7 Ways to Test for Tennis Elbow at Home and in Office – Sports Medicine Weekly | Dr. Brian J. Cole
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Published on: 07-Jun-2020

Tennis elbow, or lateral epicondylitis, develops when the forearm muscles that connect to the outside of your elbow become irritated. This can cause pain and tenderness that’s usually located on the outside (lateral) part of the elbow. Oftentimes, there’s also pain when gripping and carrying objects.

The condition often occurs due to overuse or improper form during athletic activities. Using your arm or wrist for vigorous repetitive movements or heavy lifting can cause tennis elbow.

There are several simple tests you can do to determine if you have tennis elbow. You can do most of these tests on your own, but a few do require the assistance of a doctor or medical professional.

Read on to learn more about tests for tennis elbow, as well as treatment options.


Tests for tennis elbow

The bony bump on the outside of your elbow is known as the lateral epicondyle. If you experience pain, tenderness, or discomfort in this area during any of these tests, you may have tennis elbow.

Use your affected arm to perform these tests. If you want to feel the difference between your arms, you can perform each test on both sides.

1. Palpating

  1. Sit with your forearm extended out in front of you on a table.
  2. Apply gentle pressure to examine your lateral epicondyle and the area above it.
  3. Note any areas of pain, tenderness, or swelling.

2. The coffee cup test

  1. For this test, simply rate your level of pain while grasping a cup of coffee or a carton of milk.

3. Resistance

  1. Extend your affected arm straight out in front of you with your palm facing down.
  2. Place your opposite hand on the back of your extended hand.
  3. Press your top hand into your bottom hand and attempt to bend the bottom wrist backward.
  4. Create resistance by pressing the top hand against the bottom one.

4. Middle finger resistance

  1. Extend your affected arm straight out in front of you with your palm facing upward.
  2. Use your opposite hand to pull your middle finger back toward your forearm.
  3. At the same time, use your middle finger to resist this movement.
  4. Next, turn your palm to face downward.
  5. Press your middle finger down while at the same time resisting this movement.

5. Chair pickup test

  1. You’ll need a light chair with a high back for this test.
  2. Stand with a chair in front of you.
  3. Extend your affected arm straight out in front of you.
  4. Bend your wrist so your fingers face downward.
  5. Use your thumb, first finger, and middle finger to grasp the back of the chair and lift it.
  6. Keep your arm straight as you raise the chair.

6. Mill’s test

Do this test with a doctor.

  1. While seated, straighten your affected arm.
  2. The doctor will fully flex your wrist to bend it forward.
  3. Then they’ll rotate your forearm inward while examining your lateral epicondyle.

7. Cozen’s test

Do this test with a doctor. Cozen’s test is sometimes referred to as the resisted wrist extension test or the resistive tennis elbow test.

  1. Extend your affected arm in front of you and make a fist.
  2. Rotate your forearm inward and bend your wrist toward your forearm.
  3. The doctor will examine your lateral epicondyle while resisting the movement of your hand.

More in-depth tests 

If any of the preliminary tests indicate that you have tennis elbow, you may require further testing to see if there are additional causes for any of your symptoms.

Your doctor may order an X-ray to rule out other potential sources of elbow pain such as arthritis. Sometimes, a magnetic resonance imaging (MRI) scan is also done to look at the anatomic structures about the elbow in greater detail.

Electromyography (EMG) is a test that’s done if your doctor is concerned there’s a nerve problem responsible for your elbow pain.


Who is at risk?

Lateral epicondylitis affects athletes such as tennis and badminton players, golfers, and swimmers. It can also occur in people who use their hand, wrist, and elbow for repetitive motions during work or daily activities, such as painters, carpenters, and musicians.

In some cases, tennis elbow occurs without an obvious cause.


Treatments 

There are several ways to manage tennis elbow on your own. It’s most important to rest and take a break from any activity that requires the use of your arm.

Things to try first

Once you try and return to activity, go slowly and build up the duration and intensity of your exercise and workout to see how your body responds. Examine your form and technique during any athletic activity or repetitive type of motion.

If possible, use a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, or naproxen to manage pain, swelling, and inflammation. For more severe cases, your doctor may consider the use of different types of injections.

In some cases, surgery may be necessary.

Other things to try

  • Take herbs and spices such as turmeric, cayenne pepper, and ginger to manage inflammation.
  • Use an ice pack for 15 minutes at a time.
  • Undergo an acupuncture session, or apply a muscle rub to manage pain naturally.
  • Apply a CBD salve or diluted essential oil blend topically.
  • Wear a strap or brace on your forearm to help reduce stress on your elbow. A brace can also help to prevent your muscles and tendons from working too hard.

Alternative options

Extracorporeal shockwave therapy is a treatment modality that transmits sound waves to the affected area. This causes micro trauma to the region that it’s applied to and is thought to stimulate healing.

Research from 2020 points to its safety and effectiveness in reducing pain and improving function in the short and middle term. However, more in-depth research is needed to expand upon these findings.

Exercises

Once the pain and inflammation subside, perform exercises that target your elbow, forearm, and wrist. These exercises may promote healing and reduce future injury by improving strength and flexibility.


Recovery 

Symptoms of tennis elbow can usually be treated and managed on your own at home. Your recovery will depend on the severity of your condition and the degree to which you follow your treatment plan.

This includes whether you’re able to modify, or avoid altogether, the activity that caused your symptoms. Usually, you’ll start to see an improvement after a few weeks of rest and treatment.

Once you make a full recovery and return to your usual routine, carefully note if any of your symptoms start to creep back in and then adjust accordingly.

When to see a doctor 

If you suspect you have a severe case of tennis elbow or there’s noticeable swelling about your elbow, you should seek medical attention. Your doctor can then determine if there’s a more serious explanation for your symptoms.

An occupational or physical therapist can show you exercises, make sure you’re doing them correctly, and teach you correct movement patterns. They may also use ultrasound, ice massage, or muscle stimulation.

Surgery may be necessary if your condition doesn’t improve despite a trial of nonsurgical treatment. Surgery for tennis elbow can be performed either through an open incision or arthroscopically through several very small incisions. After surgery, you’ll do exercises to rebuild your strength, flexibility, and mobility.


The bottom line

You can do some of these tests for tennis elbow on your own. Usually, you can ease your symptoms and improve your condition on your own by sticking to a treatment plan that includes plenty of rest.

Change your form or technique if your daily or athletic movements are causing pain. Continue to do exercises to improve strength, flexibility, and mobility in your arms even if you’ve made a full recovery.

Talk to your doctor if your condition doesn’t improve, gets worse, or is coupled with other symptoms.


Originally published in Healthline.com

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