07 Aug Tennis Elbow
Tennis elbow is an overuse injury that strikes many tennis players who look forward to a summer on the courts, then find their arm becomes distressingly painful after too much tennis. Once this condition develops, it can be painful to swing a racquet through the air, let alone volley back and forth.
The condition is so common that many players know the drill. They’ve talked to other players who explain what has happened. To set the record straight, let’s review the basics.
What Is It?
Tennis elbow is an inflammation of tendons, which are tissues that connect muscles to bone. In this case, the tendons affected connect the muscle in your forearm to your elbow – specifically to the outside of your elbow, which is a hinge-type joint.
While tendons connect muscle to bone, ligaments are fibrous tissues that connect bone to bone, adding stability to joints. There are three primary ligaments of the elbow, called the ulnar collateral, the radial collateral, and the annular ligaments. These wrap around the joint to hold the various bones in place.
Near the end of the humerus is a small knobby protrusion called the lateral (outside) epicondyle. The clinical name for tennis elbow is lateral epicondylitis, which describes swelling in the area of the lateral epicondyle, which anchors both the radial collateral ligament and to a tendon the runs to the supinator, a broad muscle in the posterior compartment of the forearm.
Tennis elbow (or lateral epicondylitis) develops after repeatedly striking at an object – such as a tennis ball – with the muscles contracted, which occurs when a tennis player is using a backhand motion. This sudden jolt, repeated many times, puts a strain on the tendon attached to the epicondyle.
Tennis players, however, do not have an exclusive on tennis elbow. While age is a contributing factor, frequent golfers can also come down with symptoms of tennis elbow – called, of course, golfer’s elbow. A repeated striking motion also occurs with some factory jobs. Painters, butchers and other occupations that use frequent use of the arm in the same motion can also be prone to tennis elbow.
A diagnosis of tennis elbow can usually be done in the physician’s office. The doctor will have you use your affiliated arm in various motions to isolate where the inflammation originates. Doctors will also ask when the pain was first noticed and when the patient says, “on a tennis court,” or “on a golf course,” the diagnosis can usually be confirmed.
If the diagnosis is uncertain, imaging may be required by the use of X-ray or an MRI (magnetic resonance imaging).
Resting the elbow is commonly recommended for tennis elbow, although usually, it is sufficient to stay away from the activity that causes the most pain. Often elevating the elbow helps. Doctors could also recommend the arm be stabilized, generally by wearing an arm sling temporarily.
Aside from rest, anti-inflammatory medication, icing, and elevation, doctors could also recommend several procedures. These include:
- Plasma or Botox injections
- Ultrasonic tenotomy (inserting a needle to deliver targeted ultrasonic energy to the inflamed tendon)
- Surgery is recommended to remove damaged tendons if non-invasive measures don’t work
- An armband that re-orients the ligament can also help