A Guide to the cause of tennis elbow treatment and Prevention

Also known as lateral epicondylitis, tennis elbow is a condition characterized by pain of the elbow due to overuse of the elbow muscle and tendons. In details, it is the inflammation of the tendons joining the muscles of the forearm on the outside part of the elbow. These forearm tendons and Extensor Carpi Radialis Brevis (ECRB) muscle tend to be damaged or develop small tears due to similar repetitive motions of the arm over time. The damage leads to inflammation putting stress to the rest of the hand thus making it painful to grip or lift things. The injury is mostly associated with tennis players hence the name. However, it is good to note that anyone can suffer from tennis elbow even those who are not so sporty. Up to 3% of the population suffer tennis elbow especially those between the ages of 30 and 50 years. However, despite the name, less than 5% of the tennis elbow cases are the ones linked to tennis and other racket games. In most tennis elbow patients, pain is reported to occur along the outside of the elbow at the area of the lateral epicondylitis. These patients will also experience the joint stiffness, especially in the morning, joint weakness and numbness or tingling sensations which go down into the fingers.

Tennis Elbow

Causes of Tennis Elbow

Tennis elbow is caused by a repetitive stress or injury brought about by overuse that leads to damage of the forearm muscles. All activities that are known to involve use of hands and especially those that strain the elbow muscle can be a cause. Also people who engage in activities requiring overhead arm use are also at a high risk of developing tennis elbow. Golfers suffer same kind with a different name “golfer’s elbow”. While playing tennis, hitting a backhand stresses the forearm muscles and repeatedly contracts once you hit the ball. For those with poor techniques on racket grip or hold it too tightly, the stress may increase on the tendons connecting the elbow and forearm muscles.
It is good to note that not only Tennis or golf players can suffer tennis elbow. Those playing other racquet sports like squash or racket-ball are prone to this injury. Your occupation also plays a role in placing you at a risk of having tennis elbow condition. One can also get tennis elbow from the activities or jobs involving repetitive arm movement. These jobs are:

  • carpentry
  • painting
  • tree cutting
  • Some musical instruments playing.
  • butchers
  • cooks
  • plumbers
  • Assembly-line workers etc.

However, studies show that sudden forceful pull, forceful extension and trauma caused by direct blow on the epicondyle cause more than half of these tennis elbow injuries.
Not forgetting, age is also a risk factor of one developing tennis elbow. The most common cases are reported to be increased in people of ages between 30 and 50 years of age.

Symptoms of Tennis Elbow

It is important to know the symptoms to avoid misdiagnosing yourself and treating something totally different from your problem. The common symptom of tennis elbow is pain on the outside of the elbow which progresses to chronic pain over few weeks or months. This may lead to the outer elbow becoming so painful to even touch and swelling. Eventually it becomes more painful to lift or grip things. At times, the tennis elbow affects both arms. Individuals with tennis elbow report pain that worsens when: lifting, shaking objects, opening a door, making a fist, raising the hand or straightening the wrist etc.

 

Tennis Elbow Treatment

Tennis elbow is a self-limiting condition, meaning it will sooner or later get better on its own without any treatment. However, tennis elbow sometimes can last for weeks or months or sometimes a year and more, this is basically because tendons take long to heal. In rare cases, tennis elbow can last for a year or more.
Several simple treatments listed below can help reduce or eradicate the pain of tennis elbow either at home or in the hospital.

  • The most important thing to do is rest the injured arm. Stop doing activities that caused the problem. Rest gives the tendons and muscles time to heal.
  • Holding a cold compress like ice cubes or frozen bag or peas wrapped in a towel, against your injured elbow can help relieve the pain.
  • Modifying or avoiding activities that strain the affected muscles and tendons can help. If you use your arm at work you might request the employer to shift you to another department or simpler work that doesn’t involve using your elbow muscles.
  • Physical therapy/ physiotherapy- Your therapist may use manual therapy techniques like manipulation and massage to relieve the stiffness and pain around your elbow. This encourages blood flow to your arm as well.
  • Exercises- A gym trainer or physiotherapist can show your arm exercises that will strengthen your forearm muscles and others that will keep your arm in motion to prevent stiffness and pain.
  • Taking painkillers like paracetamol and non-steroidal anti-inflammatory drugs like ibuprofen, naproxen and aspirin, may help in pain alleviation and inflammation caused by tennis elbow. Others are available in form of creams and gels applied on the specific area injured. Most are available over the counter.
  • Corticosteroids- which are a type of medication containing man-made versions of hormone cortisol. These injections may help reduce the tennis elbow pain in the short term. The injection is directly administered to the area around your elbow after one has been given a local anesthesia.
  • Shock wave therapy- This is a non-invasive treatment, where high energy shock waves are passed through the skin to help relieve pain and aid movement in the area affected. The sessions needed depends on the severity of the pain.
  • Surgery is amongst the last option to be considered incase other non-invasive treatments fail. It will only be considered in severe cases of tennis elbow where pain is persistent and very severe. The surgery involves the removal of the damaged part of the tendon to help relieve the pain.

 

Prevention

It is difficult to prevent tennis elbow injury. However, avoiding strain on the elbow can help prevent the condition or prevent worsening the symptoms. Below are some of the measures one can take to prevent tennis elbow from developing or recurring.

  • When tennis elbow is as a result of playing tennis, another factor comes in which is experience and ability. Poor techniques increase the chances of injury just like any other sport. Therefore any player needs to be well versed with all techniques of this sport. This includes racket-holding techniques.
  • If you already have tennis elbow, avoid doing those activities that are causing pain. Alternatively, find another way of doing that activity ensuring you do not put stress on the tendons around the elbow.
  • Avoid the use of elbow and wrist more than the rest of the arm. Ensure load weight is spread to the arm larger muscles like the shoulder and upper arm muscles.
  • Before playing any sport that involves repetitive arm movement, make sure to warm up properly. Also, stretch your arm muscles gently to avoid any injuries during play.
  • When working with your arms, use lightweight tools and while playing use light rackets and enlarge their grip size. This will help you to avoid putting too much strain on your tendons..
  • Whenever you are playing using your arm, wear a tennis elbow splint. Take it off while resting or sleeping to avoid further tendons damage. Get advice from a physiotherapist on the most suitable type of brace or splint to use.
  • Increasing the forearm muscle strength can help prevent tennis elbow. A physiotherapist or a workout trainer can advise on the best exercises that will help build up your forearm muscles.

 

Conclusion

Tennis elbow is a condition that arises from the strain, overuse or injury at the elbow joint. The pain is majorly felt on the outer part of the elbow. However, it is a manageable condition and it is easily treatable. Prevention is better than cure, so stretching your arm muscles before any racket game could go a long way in preventing tennis elbow. Rest can help relieve pain of tennis elbow and reduce the inflammation. It is good to understand that muscle and tendon injuries take long to heal and patience is necessary. Some risk factors associated with tennis elbow are age-common with people between the ages of 30 and 50 years, Occupation-people with jobs involving repetitive motion of arm and wrist and lastly certain sports- most racket sports if you have poor stroke and racket grip techniques. Treatment for this condition ranges from simple home remedies such as placing compressed ice cold packet of peas wrapped in a towel on the elbow, to over-the-counter medications and more complicated treatments like shock wave treatment and surgery. In most cases, tennis elbow is treated effectively using non-invasive techniques. Seek medical attention if the pain is so persistent and severe and last for long. There could be another underlying problem or illness and not necessarily tennis elbow.

 

 

REFERENCES:

  • https:///orthoinfo.aaos.org/en/diseases-conditions/tennis-elbow-lateral-epicondylitis/
  • https://wwww.webmd.com/pain-management/tennis-elbow
  • https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987
  • https://www.nhs.uk/conditions/tennis-elbow/prevention/

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