For those who love to watch Wimbledon – either attending the event or on TV, it is always exciting to watch some of the best tennis players in the world going head-to-head. Radar guns show that serve speeds on Centre Court can reach up to 130mph, so it’s easy to see why these elite players are particularly prone to upper arm injuries.
However, even among amateur athletes, the repetitive action of hitting the ball can strain the tendons of the forearm. Tennis elbow – also called lateral epicondylitis – is a painful stress injury caused by damage to the tendons on the outside of the elbow.
As well as tennis players, the condition is common among other people who play sport, including golfers, squash players and bowlers. Certain jobs also have an increased risk of tennis elbow, including painting and decorating, carpentry, gardening, dentistry and even using a computer keyboard for prolonged periods.
Why does tennis elbow occur?
The bony bump on the outside of your elbow is attached to the muscle by the lateral epicondyle tendon. When the muscles of the forearm start to tire due to making repeated arm movements, the tendon is forced to take more of the load. This can cause inflammation and pain (known as tendinitis) and may result in the development of tiny tears in the tendon. It tends to be the dominant side that is affected, although tennis elbow can occur in either arm.
What are the symptoms of tennis elbow?
The symptoms of tennis elbow can vary in severity from mild discomfort to debilitating pain and weakness. They tend to develop slowly and may worsen if you continue to perform whatever action is causing the problem. Symptoms include a sharp pain or burning sensation on the outer side of your elbow, which may extend down to your wrist and the back of your hand. You may notice the pain, in particular, when making a twisting movement or bending your arm. Your grip may be weaker than normal and your elbow may be stiff or swollen.
How is tennis elbow diagnosed?
You should visit a doctor if you experience severe or prolonged symptoms or you suspect tennis elbow. They will ask when the symptoms began and will carry out an examination of your elbow joint, including asking you to make certain movements to ascertain if they exacerbate your symptoms. You may be sent for an ultrasound, MRI or CT scan to check if there is damage to the soft tissues. An X-ray may be used to rule out a fracture or other possible causes of elbow pain, such as arthritis. In some cases, electromyography (EMG) checks may be used to measure nerve electrical activity and check for nerve compression.
What treatments are available for tennis elbow?
Many cases of tennis elbow get better by themselves, however, the damaged tendon needs time to heal so you will need to avoid or decrease whatever activity caused the problem in the first place. Recovery can take up to 18 months, during which time you can use anti-inflammatories and ice to relieve the pain and reduce inflammation. Your doctor may recommend wearing a brace to relieve tension on damaged tendons and muscles and a physiotherapist can recommend exercises to strengthen your grip and reduce stiffness.
An injection of corticosteroids into the elbow joint may provide temporary relief from pain and inflammation. These are given with the aid of ultrasound to ensure the medication is delivered directly to the affected area. Platelet-rich plasma injections are sometimes used to aid the body’s natural healing process. A small amount of your own blood is extracted and treated to separate the platelets from the other components of the blood. A concentration of platelets is then injected into the damaged elbow joint to accelerate healing.
In some cases – particularly if symptoms are severe or persist for longer than a year – you may be offered surgery to remove or repair the damaged tendon. This can normally be carried out arthroscopically (keyhole surgery) and, if the tendon is removed, an area of healthy tendon from another part of your body can be used to replace it. Full recovery from this type of surgery can take a few months and you may need to wear a brace to support your elbow during this time.
Preventing tennis elbow
To prevent tennis elbow from occurring, it is important to rest when your body feels tired or if you experience pain. Good technique and using the correct racquet can help to reduce stress on your forearm. A physiotherapist will be able to recommend exercises to stretch and strengthen your wrist and forearm.
For advice on diagnosing tennis elbow and information on possible treatment options, contact us for more information.
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