Is Tennis Elbow Always Caused by Playing Tennis?

The term tennis elbow is a catch-all phrase used to describe a tendonitis condition affecting the upper forearm muscles that are typically overused when playing tennis. However, many people can and do develop tennis elbow who have never ever picked up a tennis racket in their life! We will get to the bottom some of the causes and reveal the best ways to treat tennis elbow or lateral epicondylitis.

Most of the cases of chronic elbow pain and inflammation that we see in our office are rarely from a person who plays a lot of tennis, although this can be the causative factor. More time than not, it is a combination of muscle and joint dysfunctions involving the neck, shoulder, upper back, chest and elbow. Any or all can be contributing factors. This is because of something called a Kinetic Chain Distortion Pattern. This is a just fancy term that indicates a dysfunctional movement (kinetic) condition exists somewhere along a chain of inter-related structures., In this case, the chain would be the neck, the shoulder, the upper back, the chest and finally the elbow.

We find that the majority of elbow problems are not really caused by stress at the elbow but are usually caused by exquisitely tender knots, or trigger points, that have developed in accessory muscles in and around the neck and shoulder regions. This will cause a “chain reaction” of muscle imbalances and secondary referred pain to a point or points some distance away from the actual culprit. This how a problem in the neck or shoulder can show up as elbow, wrist or hand pain.

For instance, many elbow pain sufferers will actually have very tender trigger points in the rotator cuff muscle group of the shoulder. These trigger points will cause these four muscles to spasm and ultimately cause an alteration in the biomechanics of the shoulder joint. This can in turn cause a fixation or misalignment of the first rib and/or the corresponding clavicle (collarbone). This will frequently affect the muscles in and around the neck which, when in spasm, often will “pinch” or irritate the sensitive cervical nerve roots that form the large nerve trunk (brachial plexus) that runs down the arm to the elbow and below.

So to simply treat a “tennis elbow” condition, or any other tendonitis, with a cortisone injection is at best a temporary fix and at worse can actually do more harm than good. It is well documented that multiple injections of cortisone in a joint space will actually destroy the hyaline cartilage that covers and cushions opposing bones. Once this cartilage is destroyed, you now have a bone on bone situation. A condition that is not only very painful, but one that might eventually require surgery to resolve. Of course, surgery is never any guarantee and carries a whole host of risks and possible problems from the procedure itself.

Once properly and thoroughly examined then, and only then, can all of the contributing problem areas be addressed and treated for longterm relief. Some of the treatments we use to relieve tennis elbow are trigger point therapy, Class 4 Laser therapy, specific muscle stretching and strengthening exercises and gentle joint mobilization to restore normal biomechanical function.