Tennis Elbow – Where we are in 2018 for the Best Management
Tennis Elbow (or Lateral Epicondylagia) is one of the most common overload injuries that we see in the over 35s. It is characterized by pain on the outside of the elbow, usually near the prominent bone (lateral epicondyle) where the Extensor Carpi Radialis Brevis (ECRB) tendon attaches, aggravated by gripping or wringing activities. This report summarises some of the common causes, presentations, treatment myths as well as best current treatment Tips and Tricks as at 2018. How long does Tennis Elbow Last? Duration of symptoms varies from 10 weeks to several years. It can be a ‘self-resolving condition’, becoming significantly improved within one year in approximately 83% of cases, although there are often residual symptoms. Also, recurrence rates can be high (Coombes & Vicenzino, 2015; Smidt et al, 2006). In my clinical experience, patients who have had Tennis Elbow for more than 30 days tend to develop pain and stiffness from adjacent structures such as ligaments, fascia, joints and neural structures. Furthermore, strong evidence demonstrates central sensitisation (decreased pain pressure thresholds (PPT) and thermal hyperalgesia) in those with severe or persistent symptoms (Coombes et al, 2012; Bisset et al, 2018). It is therefore a multistructural pathology which requires an individually prescriptive, multimodal, treatment approach.