Tennis Elbow

Understanding tennis elbow

Tennis elbow is a common clinical entity characterized by pain and tenderness at the outer side of elbow, when palms are facing up. It is a condition not precipitated from within the elbow joint, but resulting due to inflammation around the soft tissues outside the elbow joint.

Causes of tennis elbow

The specific causes of tennis elbow are largely known to be strain, rupture in small muscles around the joint, or work involving extensive, repeated straightening of  the forearm, just like performing 'back shots' during tennis.

How to do a self examination of tennis elbow?

  • Feel for any tenderness around the outer margin of elbow joint or 2 inches below that.
  • Pain increases when palms are turned downwards and stretching is done with drawing the wrist inside or making a tight fist.
  • Movements of elbow joint are full and not restricted, but they may be slightly painful.
  • Observe for any redness or swelling around the area.

An overview of treatment

The treatment for tennis elbow is broadly classified into the following:

Medications:  A local injection of hydrocortisone with local anaesthetic solution gives immediate pain relief. Oral painkillers are of help in acute cases.

Surgical intervention: This is rarely done in cases that do not respond to medications and physical therapy.

Physical therapy: Physical therapy plays most important role in management of tennis elbow by preventing further damage to elbow, restoring whatever healthy state of soft tissues are left and treating the current symptoms of tennis elbow.

Physical therapy regime for tennis elbow

Rest: Patient is advised to give rest to affected elbow by using a sling if the pain is too much or a simple elbow band.

Ice: Ice massage for seven to eight minutes around the elbow and below the joint or ice pack for 30 minutes gives considerable amount of relief.

Ultrasonic therapy: Most important to promote healing of soft tissues and improve blood circulation.

TENS: Gentle vibrations of a particular frequency are given to effectively reduce pain and relax the strained muscles.

Gentle exercises: Gentle movements can be done along with moving shoulder and wrist. This prevents stiffness. Use of weights can be started after 10-15 days to strengthen joint muscles to bear day to day stress, but to be done only under therapist supervision.

Dos and Don'ts for tennis elbow patients

DOs

  • Providing adequate care, rest and proper support to the elbow joint.
  • Use of weights to not exceed 0.5 kg and should progress to 1 kg.
  • Strain the joint only to do activities of yourself.

Don'ts

  • Vigorous handshakes.
  • Wringing washed clothes.
  • Tightening a screw.
  • Indulging in mechanical profession and sports involving repetitions.
  • Use of heavy rackets or weights.
  • Going for hand manipulations and trying to get rid of pain by rigorously moving the elbow.

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