Tennis elbow or Water Bucket Elbow is a pain or ache that is felt on the outside of the elbow due to an injury to the muscles that extend the wrist and fingers. Most people experience a gradual onset of pain that is intermittent at first then gradually becomes present more of the time. In some instances the pain may come on suddenly. The pain is usually around the outside of the elbow although you may feel some stiffness along the top of the forearm too. Repetitive strain or trauma leads to micro tears in the extensor carpi radialis brevis tendon (ECRB) close to where it inserts on to the bone (called the lateral epicondyle of the humerus) this initiates an inflammatory process causing pain and discomfort.
Often the condition is present long before the person actually starts to feel the pain, and usually only pain to touch, or when bumping into door frames. People may experience symptoms which range from pain while gripping objects (shaking hands, picking up a kettle, carrying a briefcase, brushing teeth) or resisted wrist/finger extension or when the muscles are stretched but also to a constant and unremitting ache that disturbs sleep.
It can often be linked to an increase in a specific repetitive activity or a new type of activity with repeated extension of the wrist against resistance (onset of tennis season, DIY, typing, bricklaying, sewing, knitting, excessive computer use, hairdressing, playing the violin, gardening, picking up buckets of water) or incorrect technique or overuse of weights, dropping a heavy weight without control (i.e. kettlebell swings) and excessive gripping. Through accumulation or excessive movement, the forearm muscles develop muscle contractures and fascial adhesions which make them tight, weak and will increase the probability of injury to the ECRB tendon. Tennis elbow can also be caused by poor posture/biomechanics of the whole arm, shoulder and neck.
You may want to consider seeing an osteopath to have a proper examination and diagnosis of the pain. There are many causes of pain around the elbow. The correct condition and cause must be identified in order to treat it correctly. Osteopaths consider a range of muscle, ligament, joint injuries and neurological dysfunction when coming to a diagnosis. The goal of osteopathic treatment is to allow the tendon to heal, release the muscle contractions and fascial adhesions and mobilise the joints thus stopping the muscles from over contracting and pulling on the injured tendon. Osteopathic treatment may involve subtle cranial osteopathic techniques, myofascial release, soft-tissue massage and joint manipulation.
With osteopathic treatment the muscle ache and pain is reduced, the muscle tightness lessened and the strength to grip, lift and carry improves. Specific advice such as isometric exercise may be given to aid further recovery and limit recurrences. This normally significantly reduces the need for injections or surgery. Left untreated this problem persists and will intermittently return.
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