Tennis, Mouse and Golfer's Elbow

The disease mainly affects people who work several hours a day at a computer. But the symptoms are also common in the textile and food industries. All three diseases are triggered by repetitive movements of the same muscle groups for more than two hours or with a great effort of more than 20 kilos. This is often accompanied by poor posture. Sometimes, however, the pain develops spontaneously. This is usually the case after a short, intensive overload, such as painting, trimming a hedge or assembling furniture with screwdrivers. How exactly the symptoms of tennis elbow, golfer's elbow and mouse elbow develop has not yet been clarified. It is assumed that a biochemical exhaustion of the muscles and tendons in the forearm could be the decisive factor. This is supported by the fact that electromyographic examinations of the arm muscles of those affected show permanent electrical activation of the muscles in the forearm. A second hypothesis is based on repeated micro-traumas in the tissue, which cannot heal due to the too short regeneration phases between the stresses and will therefore accumulate.

In addition, discomfort and pain can encourage relief postures and muscle tension, which in turn increase pain and functional limitations. It is also possible that a pain memory is formed, which can contribute to chronification. Even minor stresses such as typing on the keyboard or clicking the mouse now leads to pain signals being sent to the brain, where they are evaluated as pain.

All three diseases are characterised by physical complaints in the arm. In the case of the tennis elbow, the pain is typically pressure pain on the outside of the elbow, which can be sharp during bending and twisting movements. In the golfer's elbow, the pain is on the inside of the elbow. The reason for the different localisation of the pain is that in the case of the tennis elbow, the symptoms are triggered by changes in the tendon and at the tendon attachment to the finger extensors. These are located above the elbow joint on the outer side of the humerus.

In the case of a golfer's elbow, on the other hand, the tendons of the finger flexors are affected. These are attached to the inside of the upper arm bone and are responsible for hand and finger flexion as well as inward rotation of the forearm. In both cases, the pain can radiate from the elbow to the hand, forearm or upper arm. Often, sufferers also notice a loss of strength in the hand. Shaking hands or grasping is now difficult.

For many sufferers, the mouse arm begins gradually with sensory disturbances, numbness or an unpleasant tingling sensation in the fingers, hands and arms, as well as cold hands. A loss of strength in the hands and forearms can also occur. As the disease progresses, the fingers may swell, the joints may stiffen, and there may be restricted movement and coordination problems. Pain usually only appears between the fingers, at the wrist, forearm or elbow later in the course of the disease. Some sufferers also experience pain in the shoulder joint, the upper arm and the neck, and some also suffer from headaches.

Basically, tennis elbow, golfer's elbow and mouse elbow have a good prognosis if those affected are willing to change their habits. The most important treatment measure is to identify the movements and movement patterns that trigger the symptoms. While this is easy to do in sports, for example, with targeted training of the racket positioning, the changes in everyday working life are usually more complex. The task is to optimise the workplace and establish ergonomic working methods. This includes, for example, raising the keyboard or using a vertical mouse. Ideally, writing should be done in a 10-finger system to put strain on all fingers. It can also help to keep varying the typing speed and to use the keyboard instead of the mouse. In addition to a height-adjustable desk and chair, attention should also be paid to the posture when working. A large distance between the body and the mouse, as occurs when leaning back comfortably in a chair, puts more strain on wrists and elbows.

In addition, regular breaks for hands and fingers as well as stretching exercises for hands, shoulders and neck are important. It is also known that risk factors such as a high work and stress load, a lack of compensation in leisure time and little exercise favour the development of these complaints. Here, relaxation techniques and sports such as yoga or Pilates can provide a balance. In individual cases, psychological counselling or therapy can also be helpful.