This is an irritation of the tendon that runs over the bony bit of the elbow. The pain comes on slowly often after the aggravating activity at first. As it becomes more severe the pain then starts to be experienced during the aggravating activity. The aggravating activities include tennis, squash but also day to day activities involving lifting, twisting and carrying like pouring from a kettle or opening a heavy door. In tennis is caused in particular by the movement required to create topspin. To treat it properly the stability of the shoulder needs to be addressed because if the shoulder is moving inefficiently more strain is exerted on the elbow. Treatment should therefore never focus purely on the elbow itself.
An insight into treatment…
1) Observe how your shoulder moves as you lift your arm by standing with one side to a mirror. The shoulder should stay in position as you lift your arm up to about 80 degrees from your body. If the whole shoulder moves forwards with the arm then you will need to do exercises to train the stability muscles of the shoulder blade. Please click on the link to learn how to do these shoulder exercises. Once you have trained in this way these shoulder stability muscles need to be trained through all the ranges of movement required for all your aggravating activities, including a tennis serve or top spin ground stroke.
2) You need to carry out a incremental loading programme for extensor muscles of the elbow, including working them eccentrically which enables the tendon to recover.
3) You many need to address your technique and strength elsewhere in your body to make sure you are getting maximum effect from the muscle groups designed for power, for example the gluts that provide a huge percentage of serving power.
4) Resting the arm will only give you relief for as long as you rest. When you return to the aggravating activity the pain is highly likely to return.
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