Tennis elbow is an inflammatory condition of the tendons, known as the exterior carpi radialis brevis, situated around the outer side of the elbow. These tendons, which connect the muscles of the forearm, are responsible for bending the wrist backward in the opposite direction of the palm. The swelling is the result of micro-tearing of the tendons and forearm muscles, leading outer elbow pain. Clinically, the medical condition is known as lateral epicondylitis.
Tennis Elbow Causes
The primary cause behind the development of this medical condition is damage due to overuse, repetitive movement, or excessive pressure exerted on the tendons and forearm muscles for a prolonged period of time. As mentioned before, the muscles and tendons here are specifically those of the forearm on the outer side of the elbow joint.
The medical condition is more common among players of outdoor sports like tennis, badminton, cricket, squash, etc, but is not restricted to them. Below are some instances due to which a tennis elbow may occur:
- Repetitive backhand tennis strokes spanning more than two hours
- Improper backhand strokes
- Hitting heavy balls
- Hitting balls off the centre of the tennis racket or cricket bat
- Using a short tennis racket or one that is too tightly strung
Other instance not related to spots that may damage forearm muscles and tendons are:
- Weak wrist and shoulder muscles
- Frequent use of tools like in the case of a carpenter, plumber, butcher, painter, etc.
- Working a chainsaw
Tennis Elbow Risk Factors
Some of the most common risk factors of tennis elbow are:
- Age: it is usually the most common among individuals between the ages of 30 years and 50 years. However, it can develop among individuals across ages.
- Sports: Players of specific sports like tennis, badminton, squash, cricket, etc. are more susceptible to this medical condition. These games involve repetitive movements of the forearms and the outer elbows, raising the risk of damage.
- Occupations: Certain occupations that involve overuse, repetitive movements or over-exertion of the forearm muscles and tendons also increase the risk of damage. Such occupations include carpentry, butchery, cook, painters, cobblery, etc.
Tennis Elbow Symptoms
Tennis elbow is marked by pain, ache, or burning sensation of the forearm and elbow. Without accurate tennis elbow treatment, the pain is likely to spread to the wrist and the pain may get aggravated. In such instances, the pain may be felt even when the hand is at rest. Outer elbow pain, which is the most prominent symptom of this condition, may occur in the following instances:
- Bending and stretching the affected arm
- Lifting a heavy object
- Trying to grip objects like coffee mug, pen, etc.
- A weak grip while holding objects
- Opening a jar, turning the doorknob and other similar hand movements
- Placing arm or hand on a table or other similar flat surfaces and then trying to lift the arm against resistance
Diagnosis for tennis elbow
Below is the procedure that is usually followed for diagnosing tennis below:
Physical examination: The medical practitioner is likely to undertake a thorough checkup of the area of inflammation and pain of the patient. The practitioner may exert pressure on the affected area or ask the patient to move the forearm, elbow, wrist, and fingers in different ways to check for pain and the extent of it. He/she may enquire about the patient’s medical history to evaluate whether any of his/her past or existing medical history may be related to the present symptoms. The practitioner may recommend some diagnostic tests.
Tennis Elbow Treatment
Below are the most commonly recommended treatments for tennis elbow cure:
- Rest: Complete rest of the affected hand and a break from the activity that has caused the medical condition may be advised.
- Ice pack: This may be prescribed to control inflammation.
- Medications: OTC (over-the-counter) anti-inflammatory pain-relievers like ibuprofen or naproxen may help in reducing the stress on the affected tendons and muscles.
- Physical therapy: The doctor may refer to a specialist who is an expert at evaluating the tennis strokes that are most likely to have led to the damage of muscles and tendons. He/she will then recommend the future course of physical therapy to relieve stress and heal the pain. This therapy refers to stretching exercises that are known to gradually stretch and strengthen the muscles. For example, slowly moving the wrist upwards and then lowering it gradually is often recommended for this purpose. An elbow strap or brace may help in controlling and healing the stress on the affected area.
- Ultrasonic tenotomy: Also referred to as the TENEX procedure, this procedure involves inserting a special needle through the skin till the damaged tendon under ultrasound. The ultrasonic waves make the needle vibrate enough to liquify the damaged tendon. The liquified tissue can then be suctioned out. Steroid injections may also be administered to control the inflammation and reduce pain.
- Platelet-rich plasma or dry needling injections: Prolotherapy or insertion of an irritant or botox may be administered right into the damaged tendon. Dry needling or the process of inserting needles into the tendon may also be recommended
- Surgery: Arthroscopic surgery may become necessary only when the condition does not improve after 6 to 12 months, despite ongoing treatment(s). In such cases, a non-operative procedure may be conducted for eliminating the damaged tissue. Such surgery may be undertaken through one large incision or several small incisions used as arthroscopic portal surgery is followed by rehabilitation exercises for a speedy recovery. However, surgery is required only in rare cases.
Preventive Measures and Home Remedies for Tennis Elbow
The following home remedies should be kept in mind to prevent the medical condition from recurring or from worsening.
- Use the right technique for the sport that has caused the damage.
- Use the right equipment to prevent further injuries and inflammations.
- Exercise to strengthen the muscles before performing repetitive actions.
- Ice the elbow after intense physical activity.
- Rest the elbow at frequent intervals.
- Don’t exert on feeling pain and when stretching or bending the arm becomes painful.