The full story of elbow pain at work
Understand the causes of and how to tackle the elbow niggles
HAVING ELBOW PAIN AT WORK? You need to read this. You might not have the best single arm backhand in the world or might not have even stepped onto a tennis court, but you could be affected by a condition called Tennis Elbow (TE). Lateral Epicondylalgia, more commonly referred to as "Tennis Elbow", is characterised by pain into wrist extension localised to the lateral (outside) elbow, which sometimes radiates into the forearm.
Why would I get it with computer work?
Tennis elbow is commonly experienced in the age population range of 30 to 50. The usual story reported by people this affects includes large volumes of wrist activity with the wrist stabilized in extension (bending wrist upward). Some examples of potential activities causing tennis elbow include racket sports, tool use (eg. Hammers), sewing and knitting.
Not only playing tennis, but excessive computer use is also considered as a general mechanical contributing factor to tennis elbow. The main cause of Tennis Elbow is tendinopathy, an overuse injury, to the proximal tendon of a big group of forearm muscles - extensor carpi radialis brevis (ECRB), which attaches to your lateral elbow. This muscle is placed at high levels of mechanical stress as a result of shearing of the tendon during wrist flexion/extension activities, ie. typing and using a mouse. Compression also occurs around the muscle-tendon insertion.
Everyone told me it's an inflammation
You might be told that tennis elbow is due to tendon or muscle inflammation.
IT’S NOT! An accurate diagnosis would be tendon tendinopathy.
Essentially, one of the tendons of the forearm muscles undergoes degeneration due to overuse, more than an inflammatory process. In fact, research shows there’s no inflammatory reaction in this condition. When a tendinopathy happens, some micro tears may develop within the tendon. However, in some instances a tear may be the primary pathology.
Knowing the early signs
Symptoms are generally well-localised lateral elbow pain (“aching”). The presentation may be acute, a few days after a relevant unaccustomed activity (e.g. weekend of DIY, new tennis racket, etc.). Likewise a single instance of exertion may also trigger the condition.
During the physical examination from your physiotherapist, testing of ECRB would be positive and a few other special diagnostic tests for lateral epicondylalgia exist that may be positive. To touch, the maximal area of tenderness is 1-2 cm distal to the lateral epicondyle on the ECRB tendon.
Best ways to tackle your elbow pain
Surely, an accurate clinical assessment would be the key, laying the ground for effective treatments. Soft tissue release will help relax any overactive muscles. Managing the load (amount of work) that the forearm undergoes is crucial in the early stages, so a gradual re-introduction of wrist movements is needed to get you back to normal function.
At Helix, we utilise specific progressive strength training for the wrist extensors (forearm muscles), which is significantly better than purely using passive modalities such as ultrasound and electrical therapies, because we actually train the muscles and tendons that were previously injured, and strengthen them in a progressive manner. Our treatment plan will help get you back to work and playing sport pain free with Rafael Nadal Championship winning form.
Progressive loading is the key towards a strong and healthy elbow.
MOVE BETTER. FEEL BETTER. LOOK BETTER.
References:
Cutts, S., Gangoo, S., Modi, N., & Pasapula, C. (2020). Tennis elbow: A clinical review article. In Journal of Orthopaedics (Vol. 17, pp. 203–207). Elsevier BV.
Vicenzino w, & Scott A, & Bell S, & Popovic N (2017). Elbow and arm pain. Brukner P, & Clarsen B, & Cook J, & Cools A, & Crossley K, & Hutchinson M, & McCrory P, & Bahr R, & Khan K(Eds.), Brukner & Khan’s Clinical Sports Medicine: Injuries, Volume 1, 5e. McGraw Hill.