Tennis Elbow

If you're experiencing pain at the outer-side of your elbow, possibly traveling down your forearm to your hand, you may have a condition commonly referred to as "Tennis Elbow". This condition is commonly seen in tennis players, but can occur with anyone. Typically it results from anything that involves extending your wrist or rotating your forearm, and repetitive activities that strain the tendon. For example, activities such as twisting a screwdriver or lifting heavy objects with your palm down can cause tennis elbow.

If you have Tennis Elbow, you may experience pain all the time or only when you lift things. Another symptom is swelling of the elbow along with redness & feeling warm to the touch. It may also hurt to grip things, turn your hand, or swing your arm. Occasionally, any motion of the elbow can be painful.

If you are experiencing these symptoms, it is time to seek medical attention.

WHAT IS TENNIS ELBOW?

Tennis elbow, also known as lateral epicondylitis, is an inflammation around the bony knob on the outer side of the elbow. It occurs when the tissue that attaches muscle to the bone becomes inflamed or irritated. The bony knob is called the lateral epicondyle.

WHAT ARE THE CAUSES?

Overuse - A variety of racket sports or activities such as twisting a screwdriver or lifting heavy objects with your palm down can cause tennis elbow. Anything that involves extending your wrist or rotating your forearm. Overuse or activities that place stress on the tendon attachments, through stress on the extensor muscle-tendon unit, increases the strain on the tendon. Stress can be caused by “repetitive” gripping and grasping activities, i.e. meat-cutting, plumbing, painting, weaving, etc.

Trauma – A sudden extreme action, force, or activity could injure the tendon as well as a direct blow to the elbow resulting in swelling of the tendon that can lead to degeneration.

TREATMENT

Conservative (non-surgical)

Activity modification - To begin with, activities causing the condition should be limited. That doesn't mean you have to have total rest, however, by limiting the activity or modifying grips or techniques, such as use of a different size racket and/or use of 2-handed backhands in tennis, you may relieve the problem.

Medication – Anti-inflammatory medications may help to alleviate the pain

Brace – A tennis elbow brace, a band worn over the muscle of the forearm just below the elbow, can allow it to heal by reducing the tension on the tendon.

Physical Therapy which provides stretching and/or strengthening exercises may be helpful as well as

ultrasound or heat treatments.

Steroid injections – A strong anti-inflammatory medication such as a steroid can be injected into the area, however, no more than 3 injections should be given.

PRP Treatment - This is the use of platelet rich plasma (PRP), to promote healing of injured tendons, ligaments, muscles, and joints. This treatment can also be applied to various musculoskeletal problems. Because platelet activation plays a key role in the process of wound and soft tissue healing, this can be a very effective treatment. With PRP Treatment, a portion of the patient’s own blood, which has been enriched with a platelet concentration above baseline, is used to promote healing.

Surgery

Surgery should only be considered when pain is incapacitating and has not responded to conservative care, and symptoms have lasted for more than six months. Surgery involves removing the diseased, degenerated tendon tissue. There are two surgical approaches available; traditional open surgery (incision), and arthroscopy – a procedure performed with instruments inserted into the join through small incisions. Both options are performed in the outpatient setting.

Recovery

Physical therapy to regain motion of the arm is part of the recovery process. A strengthening program will be necessary in order to return to prior activities. You can expect recovery to take 4-6 months.

If you think you may be suffering from Tennis Elbow, or any other conditions of the hands or upper extremities, call Dr. Sagini's office at (239) 337-2003 for an appointment.