‘Tennis elbow’ indicates muscle and tendon damage – 06/10/2023 – Equilibrium

It starts with a nagging pain on the outside of the elbow and gradually becomes more debilitating. This can happen to you even if you’ve never picked up a tennis racket or golf club. Although up to 50% of exercisers develop it each year, lateral epicondylitis, as it is known by experts, is one of the most common repetitive strain injuries in the upper body.

The causes of tennis elbow vary, but can include long-term use of a hammer, painting, weight training, and even gardening. Or it could be a combination of triggers.

Study shows that people over 40 are more susceptible, as well as smokers, obese and those who practice repetitive movements for at least two hours a day. If you suspect you have tennis or golf elbow, there are ways to heal, return to activity, and hopefully keep the pain under control.

What is tennis elbow?

Both tennis elbow and golf elbow are overuse injuries resulting from damage to the muscles and tendons running from the wrist to the elbow. If overused, and you don’t have enough strength in your shoulder muscles and core, the tendons can undergo microscopic tears where they attach to the elbow, causing pain and inflammation.

The first sign that you might have the condition is pain near your elbow, says Theresa Marko, a physician and physical therapist in New York City and a spokesperson for the American Physical Therapy Association. “You may also feel a tightness in the muscles in your forearm,” she points out. “Sometimes you’ll feel a ‘click’ or ‘grab’ sensation, or you won’t be able to fully extend your elbow.”

The pain was Melanie Madden’s first indication that something was wrong two years ago. “I had been playing tennis for about three months when I first noticed,” says the 45-year-old realtor from Boulder, Colorado. “I had a new dog at the time, and I frequently threw a ball for him, did yoga, and played golf. I kind of ignored the pain and waited for it to get better.”

Before long, the pain was waking Madden up in the middle of the night, and even as she reached for a cup of coffee.

How to deal with the condition

Managing the pain as soon as it starts can shorten the time it takes to get over it. “It can be a stubborn injury,” says Marci Goolsby, a sports medicine physician and director of the Center for Women’s Sports Medicine at the Hospital for Special Surgery in New York City.

The first lines of defense against tennis or golf elbow should be to identify the activities that cause it. “If you’ve had a sudden spike in your Ping-Pong game, for example, cut back,” recommends Marko. If you catch the problem early enough, reducing the time spent on the aggravating injury may be enough. If not, stop completely until you progress through the rehabilitation exercises.

This can be tricky because many simple daily activities – using the phone, household chores like sweeping, sewing or even washing dishes – can aggravate the injury.

Next, experts recommend ice and anti-inflammatories, as well as wearing a tennis elbow brace, which provides compression at the point of pain (although some studies have found the effect may be psychological).

Some experts also suggest a wrist splint (wrist brace) for severe pain, as it prevents you from extending your wrist in a way that causes elbow pain. You can also try gently massaging the upper part of your forearm, with your hand facing down, 3 to 5 cm below your elbow, says Marko.

In most cases, however, the root of the problem is a lack of strength in the shoulder area, she points out. “Right away, you can start doing some shoulder and rotator cuff exercises.”

One attempt is shoulder external rotation: Lie on the unaffected side, with a rolled towel between your arm and torso. Bending the upper arm at the elbow, lower it towards the stomach and back again, repeating 15 times in three sets. You can also add simple shoulder blade squeezes while standing or sitting, repeating 15 times in three sets. Over time and as you feel better, you can add weights or resistance bands.

“However, if the elbow is hurting, holding a weight will be painful,” says Marko. “What I do is I put an ankle weight around the person’s wrist and have them relax their hand as they go through the side-lying exercise movements.”

The American Academy of Orthopedic Surgeons has a home exercise program (click to read in English).

If you’re not making progress, a physical therapist can help you manually loosen the joint and develop a personalized strengthening program. The professional may also put your arm in motion to assess your readiness to return to your sport or activity.

As you begin to heal, try testing your elbow in small increments of the sport or activity, letting the pain be your guide. Worst case scenario — if you’ve rested for several weeks and even visited a physical therapist — it’s worth seeing an orthopedic specialist, says Robert Parisien, an orthopedic surgeon at Mount Sinai in New York City.

“Not because we’re going to suggest surgery, but to consider other treatments,” he says. “There is about a 95% success rate with a combination of treatments.”

Translated by Luiz Roberto M. Gonçalves