Gardening requires flexibility, strength, and endurance, and it necessitates using an array of tools such as secateurs, shears, clippers, and long-handled equipment. These tools demand repetitive movements of certain muscles and tendons in the hands, arms, shoulders.
Subsequently, gripping, clipping, shearing, and pruning strains the forearm, and can lead to inflammation and pain just below the elbow. Sometimes referred to as ‘tennis elbow’ or lateral epicondylitis, this condition can feel achy and painful, and worsens with gripping activity.
The forearm (lower arm) is a complex assembly of many muscles. A portion of these muscles are responsible for bending and extending our wrists and fingers. When this group of muscles (called wrist and finger extensors) are pushed beyond their capabilities, something ‘gives’ where the muscle attaches to the bone at the elbow (the lateral epicondyle). As a result, inflammation of the muscle and tendons occurs and creates a very painful and tender region around the elbow.
Besides gardening, other activities that can lead to tennis elbow include:
- Spending considerable time typing at a keyboard
- Hammering a lot of nails
- And yes … playing tennis!
Often, the strain around the elbow that results in inflammation and pain will occur after a sudden increase in participation of these activities. For example, a weekend of enthusiastic spring gardening — after a hiatus of gardening activity –may culminate in overuse.
Doing ‘too much too soon’ does not allow forearm muscle group to build enough strength to cope with increased activity. Consequently, this leads to progressive tightening of the muscles, inability to activate and operate the muscles efficiently, strain on the lateral epicondyle (muscle attachment at the elbow), and pain! This pain can build over time, to the point that it is constant with every hand movement. The loss of grip strength typically occurs, as well. Even holding a cup of tea or coffee can become challenging!
Tools for treatment and injury prevention
Tennis elbow can be difficult to treat because we rely on our hands for many daily tasks. Above all, the first line of treatment is REST, but this is often difficult to accomplish – particularly if you are a keen gardener!
5 things you can do to prevent or manage tennis elbow:
1. Stretch the forearm muscle group.
This is a simple treatment and can reduce the pain. Our exercise physiotherapist demonstrates two stretches that you can perform at least 3 times per day. https://youtu.be/KFsP72PXRYA
2. Rest from the aggravating activity.
If you are already experiencing elbow pain, you should halt the activity.
Start gradually. Apply the 10% rule for any new activity or activity you recognize is aggravating your arm pain. Start with a small session, and do not do it on consecutive days to begin with. After that, increase load or volume by no more than 10% each week.
3. Assess how you can change the way you perform an activity:
- Wear gardening gloves and vary the width of the handles of your secateurs and other equipment you use. To recruit and distribute the load amongst various muscles, alter the width of the secateur and clipper handles. This will activate a range of muscles and tendons in different ways, instead of utilizing one specific muscle of the arm.
- Alternate between use of the right and left hand. You can divide the strain on your forearms by alternating tasks between your dominant and non-dominant hands. Experiment with both right and left arms, independently. Hone your ambidextrous skills!
4. Examine your gardening equipment:
- Maintain your equipment. Excessive resistance caused by friction of pruning shears or secateurs requires extra effort of the hand and arm. So, ensure that your gardening equipment is free of rust and is well oiled.
- Purchase lightweight tools. The weight of identical gardening tools varies considerably. Weight is typically attributed to the size of the equipment and the metal alloy of the tool. Before you purchase check weight specifications online.
5. Improve your shoulder strength:
- When the muscles around the shoulders have lost strength then the muscles around the elbows and wrist compensate and need to do more. This leads to a greater chance of overuse of these muscles. A great way to strengthen your shoulders is to perform wall angels and add small weights as you become stronger – see our video