain-relieving exercises are called ‘eccentric’ because you actively contract a muscle while lengthening it.
Preventing Tennis Elbow.
It’s for good reason that I return to the best treatment for a condition being to prevent it. For tennis elbow the prescription is straightforward: stretch and strengthen.
Here are some wrist-focused stretches to prevent tennis elbow.
Stretch Your Wrist.
1. Extend your arm in front of you with your palm up.
2. Bend your wrist back so that your fingers point toward the floor.
3. With your other hand, gently bend your wrist further. You should feel a gentle stretch in your forearm.
4. Hold this position for 30 seconds, and repeat 2 or 3 times.
5. Now, do the same four steps as above, but start with you palm facing downward.
1. Hold a can, or similar weight in your hand with your thumb pointing upward. You may wish to stabilize your forearm by resting it on a table. It’s as though you were shaking hands with the can.
2. Slowly move the weight up and down using your wrist only. At the extremes, hold the stretch for at least 10 seconds, and repeat several times.
Using the same starting position as the handshake, rotate your wrist from side to side. Again, hold the position for about 10 seconds at the extreme of each rotation.
Balance in all things, especially the musculature, is critical to maintaining a healthy, pain free body.