Athletes Not Only Ones to Suffer From Tennis Elbow

John DeCarlo Alaska Spine Institute

Elbow pain is one of the most common injuries doctors and, ultimately, physical therapists see, whether in Anchorage or in Austin. While there are several reasons for elbow pain, lateral epicondylitis – or what is commonly known as tennis elbow – is one of the more frequent causes. Tennis elbow is characterized by a pain on the outside of the elbow that feels worse when objects are grasped or while cocking back the wrist. Doctors first identified tennis elbow more than 100 years ago, and today, nearly half of all tennis players suffer from the disorder at some point.

Most people who suffer from tennis elbow say the pain got worse gradually, but it is possible for it to come on suddenly. Symptoms include a difficulty in holding onto, pinching or gripping objects, and pain or stiffness during elbow and hand movement. Forearm muscles might experience tightness and some patients notice their forearms don’t have their normal strength. Movements such as gripping, lifting and carrying can be troublesome. Pain can occasionally radiate down the arm toward the wrist.

The exact cause of tennis elbow isn’t known, although most think it is due to small tears in the tendons that attach the muscles of the forearm to the arm bone at the elbow joint. Tennis elbow is not just linked to sports enthusiasts, it’s also common among manual laborers who work with their hands, especially those who repeat the same motions all day long. It can result from any activity that puts the lateral or medial compartments of the elbow under repetitive stress and strain, such as hammering, turning a key, using a screw driver, working on a computer or even excessive hand shaking.

Tennis elbow isn’t just an inflammation of the tendons around the elbow, but more a result of aging or repetitive use. If you suffer from tennis elbow, you’ll be happy to hear that more than 90 percent of those who have it don’t require surgery. The first step is to see a doctor to determine that tennis elbow really is the problem. Depending on the severity of the injury, and each patient’s lifestyle, a doctor might recommend anti-inflammatory medications. Cortisone injections are a reasonable option, if oral anti-inflammatories don’t do the trick.

In extreme cases, surgery to release the damaged tendon might be needed, but only in about 3 percent of those suffering from tennis elbow. When surgery is required, a portion of the damaged tendon might be removed or the attachment of the affected tendon is released. The healthy part of the tendon also can be repaired in some cases.

Physical and occupational therapy are typically the next intervention after being seen by your doctor. By strengthening the muscles and tendons, many patients can prevent the problem from returning. Get a knowledgeable physical therapist to design a workout routine that includes stretching and strengthening exercises. The goal is to improve muscular strength and endurance, and to maintain or improve flexibility so that the patient can return to the sport or normal level of activity free of pain.

In general, the more chronic or longer you have experienced the condition, the longer the recovery time. An important step to recovery is rest. That doesn’t mean stopping all activities, in fact activity will help the body to heal, but rest the elbow by avoiding activities that aggravate the injury. Use pain as your guide for deciding appropriate type and levels of activity. If the injury was caused by playing tennis, using the wrong racquet or swinging incorrectly may be the problem. Get an occupational therapist to help evaluate how you perform your activities of daily living before returning to the activity that may be source of the problem.

If the injury is a result of repetitive movement at work, an assessment of the ergonomics of the workplace is highly recommended. Trained occupational therapists can go into the workplace to identify the behaviors, postures, dangerous loads and repetitive motions that put workers at risk. Employers who have an ergonomics study performed receive a list of recommendations that might include changes in equipments or the way work is done to improve safety and decrease the risk of injury. Return to work evaluations also can be developed to help determine if injured employees are physically able to go back to work. Companies across Alaska have seen the benefit of these evaluations in less overall injury rates and lower re-injury rates.