What Causes Lateral Epicondylitis?
The 3 main events that cause tennis elbow.
Although over 50% of tennis players will experience tennis elbow at some point in time, it is caused by many common activities. It generally affects men and women between 35-65 years of age who stress their wrist and elbow through twisting or extending motions in repetitive work or activities. This condition is very common with sports participants (racquet sports, golfers, fencers, swimmers, throwing sports) as well as plumbers, carpenters, landscapers, painters, waitresses, librarians, office workers and musicians.
- Acute Trauma: this can occur from an accident or high intensity movement. An example of this would be straightening your arm while putting too much force into hitting a return with a racquet.
- Repetitive Stress: this happens through overuse of the elbow joint without properly treating it before using it yet again. An example of this would be spending hours per day typing at a computer without taking a break.
- Re-Injury (Chronic Trauma): this injury is from continually injuring your lateral epicondyle tendon. Small tears in the tendon form and worsen over time, allowing the growth of scar tissue. An example of this would be painting high walls or ceilings with an already damaged elbow day in and day out.
Tennis elbow typically results from vigorous use and movements of the wrist, arm or hand over via overuse or via overstraining. The affected soft tissue are forearm muscles that move your fingers, hand, wrist and forearm and their corresponding tendons. Overuse of these muscles depends on how long you do something and how much effort you exert doing it. The constant tugging at the point of attachment on the outside of your elbow (lateral epicondyle) can cause these tendons to become inflamed and strained.
Your muscles and tendons can then become irritated which will result in weaker tendons, tiny tendon tears and development of scar tissue and/or calcium deposits. The development of scar tissue will put pressure on your soft tissue and nerves, and interrupt the blood flow to this area. Scar tissue is tough to get rid of and can cause significant pain over a long period of time. Fortunately, Circulation Boost treatments aid in the reduction of scar tissue and when combined with PT and a conservative treatment plan, most patients can rid themselves of epicondylitis and get back to a normal pain free lifestyle faster than would ever expect.
Tennis Elbow Re-injury
There can be different factors leading to a re-injury of your lateral epicondyle, but in most cases, the strongest reasons are:
- Strenuous Activity
- Age (a person with a greater age has a greater chance of contracting tennis elbow)
- Technique of Movement and Tools Used (ie. proper versus improper form on the court, use of an ergonomic keyboard when typing may help prevent tendonitis, etc.
- General Health and Wellness (armchair & weekend athletes are at greater risk of a tendon injury compared to an athlete that does such activities on a daily basis.
Activities - If your household, workplace, or recreational activities involve significant repetitive movement of your wrist, forearm, upper arm, and/or shoulder you are at risk for developing Tennis Elbow. Some common activities that can cause Tennis Elbow include but are not limited to: painting, house cleaning, playing an instrument, playing sports, heavy lifting, frequent use of a computer (or typing), shaking hands frequently, and/or frequent holding of a phone to the ear
As you can see, its not just professional athletes or people with physically demanding jobs who suffer from Tennis Elbow.
Actively moving your arm for long periods of time can cause a lot of stress to be exerted on your elbow. Repeated movements gradually increases the stress placed on muscles.If you don't give your body a chance to rest and regain strength, stronger muscles ( like the ones in your shoulder )have no choice but to transfer energy to less capable structures (such as the muscles in your hand or wrist ). Weaker muscles cannot handle the impact stronger muscles can. As a result, they begin to strain and even tear.
It is important that you allow your body to rest between periods of exertion or repetitive movement. Fatigue in your muscles can lead to bad form, or overuse. You body is an amazing thing! It is -constantly trying to heal itself and perform at its fullest capabilities. When you don't allow your body to rest and push yourself beyond your physical limitations, chances of becoming injured are quite high.
So What Happens To Your Tendon If It Is Forced To Deal With Overuse And Repetitive Movement?
Your tendons attach your forearm muscles to the bone of your elbow. When high levels of stress are exerted on your forearm, tendon fibres stretch beyond their limits. If this action is repeated over and over again, tendon fibers lose their strength and elasticity. They can become disorganized and tangled. If repeated long enough or with too much stress exerted, your tendon fibres may even begin to tear.
These small tears cause inflammation in the area of your elbow called the epicondyle ( the bony bumps just below your elbow where the tendon attaches the forearm muscles to your elbow bone ). You elbow may become swollen, bruised, or disfigured. Your elbow joint is a very small complex structure and doesn't handle swelling well. Swelling will limit blood flow. Micro tears and swelling can cause mild discomfort to intense pain. The limited blood flow can restrict your body's ability to heal. If not treated, your tendon will begin to deteriorate. It can take months for you to fully recover.
If you repeatedly injure your tendon without proper treatment and recovery, scar tissue will form. Scar tissue is weak and inflexible tissue that hardens around the tendon without giving it any support or strength. Scar tissue will never heal into healthy, mature, strong tissue. Scar tissue will put pressure on your soft tissues and nerves. It interrupts the blood flow to the areas of your elbow causing pain and delaying recovery. It is important to prevent the growth of scar tissue with conservative treatments.
This is why it is very important to seek medical advice when you've had an accident or injury. Your doctor will be able to recommend the best course of action for treating your injury using cooling and heating treatments. Incorporating Circulation Boost (via use of an Elbow T•Shellz Wrap®) will increase your body's ability to heal faster (and thereby reduce growth of scar tissue) by promoting significantly higher flow of blood to your elbow or forearm injury.
How Age Affects Risk of Tennis Elbow
If you have read a few pages on this website, you probably know that Tennis Elbow is all about tendons - damaged extensor tendons that attached to the lateral epicondyle to be exact. So when we talk about aging and its effects on Tennis Elbow, we are really talking about the effect that age has on tendons in the forearm.
Age is always a factor when it comes to injury. As we become older, our tendons begin to weaken and eventually break down. By not actively participating in exercise and physical activity, the degradation of soft tissue (tendons, ligaments, muscles) accelerates. However, an accelerated breakdown of soft tissue will also occur in individuals that overuse their tendons/muscles - meaning the soft tissue is stressed yet not allowing enough resting time to heal before they are used again.
Degeneration, or the break down of tissues, is especially noticeable in individuals who have a repeated history of overuse.
Over time, repeated damage to your tendon can cause you to develop a condition called 'Tendinosis'. This means that your tendon becomes unable to ever heal fully. Age and repeated injury without proper treatment can cause the breakdown of your tendon.
Initiating Recovery for Tennis Elbow So It Doesn't Come Back
Your body is an amazing organism and has all of the tools to heal itself. However, healing your tendon can take a very long time. It is unrealistic to expect anyone to put their life on hold for weeks or months. Without the proper treatments, your tendons will thicken with weak, inflexible scar tissue.
If you are experiencing a deterioration of the tendon (tendinopathy), it can take from two to six months to fully recover. Many cases of lateral epicondylitis become chronic problems that progressively get worse if sufferer continues performing the causal activity that started the condition in the first place. When you do this, your body definitely indicates there is a problem as the area will continue to generate a lot of pain.
Only you can prevent injury. Take steps before you injure your body to avoid spending valuable time in recovery instead of at work, with your family, or your favorite activities.
It is important that you speak to your doctor about the recovery and prevention options available to you.
The more committed you are to your recovery, the faster you can return to your active lifestyle free from pain and immobility.
- Have you recently re-injured your elbow by returning to your normal daily activities too quickly?
- How many times in the past have you aggravated your elbow just trying to perform basic tasks around your house?
- Is your tennis elbow preventing you from work or activities you love to do?
If this sounds like you - You're not alone...
Most people we deal with tell us these scenarios have happened to them many times in the past. The real challenge is how to promote blood flow to your injured elbow without causing further damage. This goal is even more complicated by the fact that you have to use your arm / elbow for almost everything in everyday life.
What Can You Do To Actually Start Healing Your Tennis Elbow?
To take a deep dive into conservative treatment options for soft tissue injuries in the elbow and forearm, please go to our tennis elbow treatments page.
Techniques and Tools To Help Prevent Tennis Elbow
Your environment plays a huge part in the health of your body. Using tools that are properly fitted and weighted to your body and abilities will help you perform with success and avoid injury.
Young athletes with improper training are among those suffering from Tennis Elbow symptoms. When starting a new job, activity, or exercise routine, it is important to learn and understand the best techniques for you to achieve your tasks and goals.
It is important for athletes to have their techniques and equipment checked by professionals for the best fit and performance. Why use movements or tools that don't give you the best opportunities for success?
Just like athletes, workers with physical jobs or people performing repetitive tasks should refer to occupational therapists. These specialists understand how the body works and which movements should be avoided as they can lead to injury.
Over extending your arm while painting can cause an injury just as easily as an improper back hand swing. It is important to understand that your body is a complex network of connected structures. When using the wrong muscles or positioning, you put yourself at risk for injury.
General Health and Fitness Help Prevent Injury
Maintaining your general health and fitness can help you prevent injury.
Training your body to perform the ways you need it to will decrease risk of injury. An untrained body may make movements with the least amount of effort... BUT ...this can lead to awkward motions with badly distributed, stress causing, long term injury.
It is important to remain physically active. The health of your whole body contributes to the health of the individual parts. Maintaining a healthy weight and overall level of fitness through regular activity and healthy eating will increase your ability to avoid injury.
Lack of activity can cause muscles to become weak and unsupported. Without strong muscles your body places the stress on weaker structures like joints. Strong muscles help maintain a strong body, evenly distributing weight and forces to the areas that can handle it properly.
Remember to drink fluids and rest. Resting your body will help reduce fatigue in your muscles. Energized muscles are strong and will help you complete tasks efficiently and effectively.
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