Tennis Elbow
Definition
A condition characterized by pain over the lateral or medial epicondyle (bony prominence) of the humerus (arm bone) radiating to the outer side of the arm and forearm. Also known as golf elbow, lateral or medial epicondylitis.
Description
Tennis elbow, one of the most common stress injuries of the arm, is a type of tendinitis that at some point afflicts almost one-third of all Americans who play tennis. Yet tennis players are not the only persons at risk, since any activity that calls for forceful, repeated contraction of the arm muscles can bring on tennis elbow. Working with carpentry tools, gardening, raking leaves, or even tightly gripping a heavy briefcase are only a few of the activities that can cause tennis elbow. Baseball, golf, bowling, racket sports, and even playing darts can bring it on.
Causes
Who Gets It? To some extent, this depends on the condition of your muscles and how much they are overused. In tennis, the injury occurs most frequently among recreational players who are 35 to 50 years of age, when muscles have begun to lose their resiliency, and who play at least two or three times weekly. Occasional players are less vulnerable as they tend not to play often enough or hard enough to overstress their arms. Pros are generally protected by superior conditioning and technique, although they too can develop tennis elbow as they grow older.
Symptoms
The injury occurs when you flex, twist or contract the tendons that connect muscles to the elbow joint. In time, the overstressed tendons develop microscopic tears, producing tendinitis (painful inflammation of the tendons) centered around the epicondyle, the point at which the tendons attach to the elbow. The pain can radiate down to the wrist and up to the shoulder. Moving your arm or gripping something aggravates the pain. Most recreational tennis players who are afflicted feel pain in the lateral part (the outer part, when your palm is up) of the elbow. Experts often attribute this to poor backhand technique, improper serving and a late forehand stroke. Advanced players tend to feel pain on the inside (medial part) of the elbow, usually because of strain from hitting powerful serves.
Treatment
Treatment is rest and avoidance of activities that exacerbate the conditions. The use of “counterforce” straps over the wrist are probably poor substitutes for rest. In mild cases, non-steroidal anti-inflammatory agents may be helpful. Injection of corticosteroids and a local anesthetic into the painful area may be of assistance in cases that have not been helped by conservative therapy. In some cases, surgical intervention may be indicated. After the pain has resolved, a daily physical therapy program involving stretching of the tendons may be helpful. It is also useful to consult a professional about your playing technique and the grip size on your racket.
Questions
What type of treatment will you be recommending? How effective is this treatment? How long will the elbow need to rest? How effective is corticosteroid injection? What are the side effects? How can this be prevented?
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