Cricket and the tennis elbow - Treatment
How is an acute tennis elbow managed and treated?
In most cases, avoidance of any motion that is
painful will suffice. The immediate treatment could
be a combination of ice and anti-inflammatory
ointment. Along with this, physiotherapy treatment
such as ultrasound and interferential therapy is
important. It would be advisable to place a splint
that will immobilize the wrist and keep it in a
neutral position. Wrist immobilisers, like a
cock-up splint or a plaster cast, relieve the
tension on the wrist extensors.
Crepe-bandaging or immobilization of the elbow
itself need not be done.
First aid: Besides the described treatment given by
the physiotherapist, I would recommend the
application of ice every hour, for a period of
10-15 minutes atleast four to five times a day and
wrapping of a wet bandage around the forearm and
elbow for 10 minutes after icing. This should be
done until the pain lessens.Anti-inflammatory
ointments could also be applied two to three times
a day .
As the acute condition subsides, the player could
start stretching, strengthening and toning
exercises of the wrist. However, he should resume
playing cricket until the physio gives him a green
As the local swelling shrinks, an inelastic scar
tissue is formed. Stretching exercises are
therefore of great value, as they help nullify the
likely consequences of an inelastic scar tissue.
Stretching exercises of the forearm:
The injured player should face a wall, keeping the
dorsum (back) of the hand, flat on the wall. He
should keep the elbow locked. When he leans
forward, the wrist is forced into 90% flexion.
Stretching with a bat: Grasp the centre of the
handle and slowly raise the bat almost parallel to
the ground. Then bring it down gradually. Repeat
this 10 times.
Stretching with the back swing: Assume the correct
stance. Grip the handle and use the back swing
motion in a full follow-through with a bat.
Stretching from the fist: Turn the hand inwards, so
that the thumb points downwards. Then stretch the
elbow and push the arm outwards. Angle the hand at
the wrist far enough outwards, so that tension is
felt in the muscles of the lower arm (repeat this
exercise five times, each time for 10-15 seconds)
Resistive exercises are used to re-strengthen the
forearm and wrist extensors. These exercises can be
performed with the help of weights of two kgs. The
forearm is supported on a block or over the couch
and full range of motion is attempted. Therabands(????)
can be used as a power band extension exercisor. It
can be performed where one end of the band is
placed beneath the foot and the other end gripped.
The wrist extension movement can be performed.
Place the forearm on a table surface, while keeping
the wrist at the table's edge. The hand should
freely move up and down. FLEXION EXERCISES: The
palm should face downwards as you hold the bat at
right angles in front of the body. The bat is held
in such a manner that it's weight is evenly
distributed across the palm. Now turn the hand in
both directions, i.e. left and right.
It is important to reduce the stress from
exacerbating activities and the use of counterforce
bracing is effective while playing. The
counterforce brace consists of a tight strap that
is placed around the upper forearm to create
lateral pressure when a bat is gripped. The aim is
to redirect and disperse overload to the healthy
tissue or the band itself, and in so doing, reduce
painful inhibition and permit a more forceful
Sachin Tendulkar and his tennis elbow.
Ergonomics plays an important part in the
management of this condition. Enlarging the grip of
the bat's handle is important in most cases.
The correct grip-size can be calculated by
measuring the distance from the tip of the
ring-finger to the bottom lateral crease of the
palm. The figure obtained represents the
circumference of the bat handle. Placing a thick
piece of sponge around a handle can also help
enlarge the grip and reduce the shock that travels
from the handle to the hand. In some cases, a grip
that is too large may also pose a problem, so to
assess whether the grip-size is a relevant feature,
ask the person to grip a thin handle and then a
large one, to find out which one of the two causes
WEIGHT OF THE BAT: A heavier bat has more momentum
and will place greater strain on the forearm, which
ultimately causes a TENNIS ELBOW.Hence, it is
preferable to use a bat that is relatively lighter.
It will reduce the chances of a tennis elbow in the