• Jason Pestel

Game, set and please stop!

In the tennis world, 2018 has been the year of comebacks. Although Andy Murray was not quite ready to make his return, we have witnessed the return of Novak Djokovic and his brilliant tournament win.

Following Djokovic’s rehabilitation from an elbow injury that saw him out of action for more than six months and having to pull out of the tennis circuit half way through 2017. His road back to full fitness has been slow and arduous. He was even quoted as saying at one point that he questioned whether he would get back to his desired level ever again.

One common complaint that can afflict the elbow of both tennis and non-tennis players is called ‘tennis elbow’ (known medically as lateral epicondylitis). This is a strain or partial tear in the extensor muscles of the forearm. These muscles attach to the bony prominence on your elbow and in many cases the ‘extensor carpi radialis brevis’ muscle is particularly involved. Contractile overloading of the forearm muscles stresses the tendon that attaches to the joint and this is what causes tennis elbow.

Despite its name it should always be remembered that only about 5% of those who suffered are actual tennis players. The constant actions of forceful forearm actions, unforgiving vibrations and repetitive upper activities are commonly seen in occupations that involve computer use and heavy lifting. People with jobs that involve repetitive one-sided movements such as gardeners, electricians and carpenters also regularly present with this condition.

To recall on my experience, as a tennis player, I trained too hard. Often on court more than 4 times a week for long periods, rest intervals in between matches were minimal and the build-up of damage and micro-tears on the forearm eventually took their toll. It felt at the time that the condition happened all of a sudden, but lateral epicondylitis is classified as an overuse injury, and this is exactly what occurred with all my over exertions. The result was that I was out of the game for effectively a whole season lasting six months and suffered pain on a daily basis.

If you have this condition you may experience worsening pain with everyday activities such as brushing your teeth or increasing pain in the elbow joint when shaking hands or gripping objects. If not treated, simple daily tasks that we all take for granted, such as lifting a cup, become excruciatingly painful.

The pain does not just stop at the elbow, as other muscles come into play, pain may begin to radiate down into the wrist and/or further up the arm into the shoulder and neck.

Without treatment, the symptoms will get worse over time, so it is really important to seek out expert help and be patient with your recovery as the elbow can take time to heal.

Treatment involves reducing the level of pain and inflammation that you are experiencing and only then gradually restoring the mobility and strength to a point where normal functional tasks can be resumed without pain. Your doctor can advise you on prescribed medication for pain relief in the early stages.

As a sports therapist, I can also provide you with expert advice on:

  • Rest duration. Despite how it sounds, this is probably the most important part of the treatment and is often the most difficult. If you continue to use the elbow, recovery times will be hindered, and the injury may become chronic and difficult to treat. Avoidance is key on simple tasks such as gripping tools too tightly, opening heavy doors and returning to sport too soon.

  • In the first 72 hours post injury, applying a cold compression wrap to the injured area 2-3 times daily for 10 minutes, taking care to protect the skin. Icing can help relieve pain and reduce inflammation. For longer term conditions I can advise you on ice and heat combination therapy.

  • Sports massage and therapy is very beneficial, particularly with long-standing conditions. Cross friction massage on the elbow tendon is a technique that can be performed and then continued daily at home by rubbing across the tendon for 1-2 minutes. The purpose of this treatment is to encourage a fresh supply of blood and nutrients to the injured area to aid healing.

  • Wearing a specialist elbow brace or support can enable the healing to take place as it reduces the strain on the tendon. Kinesio taping is the new buzzword in the discipline of sports medicine, this remarkable tape can help stabilise any area of weakness, off load the pain simply and effectively without affecting your range of movement.

The road back for Djokovic took time and he had a number of setbacks along the way. Tennis elbow typically takes a considerable period of time to recover, but you are not on your own. I can provide you with advice, treatment and a rehabilitation program which will include gentle stretches to the area and a strengthening regime to help prevent future recurrences of the injury.

Whilst most of us can safely say that we won’t be winning Wimbledon next year, we can however confidently achieve our own personal goals without pain and with full mobility.

If you are suffering from any of the above issues and would like help with your recovery, please get in touch.

Jason Pestel

Telephone: 07977 917331

Email:: jasonpestel@hotmail.com

Website: jasonpestel.com

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