Pathology of Tennis Elbow
Tennis elbow is a condition, despite its name, that has very little to do with the elbow joint. It describes a number of separate conditions which manifest themselves as an inflammation of the common extensor tendon origins on the lateral epicondyle of the humerus. (fig. 1) This inflammation is brought about by over use and strain of the muscles on the back of the forearm caused, in the main, by the actions of the wrist. It is characterised by pain and tenderness over the outside of the elbow, with pain often radiating down the back of the forearm.
Any actions of the forearm which involve gripping and rotation cause discomfort and pain. These actions include taking lids off jam jars, turning doorknobs, pouring water from the kettle, wringing out the washing, executing 30 yard rushes, etc.
The croquet player with the Standard grip on the mallet is more likely to suffer tennis elbow on the top arm. Players using the Solomon grip may suffer the condition in either arm, or both!
Diagnosing "Croquet Elbow"
The management and treatment of the condition depends largely on two factors: how bad it is and how long it has been present. It is important to get an accurate diagnosis before embarking on any treatment regime if other than conservative treatment is needed. The person carrying out this treatment will be able to give you a precise diagnosis.
As a rough guide, bend your elbow to a right angle, clench your fist with your palm downwards, and with your other thumb press over the point shown in figure I. If that hurts, it's tennis elbow!
Acute tennis elbow will often resolve spontaneously providing a sufferer abstains from the actions that cause pain. However, spontaneous resolution may take anything from a couple of weeks to a couple of years, and most players are reluctant to wait that long. On the other hand, a condition that has become chronic, and ignored, becomes far more difficult to cure and may in the end require surgery.
Finding the right treatment
There are a wide variety of treatments available; which is most suitable will depend on individual pathology.
After treatment, critique your technique
It is important, following successful treatment, that the player's technique is examined to eliminate any bio-mechanical faults or to make any adjustments that may be needed. For example, increasing the diameter of the mallet shaft and thereby opening the grip slightly will help to prevent a possible recurrence of the condition.
Upcoming in this series: Frozen Shoulder. Reprinted by permission of the Croquet Gazette.
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