Tennis elbow - epicondylitis or elbow tendonitis and osteopathy
What is tennis elbow?
Tennis elbow is a tendinopathy of the lateral aspect of the elbow. It is the most frequent pathology of the elbow (80% of elbow injuries) and it is also one of the most common occupational diseases.
Tennis elbow" comes from the English language and means "tennis elbow". This pathology is a lateral epicondylitis of the elbow, that is to say an affection of a set of tendons called "epicondyliens" which are inserted on the lateral side of the elbow and more precisely on the lateral epicondyle, a bony relief of the humerus.
The tendons of the muscles concerned are those of the wrist and elbow extensors, we find the muscles :
- Long Extensor Radial of the Carpus
- Short Extensor Radius of the Carpus
- Supinator
- Ulnar extensor of the carpus
- Anconé
- Extensor digitorum communis
- Extensor proper of the V.
Causes of tennis elbow
Lateral epicondylitis is related to too intense or unusual mobilization, often with repeated movements of these muscles and most often affects the dominant arm.
It affects tennis players very frequently because of repetitive movements but the backhand is also very involved in the appearance of this pain. However, professional tennis players are less affected by this injury because of their good technique and regular practice.
Factors favouring elbow epicondylitis
- Resuming sports too intensely
- Do-it-yourself or gardening too intensely: it is better to do a little bit regularly than all at once.
- Lack of hydration
- Bad equipment
- Vibrations on the arm: very common in the building trades.
- Tooth decay: a cavity is a bacterial entry point and can weaken the body. It is necessary to have a dental check-up regularly, especially for athletes.
- Iron deficiency: it can weaken the tendon fibers.
In the athlete :
- Change or work on the technique
- Change of racket
- Change of surface
- Balls not adapted (too heavy)
- Bad rope
The stringing of the tennis racket:
There are different types of ropes:
- Monofilament: this is the cheapest and strongest string but it is also the most problematic in terms of injury.
- multi filament,
- gut : the cost of gut racquets is very high and a pro player can only play one hour with this type of racquet because the string breaks.
- Mixed: the mixed string is ideal and is what we recommend to limit elbow tendinopathy.
Clinic/Symptoms of Tennis Elbow:
- The pain appears mostly in a progressive way but can also occur in a brutal way (a rupture of the tendon fibers can be associated)
- The pain is located on the side of the elbow and can go down into the forearm and sometimes even into the hand.
- Extension and supination movements reproduce the pain.
- Palpation of the tendon reproduces the pain which can be very acute.
Additional examination of epicondylitis
Ultrasound of the elbow remains the examination of choice to demonstrate this pathology.
Treatment of lateral epicondylitis of the elbow
Relative rest
It is still necessary to work the elbow without load but to solicit the tendon fibers a little. Complete rest must be considered in cases of severe tendinopathy but in the majority of cases it is necessary to work the tendons to optimize recovery.
Physiotherapy
Deep transverse massages, shock waves, ultra sound, muscle strengthening, here are some examples of what can be done in physiotherapy to treat tennis elbow.
Osteopathy
The role of your osteopath will be first to detect this tendinopathy, to evaluate the causes such as those named above but also those of mechanical origin. The goal will be to treat with painless techniques the causes, but also the repercussions that it could have caused.
Your osteopath, trained in kinesiotaping or strapping, will also be able to apply a kinesiotaping or strapping strip to relieve the patient.
The last function of the osteopath will be to give advice adapted to the patient, whether in the choice of his equipment, his diet, his posture, muscle strengthening or by redirecting him to another health professional in order to optimize his care through a multidisciplinary work.
Marie Messager
Osteopath for sports
in Versailles (78)
