Tennis Elbow

Tennis Elbow patient

Last Updated December 20th, 2021

Overview of tennis elbow

Joint damages and joint pains become very common after a certain age. But in recent years, people belonging to different age groups are victims of joint pains. The teens and young adults, especially the ones involved in athletic activities, often suffer from elbow and knee pain. Speaking of elbow pain, the most common disease observed in young people and in many cases in the elderly is “tennis elbow”. Research findings by the Arthritis Foundation (United States) have revealed that nearly 15% of workers engaged in strenuous and repetitive jobs on a daily basis are vulnerable to tennis elbow conditions. They also established that about 50% of tennis players are victims of serious elbow pain and nearly 75-80% of these cases belonged to tennis elbow conditions.

 

What is tennis elbow?

Tennis Elbow treatmentTennis elbow or elbow tendonitis or tendinosis is defined as the pain around the outer portion of the elbow joint and is caused due to excessive mechanical strain caused by strenuous sports or occupational activities. It is characterized by swelling and inflammation of one or more tendons present around the elbow region. These tendons are responsible for movements of the forearm and wrist. Inflammation of the tendon tissues occurs due to excessive wear and tear due to overuse injury. One important muscle called Extensor Carpi Radialis Brevis is also adversely affected in this case due to excessive gripping, grasping and twisting movements.

Tennis elbow is, however, a misnomer in many cases because it not only occurs in tennis players or athletes but can also affect people belonging to other professions as well (especially the ones demanding continuous muscular activities). The highest rate of occurrence of tennis elbow is observed in the age group of 35-54.

 

What causes tennis elbow?

Tennis elbow or lateral epicondylitis is primarily caused by overactivities of the elbow joints and muscles. The more specific causes of tennis elbow are listed below-

  • Overuse of tendons in the elbow region due to repetitive strenuous activities (especially games and sports)
  • Mechanical injury of tendons, muscles or joints in the elbow region due to accidental blows or other factors
  • Continuous activity involving gripping, stretching and twisting of the forearm (Example: Writing or desk activities)
  • Weakening and degeneration of extensor carpi radialis brevis (ECRB) muscle due to wear and tear of the tendon at the point of attachment with the lateral epicondyle
  • The postural and positional defect of the ECRB muscle for a long duration due to excessive bending and straightening of the elbow (causes repeated friction between the ECRB muscle and the bones of the elbow)
  • Trapped nerve (ulnar nerve) causing numbness and tingling in the pinky finger
  • Excessive weightlifting, which causes muscular strain
  • The rigorous physical exercise which may cause stress in the forearm muscle
  • Occupations of painters, plumbers, carpenters or writers where overuse of elbow muscle, tendons, and joints occurs
  • Use of defective equipment during gym activities
  • Incorrect stroke techniques (especially groundstroke) during tennis, golf or other sports
  • Microtrauma of the tendon due to injury (from overuse) of the extensor muscles

 

Symptoms of tennis elbow

Tennis Elbow tearTennis elbow symptoms normally start at the elbow region and gradually radiate to the forearms and adjoining areas. The common and easily identifiable symptoms of tennis elbow are as follows-

  • Recurring and throbbing pain and inflammation on the outer portion of the elbow
  • Swollenness of lateral epicondyle
  • Tenderness and touch-sensitivity of the elbow and adjoining areas
  • Dull and persistent ache even during complete rest condition
  • Difficulty bending, relaxing, flexing or straightening the elbow
  • The stiffness of elbow (especially  in the morning)
  • Pain radiating from elbow to the forearm and neighboring regions
  • Pain experienced during very minor activities such as writing, twisting of the wrist during opening a bottle cap, throwing or catching something and many more
  • Sharp twinges felt during or after minor arm movement activities
  • Mild to severe discomfort in normally moving the arm
  • Sleep disturbance due to pain during moving hands and changing postures
  • Inability to perform activities such as weight lifting due to worsening pain

 

Types of tennis elbow

Tennis Elbow patientTennis elbow conditions may be categorized into the following classes-

  • Lateral Elbow Tendinosis: It is also called backhand tennis elbow and usually experienced in the outer portion of the elbow. It is primarily caused due to excessive strain in one or more extensor muscles present in the forearm such as – Extensor carpi radialis brevis/longus, extensor digitorum communis or the distal tricep. All of these muscles generate from the lateral epicondyle region of the elbow. Hence in the initial stage, the pain is felt at the bottom of the epicondyle. Continuous and repetitive activities involving gripping, grasping, twisting, stretching and bending movements can exacerbate the pain. This kind of tennis elbow is usually persistent in nature and is very difficult to cure.
  • Medial Elbow Tendinosis: It is also called golfer’s elbow (since it occurs mostly due to an exertion of the trailing arm in golf) and is usually felt on the inner portion of the elbow around the bulging bone. This type of tennis elbow is caused due to repeated and continuous mechanical stress on the flexor-pronator muscles attached to the medial epicondyle. It can also be caused due to compression of the ulnar nerve which causes numbness and tingling in the fingers. This type of tennis elbow is also observed in baseball players (due to pitching activities) and swimmers (due to pulling through strokes).

 

Diagnosis

Proper diagnosis of tennis elbow is very essential at the onset in order to prevent the disease from attaining a chronic nature. The following diagnostic tests are normally performed-

  • X-rays (to eliminate chances of arthritis)
  • MRI scan ( to detect arm pain due to herniated disc or arthritis in neck)
  • Electromyography or EMG (to rule out possibilities of nerve compression)

 

Treatment and prevention

Treatment 

  •  Physiotherapists will help ease the pain and the symptoms caused by this condition by monitoring game techniques and making changes in the patient’s day-to-day life to help reduce stress on the arm.
  • In non-athletic cases, physiotherapy will be recommended if over-the-counter pain medications and lifestyle changes do not help as much. Exercises to help strengthen the arm will be taught to the patient.
  • In cases where physiotherapy is not as helpful, injections containing botox will be prescribed to the patient to help reduce pain.
  • Another treatment method known as ultrasound tendonectomy will be conducted to help relieve the symptoms of tennis elbow. Here, a needle is inserted into the damaged tissue through the skin and ultrasound energy makes the needle vibrate. Due to the vibration of the damaged tendon liquefies and can be removed.
  • A slit will be made over the affected area and the damaged tendon will be removed. This surgical procedure is known as an open surgery. The surgeon will remove a part of the bone to help increase the blood flow and reattach the bone. Rehabilitation is necessary post-surgery to help the patient recover and regain mobility and strength in their muscles.

Prevention 

  • Do not do any strenuous activities that puts additional pressure on your arms.
  • Rest your dominant arm intermittently.
  • Do not take any forearm pain lightly.

Facts

  • Tennis elbow is also known as lateral epicondilitis.
  • This condition can commonly be found among those who are between the ages of 35-60 years.

Facts

  • This injury is not necessarily caused due to the sport that it is named after; it can be caused due to repetitive and strenuous usage of the dominant arm.

Facts

  • The recurrence rate of this condition is 33-50%.
  • 10% of tennis players have developed this condition.
  • This condition is said to affect men more than women.

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Dos and Don'ts

Dos
  • Take rest, doing so can help reduce the pain.
  • Stretch your arm before, during and after using your hand that may require strenuous activities.
  • Go for physiotherapy, this helps in strengthening your arm.
Don'ts
  • Do any strenuous activities, this may aggravate the pain and make the condition worse.
  • Use your laptop, computer or phone to play any games; doing so can make the condition worse.
  • Wear any splints, braces or bands over the affected area, as they tend to cause more pain.

 

 

 

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Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
chloride test
Chloride Test A chloride test of the blood checks the level of chloride in body, an important factor governing the…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
ANTIPHOSPHOLIPIDANTIBODY(APL)_IgG
Antiphospholipid (APL) antibody-IgG The Antiphospholipid Antibody testing is a blood test used to determine an autoimmune disorder called Antiphospholipid syndrome linked…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…