If you have pain on the outer (lateral) or inner (medial) side of the elbow, you may have tennis elbow or golfer’s elbow. Both conditions are due to overuse of tendons that attach just above the elbow joint.
In tennis elbow, the overuse is due to repetitive wrist extension, while in golfer’s elbow there is usually repetitive wrist flexion.
The symptoms of tennis and golfer’s elbow can resolve with a few techniques that I will explain below. But what if the elbow symptoms persist, or you cannot practically discontinue the aggravating movements? In such cases, seeing an osteopath for your elbow is the way forward.
What causes tennis elbow & golfer’s elbow?
Tennis elbow, medically known as lateral epicondylitis, and golfer’s elbow, also called medical epicondylitis, are both repetitive strain injuries.
In tennis elbow, the overuse of the tendons results from repetitive wrist extension, while golfer’s elbow is due to repetitive wrist flexion. The reason for this is that the muscles that insert above the elbow are responsible for wrist – not elbow – movement.
Tennis and golfer’s elbow are not predominantly a result of tennis or golf. Often actions such as wringing clothes, or specific manual work are the culprits. This includes using screwdrivers, painting, and plastering.
In fact, many patients that come to see me for golfer’s or tennis elbow are plasterers or were recently pregnant, and aren’t tennis players or golfers.
What are the symptoms of tennis elbow & golfer’s elbow?
Pain on the outside (tennis elbow) or inside (golfer’s elbow) of the elbow is the main symptom. The area is likely to be tender to touch, and pain will increase with certain wrist movement.
You may struggle opening jars, turning a door handle, lifting a kettle, or even writing. If your golfer’s or tennis elbow is very acute, you may even find it painful to extend your elbow.
What increases the risk of developing tennis elbow & golfer’s elbow?
So the cause of tennis and golfer’s elbow is overuse. But this alone does not explain why some people get epicondylitis, while others do not.
Partly, this is explained by so-called risk factors, such as:
- during or shortly after pregnancy (because of hormonal changes, especially due to relaxin)
- smoking, obesity, lack of exercise
- hypermobility, e.g. due to Ehlers-Danlos syndrome, hypermobility syndrome, Marfan syndrome
What can I do to treat tennis elbow & golfer’s elbow?
Tennis and golfer’s elbow are easy to diagnose, but can be difficult to treat.
Sometimes, the symptoms of tennis and golfer’s elbow can resolve without treatment.
For some people, their lifestyle allows them to simply stop the activities that bring on the symptoms. This can cure epicondylitis by giving the inflamed tendons time to rest and recover.
If avoiding certain movements doesn’t help or isn’t feasible, an epiclast – a specialist splint – can be brilliant. They can be worn when you are putting strain on the tendon through repetitive movements. Epiclasts are designed to act as a fulcrum and reduce the load on the tendon.
If, for example, you know that playing squash aggravates your elbow, you could wear an epiclast during the game.
After any activity where the tendon has been loaded, icing can keep inflammation to a minimum. Ice packs or frozen peas (wrapped in a towel) are useful.
Long-term, you should consider strengthening exercises of the forearm muscles. Strengthening the muscles also has the benefit of strengthening the tendons. This will make your tendons more resilient to stress.
Stretching exercises go hand-in-hand with strengthening exercises. Stretching can realign the fascia and increase blood supply to the forearm.
Many patients ask me whether they should use pain-killers. I do not find pain-killers a good idea, as they will mask the pain. You may then not notice whether you are further irritating the tendons and inadvertently make things worse. So pain-killers such as ibuprofen or paracetamol can help in the short-term, but make things worse in the future.
Can osteopathy treat tennis elbow & golfer’s elbow?
If you have tried these approaches and your symptoms don’t improve, you should consider booking an appointment with an osteopath. Although tendinopathies (i.e. tendon problems) are notoriously difficult to treat, I find osteopathy to be effective. I have seen many patients improve after having put up with epicondylitis for 9 months or longer.
Being an osteopath, I look for subtle dysfunctions in the neck (which provides the nerve supply to the wrist muscles), the shoulder, and the elbow. I also look at the humerus, and the interosseous membrane between the ulna and radius.
Expert treatment requires expert diagnosis, and I find AK muscle testing a brilliant tool for unscrambling hidden problems.
If you have golfer’s or tennis elbow, please do not hesitate to get in touch.
To book an Osteopathy appointment in New Malden or in Marylebone, phone 020 8942 3148 or contact Aston Clinic London.
Aston Clinic London is a third-generation complementary health clinic based in New Malden and serves the local areas of Kingston, Wimbledon, Raynes Park, Surbiton, Chessington, Worcester Park, Sutton and other areas of southwest London and Surrey.
Aston Clinic London also offers Osteopathy and Herbal Medicine in Marylebone, Central London.
