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Tennis elbow plagues many racquet players and golfers, both amateur
and professional. It is sometimes referred to as tendonitis or epicondylitis
and can occur in anyone using frequent rotary motions of the forearm.
The term “tennis elbow” has long been used to describe
a pained elbow, regardless of whether the sufferer has ever picked
up a tennis racquet.
Tennis elbow is a condition of inflammation, irritation and micro-trauma
of the muscle tendon where it attaches to the bony prominence on
the outside of the elbow. The elbow is susceptible to injury due
to the small area of attachment of the muscle tendon. It creates
a greater force load when the muscle contracts. The muscle, which
extends the wrist and turns the palm up, tends to be the most vulnerable
to stress. After repetitive use of these extensor muscles, the tendon
becomes overworked and inflamed. This produces pain on the outside
of the elbow.
What are the risk factors for tennis elbow?
The development of tennis elbow often relates to the way that workers
carry out activities such as gripping, twisting, reaching, and moving.
Tennis elbow is associated with jobs that require repeated or forceful
movements of the fingers, wrist, and forearm. It can develop because
of too much force at once or small amounts of force for too long
a period.
What are the signs and symptoms of tennis elbow?
In a medical examination, pain experienced in any three of these
movements can indicate the possibility of tennis elbow. Usually
there is no outward sign of redness or swelling. Most often tennis
elbow affects only one arm, usually the arm performing all the work.
Pain is experienced mostly in hitting a backhand stroke in tennis
or with gripping and resisted movements at the wrist. Frequent contributors
to tendonitis in tennis player include the following:
- Inappropriate grip size
- Overly tight string tension
- Attempting to generate all force from the wrist and forehand
rather than proper stroke production involving the whole body, with
legs flexed, full hip rotation into the ball and weight transfer
into the forward leg
- Hitting the ball late
Tennis elbow can appear in many different ways. Some people get
symptoms gradually after doing the same type of work for several
years. Others acquire it suddenly, soon after they start doing a
new type of work. Sometimes tennis elbow can develop immediately
following a single violent muscle exertion or after an elbow becomes
injured. In other cases, tennis elbow occurs for no obvious reason.
Treatment
First and foremost, there must be a reduction in the offending activity,
whether it is playing tennis or working on a computer or any other
repetitive physical act that causes pain. Carrying briefcases, suitcases
or heavy purses may increase the discomfort. Local measures should
be undertaken, such as icing after activity, and then systemic measures
such as non-steroidal anti-inflammatory medication. Support of the
wrist and hand with a brace is sometimes helpful. Don’t let
your symptoms get out of control before seeking medical attention.
Address the problem right away. Physical Therapy can assist with
the return to activity. A physical therapist will evaluate and determine
the appropriate rehabilitation course for each individual. Physical
Therapy may include the use of modalities including anti-inflammatories,
ice, ultrasound and electrical stimulation. Stretching and soft
tissue mobilization will assist in the patient progression to strengthening
exercises. In the worse case scenario, your physician may recommend
local steroid (cortisone-type) and in a very small percentage of
cases surgical treatment may be considered.
It is recommend that tennis players who develop this problem consult
a teaching professional once their symptoms are resolved and they
are rehabilitated to the point that they're ready to return to play.
The tennis professional can then assist them with modifications
necessary to improve their symptom free tennis game.
Prevention
Paying attention to early symptoms can save someone a lot of trouble.
If a certain activity produces significant pain or soreness in the
lateral aspect of the elbow, that activity should cease. This is
not something that should just be "played through." If
someone wants to start playing tennis, it is best to take some lessons
to develop the correct form, which will go a long way toward preventing
problems.
Tennis players should also be aware that they may not know until
tomorrow the damage they did today. Just because the elbow does
not hurt today does not mean it won’t be sore in the subsequent
days. Therefore, they should increase activity gradually rather
than rapidly and players should also visit their qualified Village
professional for proper equipment modifications.
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