Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis), commonly occurs from overusing the muscles and tendons in your elbow, wrist, and forearm. These conditions can make it painful and difficult to perform everyday tasks.
What is tennis elbow/golfer’s elbow (epicondylitis)?
As their names suggest tennis and golfer’s elbow can occur from performing repetitive actions while playing sport, such as hitting a golf ball or playing tennis. Epicondylitis affects the area where the tendons in your forearm muscles connect the bony lump in your elbow. Over time this can become painful and restrict movement.
Epicondylitis can also be caused by other activities that put stress on your elbow, from using a computer for extended periods of time to activities such as painting and decorating. Epicondylitis is commonly experienced if you work in trades such as carpentry, plumbing and construction.
Lateral epicondylitis (tennis elbow) is pain on the outside of your elbow, and medial epicondylitis (golfer’s elbow) is pain on the inner side of your elbow.
What are the symptoms of epicondylitis?
If you experience pain when lifting, or bending your arm, gripping small objects such as a pen, or when performing a twisting motion that uses your forearm such as using a door handle or opening a jar, you may have tennis or golfer’s elbow. Epicondylitis is generally characterised by:
Pain and tenderness – either on the inside or the outside of your elbow, the pain can extend along your forearm. The pain will typically worsen with certain movements.
Stiffness – Your elbow may feel stiff, and it may hurt when you make a fist.
Weakness – You may find that you have weakness in your hands making everyday tasks such as holding a knife and fork difficult.
Numbness or tingling – Sensations of numbness or tingling may be felt in your fingers – commonly your ring and index fingers.
Epicondylitis can occur suddenly or gradually worsen over time.
Who is at risk of developing tennis or golfer’s elbow?
Tennis and golfer’s elbow are conditions that can affect anyone, but they are more prevalent conditions in those between 35 and 54 years of age. Regularly taking part in activities that feature a lot of repetitive arm movements can increase the risk of developing the condition.
When should I see a GP?
You should see a GP if rest, ice and over the counter pain relivers don’t ease the pain and tenderness in your elbow.
You should seek immediate medical care if:
- Your elbow is inflamed, and you have a fever
- You can’t bend your elbow
- Your elbow is visibly deformed
- You suspect that you have broken a bone
Self-care tips to prevent tennis or golfer’s elbow
There are some steps that you can take to help prevent tennis or golfer’s elbow:
- Stopping the activity that is causing pain, or finding a method/technique that doesn’t cause pain
- Get coaching advice to improve your technique if you frequently take part in sports that have heavy use of your arms such as golf, tennis and squash
- Warming up properly and gently stretching the muscles in your arms before taking part in sports involving repetitive arm movements
- Increasing the strength of your forearm muscles (our Physiotherapists can advise you on this)
How are tennis and golfer’s elbow treated?
Epicondylitis is a self-limiting condition meaning that eventually, it will get better without any treatment, there are however treatments that can improve your symptoms and increase the speed of your recovery.
It is important that you limit the activity that is aggravating your symptoms. Simple pain management such as using a cold compress or taking painkillers can help ease the pain.
NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen can be used to reduce inflammation, but physiotherapy might be recommended to not only relieve pain but to also improve the function of your arm.
Why does epicondylitis hurt more first thing in the morning?
As we get older our bodies will tighten and stiffen as we sleep. A common experience with both lateral epicondylitis and medial epicondylitis is that it’s worse first thing in the morning, tasks like lifting the covers off you, brushing your hair and teeth, buttoning your shirt or even lifting your cup of coffee can be painful and uncomfortable.
10-minute exercises for epicondylitis
Try these exercises twice a day, and you should notice less pain over several weeks. You must exercise regularly to stop the pain from returning. Massaging and applying ice packs to your elbow for five minutes every day may also help.
Wrist extensor stretch:
Straighten your arm fully. Relax your wrist so that you leave your hand hanging. With your other hand, gently push back against the back of your hand so it bends towards you. Feel a stretch along the top of your arm. Relax.
Wrist flexor stretch:
Straighten your arm fully. Relax your wrist. Use your other hand to pull your fingers towards you. Feel a stretch in your wrist muscles.
Rest your forearm on a table. Hang your wrist of the edge. Hold a light hand weight or a tin of beans. Moving only your wrist, raise the weight. Hold for 10 seconds and then slowly lower it. Repeat this 10 times.
Hold a light weight or a tin of beans. Rest your forearm on a table, palm facing up. Hang your wrist and hand off the edge. Moving only your wrist gently raise the weight. Hold here for five seconds. Gently lower the weight. Repeat 10 times.
Holding the weight or tin with your thumb pointing up (imagine you are going to shake someone’s hand). Move the weight up and down slowly. Keep your arm still by resting it on the table and only move your wrist.
Hold the weight or tin in your hand with your thumb pointing up. Turn the wrist inward as far as possible. Hold for two seconds. Then turn the wrist outward as far as possible. Hold for two seconds. Repeat as many times as you can.
Hold a rolled-up sock or tennis ball. Make a fist around it and squeeze. Hold the squeeze for five seconds. Relax. And repeat 10 times.
Hold a light weight or tin of beans. Secure your injured elbow with your other hand or by sitting in a chair and resting it on your thigh. Slowly curl the weight up towards your chest and down again. Repeat this 10 times.
Physiotherapy at Benenden Hospital
If you are experiencing pain or discomfort from tennis or golfer’s elbow, book an appointment with our team of experienced private Physiotherapists using our online booking form, or contact our Private Patients team via Livechat or on 01580 363 158.
Published on 28 March 2023