Tennis Elbow: Conquer the Symptoms by Treating Your Neck
If you’ve had Tennis Elbow before you’ll understand how frustrating it can be.
It’s stubborn, persistent and often compounded by a lack of obvious triggers.
But did you know that it may be more than just isolated elbow pain? That there’s an important piece of the puzzle easily missed?
From what I find clinically, this is significant enough to potentially hold the keys to a better understanding of the issue.
So I ask you this; is Tennis Elbow a consequence of the neck?
I think there’s enough repeatable clinical evidence to suggest it might be.
What is Tennis Elbow
For those unaware, Tennis Elbow is an overload and irritation of the wrist and forearm tendons at the elbow. It’s technical name is Lateral Epicondylitis – which implies inflammation, but this isn’t always the case.
Tennis Elbow Cause
Traditionally we equate the onset of Tennis Elbow pain with tasks that require repetitive gripping and twisting.
But we also link it to other tasks that expose you to high wrist and forearm load. Things like brick-laying, tiling, working a register and overhand carrying seem connected.
It’s often classified as an “overuse” injury for the above reasons. We feel load plus high repetition can equal tendon dysfunction.
It can genuinely be a pain in the ass.
Interestingly, I also see a large number of office workers with Tennis Elbow.
They still seem exposed to a lot of repetitive movements but less so load.
In my opinion, this highlights why there’s still an element of mystery associated with Tennis Elbow – load isn’t always involved.
And this is where the neck becomes relevant.
Tennis Elbow and the Neck
It can sound strange to suggest the neck is involved here but clinically I’ve seen enough to warrant greater attention.
It seems that in order to develop Tennis Elbow (Golfers Elbow and potentially other hand, wrist or fingers tendon issues as well), you may need to have accrued some dysfunction at the base of the neck first. I don’t necessarily mean a disc bulge or pinched nerve, but mechanical dysfunction.
When performing an assessment for Tennis Elbow I’m now keeping a keen eye out for locally stiff neck joints and related soft tissue tightness.
This is often tricky for most to comprehend as these symptoms generally won’t stand out. You have to go hunting for them to appreciate what’s going on. But it seems highly likely to be there.
And I have some thoughts on why.
How Is the Neck Involved in Tennis Elbow
The lateral elbow is effected by the neck in a few ways.
Dermatomes and Myotomes
Without going in to too much detail, Dermatomes and Myotomes are aspects of the spinal cord that serve specific areas of sensation and muscular activity throughout the body.
Formed in the Embryonic stages of our development these neurological connections are often severely underrated when trying to understand injury and dysfunction.
In terms of Tennis Elbow, the base of the neck houses connections to the lateral elbow and forearm. As a result, low neck stiffness and tightness may act like a ‘kink’ in a hose and effect the function of your arm.Low neck stiffness and tightness may act as a 'kink' and effect the function of your arm.Click To Tweet
It’s very important to understand that the normal flow of function can be suppressed or altered by dysfunction further up the chain. If you kink a hose the water pressure drops off, and this may also be true for incoming and outgoing neural information.
It seems to result in functional changes like hyper, or altered sensitivity and relative weakness – reducing the elbow tendons’ ability to tolerate normal and/or increased loading over time.
In short, there should be nothing wrong with you performing repetitive tasks.
After all the body is designed to thrive with use. But if the hose that supplies your tissues is ‘kinked’ then it’s threshold for dysfunction is likely to be compromised. Most likely without you realising until it’s too late.
It’s a similar idea here with the Radial nerve.
The nerve and it’s offshoots originate from the base of your neck and the very top of your upper back. It follows a path down the back of your arm and directly passes by the lateral part of your elbow before finishing down around your thumb.
As before, any kink in the system can have downstream consequences.
It’s important to note that our nervous system doesn’t have a lot of inherent ‘slack’ in the system. Unlike our soft tissue which has more ‘elasticity’, our nerves are more steel cabling by design. This relative rigidity helps provide a conductive pathway for neural traffic. So it’s important that our neural connections can ‘floss’ freely through their designated pathways.
But if there’s a mechanical anchor at its origin, the nervous system can become a source of restriction and anything can become dysfunctional by association.
This is often displayed as increased neural tension.
As you can hopefully appreciate, any low neck dysfunction can have functional, mechanical and performance-related consequences for the lateral elbow.Any low neck dysfunction can have functional, mechanical and performance-related consequences for the lateral elbow.Click To Tweet
If this neck dysfunction is left unattended, it may potentially become very hard for any symptomatic elbow treatment to work. And if it does, have we truly solved anything?
If you are like many long-term sufferers of Tennis Elbow and have gone through months of anti-inflammatories, elbow injections, pain medication, strength and conditioning exercises, Tennis elbow splints, braces, straps and other supports etc. all without success, then you might be missing one huge piece of the puzzle.
A New Perspective On Tennis Elbow Treatment
In light of this, please consider the health of your neck and your work/home environment.
How do you hold your neck? Do you constantly look down when reading or using your phone? Do you recline and watch TV through your feet? Are you someone who just generally slouches?
What is your neck having to buffer day to day behind the scenes?
It may not seem like these positions and shapes can equate to a sore elbow but clinically it seems there’s a connection.
By treating patients’ neck dysfunction it’s common to see some immediate change in elbow pain and an increase in strength and overall function.
It’s as close to a Tennis Elbow cure as I think we are likely to get.
The results are there to see. I urge everyone to test it out themselves – regular folk and health professionals alike.
An Unusual Tennis Elbow Exercise
Let it gently press into the lower aspects of your neck and go looking for stiffness and tightness. It’s very safe, but take the time to explore your neck and pay more attention to what you feel is relevant.
If you’re in the right area it may even communicate with your Tennis Elbow symptoms.
If unsure, go and see a trusted health professional and let them do it for you.
Game, Set, Match
So if you are dealing with Tennis Elbow make sure you respect the health and function of your neck. Take a moment to consider your postural habits and make amends where possible.
By all means work hard on your Tennis Elbow treatments and exercises. Build on the strength and mobility of your wrist, elbow and forearm musculature, but please consider the potentially bigger picture at play here.
The bottom line is that your tissue should support you if you choose to use it. Repetition should rarely be an excuse for dysfunction on its own. It may however expose already less than perfect mechanics and function over time.
This can be a hard idea to reconcile considering that we often confuse feeling ‘normal’ with being normal, but I feel the evidence is mounting.
I urge everyone to explore this idea. There’s likely something here if you’re willing to look for it.
It has been a game-changer for me and my patients and something I genuinely feel needs to be explored and officially researched. Perhaps discussing this is the first step.
Are you dealing with Tennis Elbow?
What are your thoughts on this?
I’d love to discuss this with everyone so please COMMENT below.
Alternatively, head over to the Your Wellness Nerd Community forum here and join in the conversation!