Diagnosis

At the latest when the pain in the elbow lasts longer or becomes very unpleasant, most people go to the doctor. If necessary, the doctor will refer you to a physiotherapist, who will carry out a physiotherapeutic diagnosis and the corresponding treatment. The first step there is to take your medical history.

Your physiotherapist will ask you questions about the pain and its course. Details of your symptoms are important in this interview: questions of this kind will come to you. On the basis of the anamnesis, the therapist can orientate himself and gets a first picture of your problem.

In the next step, the physiotherapist will take a look at your arm and check it for swelling, redness and skin changes. In this so-called visual findings, for example, the first signs of inflammation could be found.

How long has the pain existed?
When does the pain increase?
Is there anything that can relieve the pain?

This is followed by the so-called palpation, during which the therapist palpates the affected arm and can feel temperature abnormalities and sweat formation, among other things.

In addition, he checks the typical pressure points that are noticeable in tennis elbow. To do this, pressure is applied with one or two fingers in succession to the elbow and the forearm muscles, and you are asked about your sensation of pain. The pressure points can provide information as to whether it is rather a tendon irritation, a radial tunnel syndrome or an irritation of a nerve (N. medianus).

Furthermore, it can be differentiated which of the forearm tendons is affected. After palpation, some active and passive tests are performed on the elbow to make sure that the diagnosis “tennis elbow” is correct and that there is no other cause behind the pain. For this purpose some resistance tests are carried out from different starting positions and in different directions of movement.

The resistance tests may provoke the typical pain you already know from your elbow. In addition, the therapist moves the main joints of the arm (hand, elbow and shoulder) passively, i.e. without your active assistance. The passive movement of the adjacent joints serves to find out whether the pain in the elbow may have its origin in the shoulder or the hand. If there is a blockage or other disorder in one of these joints, this can also cause pain in the elbow. Therefore it is important to check these joints as well.