Tennis Elbow: You Don’t Have to Swing a Racket to Get It
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By Nicholas J. Avallone, M.D.
Pain along the outside part of the elbow while performing lifting maneuvers such as picking up a gallon of milk, turning doorknobs or even shaking hands can signal a common problem called tennis elbow or lateral epicondylitis. Essentially, this is a tendonitis of the major tendons in the forearm that enable bending back or extending the wrist and fingers.
Most people do not recall a particular activity that brought about their pain, although tennis players will frequently complain about this problem while hitting a backhand. Repetitive stress on these tendons is thought to create small tears and swelling along their origin on the lateral epicondyle of the humerus. Tenderness can typically be found when pressing along this part of the elbow. People over 40 appear more prone to this disorder, although it can occur at any age.
Some simple steps can be taken to provide relief. Decreasing offending activities often helps, but stretching and gentle strengthening are key. One easy exercise is to hold a 1 or 2 pound weight in your hand with your palm face down and your forearm supported on a flat surface but with your hand and wrist free. Gently bend your wrist back for the strengthening exercise and then allow your wrist to bend forward for the stretching portion. Two or 3 sets of 10 repetitions should be done twice per day. Proper warm-up before activities is also important to prevent recurrence of symptoms.
A counterforce brace can be found in the drug store. This pad attached to a strap puts gentle pressure along the irritated tendons to support them during lifting maneuvers. Anti-inflammatories like motrin or advil can provide pain relief but typically do not cure the problem. Formal physical therapy with stretching and strengthening as well as modalities such as ultrasound and electrical stimulation has been shown to speed the healing process in most patients.
If these conservative measures do not work, your physician may offer an injection of steroid into the injured area. While this does not heal the tendons, it gives significant pain relief to about 50% of patients.
Platelet rich plasma injections have recently been found to help alleviate symptoms and cure the problem of tennis elbow in a majority of patients. Once offered primarily to professional athletes to speed their recovery, this technique is now being utilized in the general population. A patient has their blood drawn and spun down in a centrifuge to collect the platelets and growth factors. This is then injected back into the patient in the injured area. Studies have shown that high concentrations of growth factors can enable the body to heal itself.
If all else fails, your surgeon may recommend a minor surgery to remove diseased tissue and stimulate blood flow to the area. This is effective approximately 75-85% of the time but also requires physical therapy afterwards.
For more information regarding elbow disorders and other orthopedic topics please contact Orthopedic Associates of the Greater Lehigh Valley at 908 859 5585 or visit www.bonedrs.com. |
