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Tennis Elbow

  • Category: General
  • Posted On:
  • Written By: Kevan E. Ketterling, MD
Tennis Elbow

If you play tennis like I do, the pain of hitting a backhand comes from knowing that you should practice more. For thousands of others, the pain comes from their elbow. Though the term was first used in a German medical journal in 1900, tennis elbow has probably been around as long as tennis itself.

What is Tennis Elbow?

Tennis elbow refers to pain and tenderness about the lateral epicondyle. This is the bony prominence on the outside of the elbow. It is where the extensor muscles of the forearm attach. These are the muscles which extend or raise the wrist. The are used to grip and control the tennis racquet and are stressed with each stroke. if these muscles lack the strength, flexibility and endurance to withstand this stress, they may be injured.

This injury consists of partial tearing of the muscle fibers near the elbow inflammation, pain and swelling follow — mild at first, but eventually becoming severe enough to prevent play. Symptoms are typically worse after activity, but may progress to become nearly constant.

How to Treat Tennis Elblow

Treatment of tennis elbow begins with reducing the inflammation through the use of rest, ice, and anti-inflammatory medication. Rest not only means some time off from tennis, but the use of a brace around the upper part of the forearm to support the injured muscles. Often a second brace will be used at night to hold the wrist up and relax the extensor muscles. Ice is used for 15 to 20 minutes, both before and after play. Ultrasound has been a particularly useful physical therapy modality which may also be prescribed to help reduce the inflammation.

In some cases, more aggressive treatment is necessary. This may take the form of an injection of steroids directly into the inflamed tissue. Occasionally even surgery to remove the injured tissue is required to relieve the inflammation in the elbow.

However the inflammation is controlled, treatment can then proceed to an exercise program. This is the most important part of the treatment of tennis elbow and is usually supervised by a physical therapist or athletic trainer. This program includes both strengthening and stretching exercise designed to improve the power, flexibility and endurance of the forearm extensor muscles.

Not only are these exercises therapeutic, but preventative. This is important since tennis elbow tends to be recurrent. An adjunct to treatment, particularly in the beginner, is tennis lessons or coaching, since improper stroke mechanics can contribute to increased stress on the forearm muscles and elbow.

Athletes in all racquet sports are susceptible to tennis elbow. Treatment is easier, faster, and more often successful if initiated early. So, the next time you feel a twinge while hitting a backhand, don’t hesitate to get out the ice and call your doctor.