If you play tennis, racquetball, another racquet sport or even if you're a carpenter, you might know all-too-well the discomfort and pain of tennis elbow. Oddly enough, though, less than 5% of all reported cases of tennis elbow are tennis players. Thus the ailment, lateral epicondylitis, is given a misnomer for a nickname.

Symptoms of tennis elbow:

  • You feel a recurring pain on the outside of the upper forearm just below the bend of the elbow. This pain can be sharp or that "dull-achy" pain. Occasionally, the pain radiates down the arm toward the wrist.
  • There is pain when you lift or bend your arm or grasp even light objects such as a glass of water.
  • You have difficulty extending your forearm fully (because of inflamed muscles, tendons, and ligaments).
  • There is pain that typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several years. Now if you've had this pain for several years, I'd be a bit worried.

There are two other elbow conditions that are often mistaken as tennis elbow. One is known as Golfer's Elbow, or medial epicondylitis. This differs from tennis elbow in that the pain persists on the inside of the elbow for golfer's elbow. Tennis elbow affects the outside of the elbow. The other condition is known as bursitis. Bursitis affects the back of the elbow.

What is tennis elbow?

You can get tennis elbow while playing racquet sports when the constant shocks from the racquet striking the ball reach elbow and create tiny tears in a part of the tendon and in muscle coverings. These injuries may heal, but are prone to tear again, leading to hemorrhaging and the formation of "rough, granulated tissue and calcium deposits within the surrounding tissues."1 This leads to collagen leaking out from around the injured areas, resulting in inflammation of that area. The pain you feel comes from the pressure from this inflammation pinching the radial nerve and cutting off the blood flow. As a result, the tendons do no receive as much oxygen and blood as muscles, thus the tendons heal more slowly.

To prevent tennis elbow:

When you pick stuff up, turn your palm towards your body. This prevents unnecessary strain on the tendons in your elbows. You can also try strengthening exercises with hand weights. With your elbow cocked and your palm down, repeatedly bend your wrist. This should stretch out and strengthen the muscles and joints susceptible to tennis elbow. Stop, though, if you feel any pain.

You should also stretch relevant muscles before beginning a possibly stressful activity by grasping the top part of your fingers and gently but firmly pulling them back toward your body. Keep your arm fully extended and your palm facing outward.

What to do to get relief from tennis elbow:

The best way to relieve tennis elbow is to let it rest from whatever is causing the pain. Time without stressing the area will allow it to heal, but you must stop doing anything that irritates your elbow. However, this won't be that easy for the manual laborer, office worker, or professional athlete who must continually inflict pain upon themselves to pay the bills and do their jobs.

The most effective conventional and alternative treatments for tennis elbow have the same basic premise: You want to rest the arm until the pain disappears, then massage to relieve stress and tension in the muscles, and exercise to strengthen the area and prevent reinjury. These steps are, of course, similar to the preventative measures you should take if you're worried about getting tennis elbow. If you have to go on with whatever caused the problem in the first place, be sure to warm up your arm for at least 5 to 10 minutes with the gentle stretching and movements described above before starting any activity. And don't forget to take frequent breaks.

For most mild to moderate cases of tennis elbow, aspirin or ibuprofen will help with the inflammation and the pain while you are resting the injury, and then you can follow up with exercise and massage to speed healing. For stubborn cases of tennis elbow your doctor may advise corticosteroid injections, which dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects. It also does not heal the damage to the tendons of your elbow. There are anti-inflammatory topical ointments that you can apply to the skin in the sore areas to reduce swelling as well.

If rest, anti-inflammatory medications, and a stretching routine fail to cure your tennis elbow, you may have to consider surgery, though this form of treatment is rare (fewer than 3 percent of patients). One option is to use the procedure where the tendon is cut loose from the epicondyle, the rounded bump at the end of the bone, eliminating stress on the tendon but rendering the muscle useless. This, obviously, would not be the ideal solution. Another surgical technique involves removing the granulated tissue in the tendon and repairing the tears.

Even after you feel you have overcome a case of tennis elbow, be sure to continue babying your arm. Always warm up your arm for 5 to 10 minutes before starting any activity involving your elbow. And if you develop severe pain after use anyway, pack your arm in ice for 15 to 20 minutes and call your doctor.

To prevent a relapse:

You should discontinue or modify the action that is causing the strain on your elbow joint. If you must continue, be sure to warm up for 10 minutes or more before any activity involving your arm, and apply ice to it afterward. Take more frequent breaks.

You can also try strapping a band around your forearm just below your elbow. If the support seems to help you lift heavy objects like your physics textbook, then continue with wearing the band. You should be aware, however, that such bands can cut off circulation and impede the healing process, so they are best used once tennis elbow has disappeared.

Call your doctor if...

1"What is Tennis Elbow?" http://www.tennis-elbow.net/tenniselbow.htm. Mad props for consulting for this w/u.

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