What is Tennis Elbow?

Tennis elbow is localized pain over the bony prominence called the lateral epicondyle on the outside of the elbow. It may also be referred to as lateral epicondylitis.

What causes it?

Tennis elbow is caused by repetitive stress on the muscles that are connected to the lateral epicondyle. These muscles extend along the top or dorsal side of the forearm to the wrist and are responsible for extending or bending back the wrist and fingers.

If too much stress is placed on these muscles, micro tears can occur. These micro tears become inflamed and cause pain that is usually localized at the muscle’s origin, but can occasionally radiate down the forearm.

The pain increases with activities that require contraction of these muscles: shaking hands, turning doorknobs, picking up objects with the palm facing down, or hitting a backhand in tennis.

How do I know if I have Tennis Elbow?

No special tests are needed to make the diagnosis. This diagnosis is made by history and physical examination of the patient. The patient may present symptoms consistent with tennis elbow and have pain when pressure is applied to the outside of the elbow. The patient frequently cannot remember the injury, but will have noticed the pain either at the beginning or the end of an activity that requires wrist and elbow movement.

X-rays are not always required when evaluating a patient with tennis elbow symptoms.

How is Tennis Elbow treated?

• Like many overuse injuries, there is no sure fire treatment. Rest itself does not necessarily cure the problem, even though it may decrease the pain. With use of the elbow again, however, the pain returns. Some physicians believe that the key to healing this overuse lies in increasing the circulation to the area while decreasing the tightness of the muscles. Therefore, stretching and strengthening exercises are frequently helpful.
• The following exercise may help. Support the forearm on a flat surface with the wrist and hand free. Hold a 1-2 lb. weight in the hand. Keeping the palm down, slowly extend the wrist. Bring it backward, or up, and then bend it forward, or down. The muscles on the top of the forearm should contract when the wrist is moved downward. To balance the forearm muscles these exercises should be repeated with the palm facing up. Each exercise should be repeated ten times slowly.
• A loop of rubber tubing with one end attached to a table leg or held on the floor with a foot can be used to provide resistance instead of the weight. This will also increase circulation to the area.
• A snug, but not tight, strap worn around the top of the forearm often decreases the pull of the muscles on the lateral epicondyle and lessens pain. When symptoms are present during everyday activities, the band should be worn during all waking hours. Occasionally, an elbow sleeve with a pad specially designed to put gentle pressure over the forearm muscles can be used. This sleeve has the advantage of not only changing the pull of the muscle, but keeping them warm as well which increases their flexibility and circulation.
• A physician may also prescribe ultrasound or electrical stimulation to increase circulation to the area.
• Nonsteroidal anti-inflammatory medications, like aspirin, ibuprofen, ketoprofen or various prescription drugs, may decrease the irritation caused by inflammation. However, if there is diminished circulation to the area these oral medications may not provide enough dosage to alter symptoms.
• Icing the joint after activity may also decrease the inflammation and relieve pain.

Tips for preventing injury

• Warm up well before play. Muscles stretch more when they are warm. Make sure to keep the muscles warm as you play.
• Choose appropriate equipment and maintain it properly. A racquet handle that is too big or too small, strung too tightly or loosely, or has a too big or too small head may increase stress to the elbow and wrist during play.
• Condition for the activity by stretching and strengthening all the muscles used in the sport. Also evaluate play techniques to make sure that they are not irritating the condition.

The specialists at Saint Vincent Sports Medicine can treat your tennis elbow to get you back on the court. For more information, call 814-835-2035.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.