Arm & Elbow

Tennis Elbow

Tennis elbow is a condition that affects the common tendon of the muscles that extend the wrist. These muscles all arise from the outside of the (lateral) elbow. The medical term for the condition is lateral epicondylosis or common extensor origin tendonosis. Patients often notice pain performing gripping activities such as lifting a jug or shaking hands.

The mainstay of treatment for this condition are eccentric wrist exercises. These should be slightly painful. To perform the exercises:

  1. Grasp a 1-2kg weight or dumbbell
  2. Keep your elbow extended and support your arm across the edge of a table
  3. Using the hand of your unaffected side, reach across and lift your wrist up. The hand of your unaffected side should do all the work for this phase.
  4. Slowly lower the affected wrist over the count of three.
  5. ‘Up with the good hand, drop down slowly with the bad one’

You should aim to do 3 sets of 15 twice a day, interspersing each set with a stretch as shown. As you improve increase the weight so that the exercises are still slightly painful.

Tennis1

1. Use two hands to lift the weight 'up'

Tennis2

2. Slowly lower the weight down over 4 secs

Golfers Elbow

This is a similar condition to tennis elbow except that it affects the inside of the elbow. Consequently it is known as medial epicondylosis or common flexor origin tendonosis. This is because the muscles that flex the wrist share a common tendon that originates at this site. The tendon of the muscle that helps pronate the wrist (i.e. turn it over from a palm down to a palm up position) also shares this origin and it is this portion of the common tendon that is most often affected.

Like other tendon injuries, eccentric exercises form the backbone of treatment. Because it is the pronator that is commonly involved, eccentric activity must target this. For example, for right-sided golfer’s elbow:

  • Find a long shafted object like a golf club or sledgehammer. Grasp this in your right hand.
  • Rest your right elbow on your right knee.
  • Over the count of three slowly rotate the golf club down so it points to 3 o’clock.
  • Reach across and use your left hand to pull the club shaft back to 12 o’clock.

You need to perform 3 sets of 15 twice a day. The exercises should be slightly painful. As you improve, hold the club or hammer further down the shaft to increase the load on your wrist.