Tennis Elbow Relief: Combining Physical Therapy and Dry Needling for Optimal Recovery
Tennis elbow, medically known as lateral epicondylitis, is a common condition characterized by pain and tenderness on the outer part of the elbow. Despite its name, tennis elbow is not limited to tennis players; it can affect anyone who performs repetitive arm and wrist movements including those that work with their hands frequently. This blog post explores what tennis elbow is, its symptoms, and how physical therapy and dry needling can offer effective relief.
What is Tennis Elbow?
Tennis elbow is an overuse injury that results from repetitive stress and strain on the tendons of the forearm muscles, particularly where they attach to the lateral epicondyle of the elbow. The condition is caused by inflammation or microtears in the tendons of the extensor muscles, which are responsible for extending the wrist and fingers. Tennis elbow commonly arises from activities that involve gripping, lifting, or repetitive motion, leading to pain and discomfort on the outer elbow, specifically at the lateral epicondyle.
Pathophysiology of Tennis Elbow
Tendon Overuse and Microtrauma:
Mechanism: Tennis elbow typically results from repetitive stress or overuse of the extensor muscles of the forearm, especially the extensor carpi radialis brevis (ECRB). Activities involving repetitive gripping, wrist extension, or forearm rotation, such as tennis or manual labor, contribute to the development of the condition.
Microtears: This repetitive stress causes microtrauma to the tendons, leading to small tears in the collagen fibers. These microtears initiate an inflammatory response and cause pain and tenderness at the lateral epicondyle.
Degenerative Changes:
Tendinopathy: With ongoing stress and microtrauma, the tendons can undergo degenerative changes, known as tendinopathy. This condition involves a breakdown of the tendon’s collagen matrix and the formation of disorganized collagen fibers.
Cellular Response: Chronic overuse shifts the inflammatory response towards a degenerative process. This process includes increased vascularity and the presence of fibroblasts and myofibroblasts, which contribute to tendon remodeling and repair.
Pain and Inflammation:
Inflammatory Mediators: The inflammatory response in tennis elbow includes the release of pain mediators such as prostaglandins, cytokines, and other inflammatory substances. These mediators contribute to localized pain, swelling, and tenderness at the elbow.
Pain Pathways: Pain in tennis elbow is due to the activation of nociceptors (pain receptors) in the affected tendons. The pain can radiate down the forearm, impacting daily activities and movements. The discomfort often intensifies with activities involving gripping or wrist extension.
Muscle Imbalance and Dysfunction:
Forearm Extensors: Imbalances or dysfunctions in the forearm extensor muscles can exacerbate tennis elbow. Weakness or tightness in these muscles can increase strain on the lateral epicondyle, perpetuating the injury.
Biomechanical Factors: Poor biomechanics or improper technique during repetitive activities can contribute to the development and persistence of tennis elbow. For example, incorrect racket handling in tennis or improper lifting techniques can lead to increased stress on the elbow.
Symptoms of Tennis Elbow
The symptoms of tennis elbow can range from mild to severe and may include:
Pain: A sharp or aching pain on the outer part of the elbow, which may radiate down the forearm. Pain often worsens with gripping, lifting, or twisting motions.
Tenderness: Sensitivity and tenderness over the lateral epicondyle, especially when pressing on the elbow or engaging in activities that stress the forearm.
Weakness: Reduced strength in the elbow and forearm, making it difficult to perform tasks that involve gripping or lifting objects.
Stiffness: Stiffness in the elbow joint, which may limit the range of motion and contribute to discomfort during movement.
Pain with Activity: Increased pain during or after activities that involve repetitive arm or wrist movements.
How Physical Therapy Can Help
Physical therapy is a highly effective approach for managing and treating tennis elbow. Here’s how:
Customized Exercise Programs: Physical therapists develop tailored exercise programs to strengthen the forearm muscles and improve elbow stability with sport or with work activities. Strengthening the muscles around the elbow helps to support the joint and reduce strain on the tendons so they can heal properly.
Stretching and Flexibility: Gentle stretching exercises can improve the flexibility of the forearm muscles and reduce tension in the tendons, alleviating pain and enhancing range of motion.
Manual Therapy: Techniques such as soft tissue massage and joint mobilization can help reduce pain and inflammation, and improve circulation in the affected area.
Education and Ergonomic Advice: Physical therapists provide guidance on proper body mechanics and ergonomics to prevent aggravation of symptoms during daily activities. This includes advice on modifying activities that contribute to elbow strain.
The Role of Dry Needling in Tennis Elbow
Dry needling is a technique used by physical therapists to target muscle trigger points and reduce pain. It involves inserting thin needles into specific areas of muscle tightness. For tennis elbow, dry needling can provide several benefits:
Release of Muscle Tension: Dry needling targets trigger points in the forearm muscles, helping to release tightness and alleviate pain associated with tennis elbow.
Improved Blood Flow: The technique enhances blood circulation to the affected area, promoting healing and reducing inflammation.
Pain Relief: By addressing specific areas of muscle dysfunction, dry needling can help alleviate pain and improve overall elbow function.
Combining Physical Therapy and Dry Needling for Optimal Results
The pathophysiology of tennis elbow involves a complex interaction between mechanical stress, tendon degeneration, inflammation, and pain. Addressing these factors through rest, physical therapy, and appropriate medical interventions is essential for effective treatment. By understanding the underlying mechanisms, individuals can better manage and prevent tennis elbow, improving function and reducing discomfort.
Combining physical therapy with dry needling provides a comprehensive approach to managing tennis elbow. Physical therapy addresses the underlying causes and contributes to long-term recovery, while dry needling offers targeted relief for muscle pain and tightness. Together, these treatments can effectively reduce symptoms and enhance function.
If you’re struggling with tennis elbow or seeking effective treatment options, consider consulting a physical therapist who specializes in elbow rehabilitation. At Wildflower Physical Therapy & Wellness, our team of experts offers personalized physical therapy and dry needling services to help you achieve relief and restore optimal elbow function.
If you are struggling with illness or injury and would like to get your body moving, schedule a physical therapy appointment with us today! At Wildflower Physical Therapy & Wellness, we can help you to get back to the life you want to live through pain management strategies, activity promotion and exercise. Our Cash Based Physical Therapy model allows us to deliver a highly individualized treatment plan without the fuss of insurance companies. Interested in trying dry needling to support your exercise routine and maximize recovery? Reach out to us today!