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Doctors first described tennis elbow (lateral epicondylitis) more than 100 years ago. Almost half of all tennis players will eventually get tennis elbow but less than 5 percent of all cases result from playing tennis. Golfer’s Elbow & Bursitis are 2 related conditions, which are sometimes mistaken for tennis elbow. How are these three conditions similar?

With tennis elbow the pain comes on gradually and is experienced as tenderness on or below the outside of the elbow. Gripping, lifting and carrying objects becomes painful. Golfers Elbow has similar causes and pain but the tenderness is felt on the inside of the elbow where the bone seems to jut out from the joint. Bursitis affects the back of the joint where the pain is and there is sometimes a visible lump. Bursitis is caused by either a fall or a blow directly to the tip of the elbow. Excessive leaning on the joint can also cause it.

Tennis elbow is a form of tendonitis. When the muscles and bones of the elbow joint are involved, then the condition is called epicondylitis. If the pain is felt directly on the back of your elbow joint, and not on the outside of your arm, you could have bursitis, which is caused by inflamed lubricating sacs in the joint. There should not be any swelling associated with tennis elbow. If there is swelling then it's probably not tennis elbow but another condition, such as arthritis, infection, gout or a tumor.


The Symptoms

Victims of tennis elbow will experience recurring pain on the outside of the upper forearm just below the bend of the elbow. Sometimes the pain radiates down the arm all the way to the wrist. Lifting with or bending the arm or even holding a light object like a cup will cause pain. Sufferers will have problems fully extending their forearm because of inflamed muscles, tendons and ligaments. The pain typically lasts for six to twelve weeks and there can be discomfort for anywhere from 3 weeks to several years.

The actual damage that tennis elbow causes is very small tears in a part of the tendon and in the muscle coverings. Once the original injury heals, these areas often tear again which leads to hemorrhaging and the forming of calcium deposits and development of some rough tissue around the injury and in surrounding tissues. Collagen can leak out from around the injured areas and cause inflammation. The pressure from this blocks the blood flow and pinches the radial nerve, which controls the muscles in the arm and hand.

Tendons do not heal as quickly as muscles do and some cases of tennis elbow can last for years. The inflammation usually goes down in 6 to 12 weeks.


Treatment

The best way to treat tennis elbow is to stop doing the things that irritate your arm. This is not a problem for the recreational tennis player, but creates a dilemma for a laborer, office worker or professional athlete. The most effective treatments for tennis elbow involve resting the arm until the pain disappears, massage to relieve muscle stress and tension, and strengthening exercises to prevent reinjury. If you have to go back to the activity that caused the problem, a 5 to 10 minute period of warm-up stretching and movement before starting that activity will help. It also helps to take breaks frequently.

Medicine offers different treatments for tennis elbow, from injections to surgery, but the pain will continue unless you stop stressing the joint. The tennis elbow will return if the joint is not given adequate rest. For mild and moderate cases aspirin or ibuprofen will help reduce the inflammation and the pain while you are resting the injury. Later you can get exercise and massage to accelerate the healing process.

For stubborn cases of tennis elbow your doctor may prescribe corticosteroid injections. These injections will reduce the inflammation, but they cannot be used long-term because of the risk of detrimental side effects. Topical ointments are another option for many sufferers, especially those who would rather not take medications.

If rest, medication, and a stretching routine fail to cure your tennis elbow, surgery may be advised. Less than 3 percent of patients require an operation. One surgical procedure cuts the tendon loose from the epicondyle, the round bump at the end of the bone. This eliminates the stress on the tendon but leaves the muscle useless. Another technique removing granulated tissue in the tendon and repairing the tears. After you have seemingly overcome a case of tennis elbow, continue to baby your arm. Always warm up your arm for 5 to 10 minutes before starting any activity that involves your elbow. If you develop severe pain after the activity anyway, pack your arm in ice and call your doctor.

Prevention

To prevent tennis elbow, try these techniques:
When lifting something, do it with your palm facing your body. Do some strengthening exercises with hand weights. Before beginning a possibly stressful activity stretch the relevant muscles by pulling the top part of your fingers gently but firmly back toward your body while keeping your arm fully extended and your palm facing outward.

To prevent a relapse, discontinue or change the action that is causing the strain on your elbow. Be sure to warm up for at least 10 minutes before performing any activity involving your arm and apply ice to it after. Take a break as often as you can.

It might help to strap a band around your forearm just below the elbow. The support should help you lift heavy objects. These bands can impede circulation and slow down the healing, so they should only be used after the symptoms of tennis elbow have disappeared.

If the pain lasts for more than a few days, chronic inflammation of the tendons can lead to permanent disability. If the elbow joint begins to swell, you may have another condition such as arthritis, gout, infection or even a tumor.