Many tennis players – from beginners to professionals – will at some point experience lateral epicondylitis, or “tennis elbow.” This pathology is not restricted to tennis players, but is also common in construction workers, employees who tote briefcases, and other professions that require repetitive forearm motions. While some shrug the pain off and continue as usual, others seek medical attention soon after the onset of discomfort. Oftentimes, the first thing offered to a patient is a steroid shot, in which a physician injects cortisone into the site of pain, in hopes of eroding the inflammation and allowing the tendons to heal, asks the patient to rest a few days, and resume as normal.
Unfortunately, this quick fix is not likely the best option, although at first will seem like a miracle cure. Is it all too good to be true? As Gretchen Reynolds points out in a recent New York Times article, the long term effects are not as great – in fact, after 6 months time, those who received a cortisone shot were in worse pain than those who did not receive the shot, even though after 6 weeks they had felt markedly better.
So what is the better treatment for tennis elbow? Physical Therapy, rest, and time. Interventions such as laser treatment, trigger point dry needling, and targeted exercise interventions are more likely to have a long term positive effect. So what causes lateral epicondylitis? The cause is widespread – it can be cervicogenic, meaning that the nerves exiting the spinal column are not transmitting properly, resulting in altered movement patterns and weakness; it can be of local origin, meaning that the poor biomechanics are specific to a structural or neuromuscular dysfunction at the elbow; or it could be a result of imbalance muscles surrounding the scapulothoracic (shoulderblade and ribcage) region…and anything in between. Physical therapists are trained to evaluate and assess the cervical spine, shoulder, and elbow joints, as well as the surrounding soft tissue structures, in order to determine what is causing each individual’s symptoms, therefore they can tailor the treatment to the client for the best outcome!
