What is Lateral Epicondylitis?
In table tennis, we develop our speed, accuracy, and skills through repetitive drills for us to improve muscle memory or enhance our engram. However, in any kind of sport, this repetitive movements might also cause strain to specific muscles or any part of our musculoskeletal system that can result to inflammation and pain.
Tennis elbow, or lateral epicondylitis, is a painful condition on the lateral aspect of the elbow caused by overuse, which is usually due to repetitive backhand stroke in table tennis. Tennis elbow is inflammation or, in some cases, micro-trauma of the tendons that join the forearm muscles on the lateral aspect of the elbow (lateral epicondyle). The forearm muscles (extensor carpi radialis brevis) and tendons tend to be damaged from overuse — due to repetitive backhand stroke. This leads to inflammation, pain, and tenderness on the outside/lateral part of the elbow.
There are various treatment options for lateral epicondylitis. In usual cases, treatment involves a team approach. Primary doctors and physical therapists work together to provide the most effective care.
How to avoid having lateral epicondylitis when playing table tennis?
1. Warmup and Stretch Before engaging in any strenuous activity, you should get the blood circulating to your muscles. This allows your muscles to be well prepared in performing your desired backhand and forehand topspin, enhance your range of motion (ROM) and improve your muscle power which is very much needed in playing table tennis. In muscle stretching, it is important for you to implement at least 15 seconds hold to achieve the ideal muscle flexibility to prevent lateral epicondylitis.
2. Do Forearm Exercises Every other day, or thrice a week, perform simple wrist flexion and extension exercises utilizing 5# dumbbells to target the muscles in your forearm (ECRL and ECRB). You need to develop the right amount of muscle strength for your muscles to efficiently contract with the proper backhand form.
3. Avoid Repetitive Tasks Consider combining a cross-training routine to offset too much repetitive movements. If you have not played for a significant span of time, make sure you start out slow to ease back into play or implement proper pacing. It may take several weeks to build your muscle strength back up and return to the proper form and technique you once had. Remember, the more tired and weak your muscles are the more likely you are to have injuries and develop compensatory mechanisms which may ruin proper backhand form.
4. Take Breaks Proper pacing is important for table tennis. If you feel some pain, you can either rest for 10 to 15 mins, or try working on other aspects of your game, like footwork drills.
5. Proper Technique Hire a professional table tennis coach such as Brian Pace to guarantee you are using proper form and technique. This is vital to avoid wrong backhand or forehand strokes – thus preventing lateral epicondylitis from even starting. Wrong form of playing can impose greater risk of injury and will be a waste of your precious time for you to improve faster. A good technique will allow you to play longer because there will be less stress on the smaller muscles and tendons.
When you start suffering from lateral epicondylitis, a kinesiotape can be beneficial. It helps in reducing the pressure inside the elbow due to the inflammation of the tendon against the lateral epicondyle of your elbow. See a physiotherapist on how to properly apply the kinesiotape for best results.
7. Ice compression and Rest
Finally, if your lateral epicondylitis worsens, you can apply ice compress with a thin cloth in between the ice and your skin directly on the lateral aspect of your elbow. This will reduce and prevent further inflammation of the tendon. Rest your arm to prevent further injury. It is not advisable to practice if you are experiencing significant pain. This may let you develop an improper stroke or form in playing due to compensatory mechanisms to avoid the pain when playing.
About the Author:
Aldin Soneja, PT, is a Licensed Physiotherapist specializing in Sports Physiotherapy for more than 10 years in the Philippines, and a Licensed Physical Therapist in the USA for more than three years, now practicing in Arizona, USA.
Aldin was also a Regional Table Tennis Champion for 6 consecutive years in the Philippines (1995 to 2001) and had been a Table Tennis Coach for Regional and National Competitions in the Philippines for more than 7 years.
He is now a member of American Physical Therapy Association, and an aspiring Orthopedic Clinical Specialist of American Board of Physical Therapy.
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