Tennis Elbow

Elbow, Wrist and Hand

Tennis Elbow – you don’t need to play tennis to get it!

Tennis elbow is so called as one of the reasons you can get it is from faulty technique in a tennis shot. This is only one of the ways that you can get tennis elbow though, it can come on from many other activities that involve a lot of wrist and forearm use.

The medical name for this condition, lateral epicondylitis, gives us more information about where the problem occurs. The lateral epicondyle is a small bony prominence on the outside of the elbow and is the point of attachment for the tendons of the wrist extensor muscles. These muscles run up the top of the forearm and play a role in movements such as bending the wrist back, making a fist, and twisting the forearm.

Lateral epicondylitis occurs if these muscles are used more than they are used to, resulting in pain and damage to the tendon where it attaches onto the bone at the lateral epicondyle. If you have tennis elbow, you will likely report an increase in pain when gripping tightly or shaking hands, using a screwdriver or twisting a jar, or any activity that requires wrist and hand use. The outside of the elbow can be very sensitive to touch, and you may find it will get very stiff, especially first thing in the morning.

In order to treat tennis elbow, it is important to identify the reason why it became injured in the first place and correct that. Apart from stopping the aggravating activity, there are often other contributing factors that need to be changed in each individual case. These can be related to our own anatomy in the elbow and arm, movement patterns which are overloading and therefore damaging the tendon, or factors relating to the equipment being used.

A physiotherapist can identify the changes that need to be made in each individual case and implement these. As well as this there is specific treatment that can be done to the tendon to ensure optimal healing such as friction massage and laser, and a stretching and strengthening program should be implemented too to ensure the muscles and tendons are in good shape to be able to cope comfortably with being used in the future.

So even if you don’t play tennis, you can still be affected by tennis elbow. Taking the right action will take your pain away.

Carpal Tunnel Syndrome

Elbow, Wrist and Hand

Carpal tunnel syndrome is a common wrist and hand injury.  It occurs when one of the major nerves called the median nerve is compressed within the carpal tunnel of the wrist.  This may occur for a number of reasons but some of the more common reasons include: pregnancy, gout, trauma (repetitive or direct trauma), or infection.  Carpal tunnel can happen at anytime, however it is more common between the ages of 40-60 and women tend to be affected more often then men.

This condition is characterized by burning wrist pain and numbness or tingling within the hand.  This often occurs at night and the patient usually wakes up due to the symptoms.   In some cases the pain can radiate to the forearm, elbow, and shoulder.

Some of the other symptoms reported by patients include poor sensation in the hand, weakness of the hand, cramping in the hand, reduced temperature in the hand, and sometimes shaking or flicking the hand relieves the symptoms.  There may also be muscle wasting around the thumb.  Movements of the hand are often pain free, however some resisted movements around the thumb can be painful.

Diagnosing carpal tunnel syndrome is often done based on the patient’s medical history.  Your physiotherapist or physician will take you through a series of tests and if carpal tunnel syndrome is suspected a nerve conduction test may be ordered to confirm the diagnosis.  Diabetes should be excluded, as it can be a risk factor for carpal tunnel syndrome.

Mild cases can be treated conservatively.  This may include splinting, activity modification, diuretics, and NSAID medications.  Techniques such as contrast baths, which are alternating baths of cold and warm water, may be used in some cases to control inflammation and swelling.  A physiotherapist may give you specific exercises that can be helpful with a patient’s recovery.  For more persistent or severe cases, corticosteroid injections or surgery may be required.

Wrist and hand injuries are often difficult to diagnose so if you are experiencing symptoms of this nature it is recommended that you see your health care professional to have it taken care of.