Tennis Elbow

What is it?

Tennis elbow is caused by inflammation of the tendons on the outside elbow (golfers on the inside, tennis on the outside).  There are 4 common sites of pain. One is where the tendon inserts into the bone, the second is caused by small tears within the tendon, the third is at the junction of the tendon and muscle and, lastly, within the muscle belly itself. It is caused by overuse, the area then becomes inflamed and painful, with even the smallest amount of exertion causing discomfort.

But did you know very few performance tennis players have tennis elbow? This is  because their stroke technique is very efficient so there is no mechanical disadvantage! Also, the racquets and string tension they use are suited to their game, ability and stature.

Symptoms

The symptoms are usually pain over the affected area, local tenderness and difficulty maintaining full grip strength because of pain.  There may be a small amount of swelling.  Simple activities may cause pain, particularly when gripping is involved.  You do not need to tennis to get this condition repeated or sustained gripping is the most common cause, for example, using tools or even mouse usage over long periods of time!

What treatment is available?

Some cases of tennis elbow may resolve on its own and no treatment is required.  In the majority of cases this will eventually occur, but may take many months or even a year or two.

Treatment can speed up this process and includes anti-inflammatory medication or gels, forearm braces and local physiotherapy to the painful area. Physiotherapy modalities such as ultra sound, acupuncture, deep friction massage, stretching and strengthening exercises are all possibilities. If the problem is caused by work or sport we can often make recommendations to adjust the causative factor.

In more consistent cases, cortisone injection is recommended.  This can be performed by your GP and involves injection of a small amount of cortisone and local anaesthetic into the painful area.  No all cases respond to treatment, and further injections may be required.

An operation can be done to help this condition, but this is usually as a last resort.  As the condition is usually self-limiting, and you should not prematurely decide to undergo an operation.

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