Why Tennis Elbow Can Serve Up Real Pain
John Temple, MD
Tennis elbow is tendinosis of a muscle called the extensor carpi radialis brevis, which affects the tendon attached to the bone on the outer part of the elbow. When that tendon is damaged from overuse, it can cause weakness and pain around the area that often also radiates into the arm. Tennis elbow can happen suddenly from an injury, or gradually from repetitive use of the arm, and usually feels worse with gripping and lifting activity.
While tennis players can be affected by tennis elbow, most of my patients with the condition don’t play tennis and aren’t necessarily athletes or even play sports.
The Aging Factor
The older we get, the more de-conditioned our muscles and joints become. One of the most frequent elbow issues we see with patients is tennis elbow, also called lateral epicondylitis. As we age, the muscles and tendons that we have relied on for many years aren’t as strong as they used to be, and inflammation and degeneration from overuse can occur.
Let the Healing Begin
Rest will almost always be the first way to treat tennis elbow in order to let the damaged tendon begin to heal. Medical providers may also use home exercise programs, physical therapy, anti-inflammatory medicines, braces, steroid injections or extracorporeal shock wave therapy as part of the healing process. A relatively new technology is Platelet Rich Plasma (PRP), which concentrates platelets and growth factors within a plasma layer separate from white and red blood cells. Outside of the bloodstream, platelets become activated and release proliferative and morphogenic proteins. These growth factors are known to be important for healing. A patient’s own blood is used to isolate the platelets.
Prevention is Key
Of course, the best option is to take measures to prevent tennis elbow from happening. It helps significantly to be in good physical condition, including maintaining strength in your shoulder, arm, and upper back muscles. Have your sports equipment checked for proper fit, focus on correct techniques and movements in your activities, and be aware of your daily activities that may cause the same repeated arm movements.
When Treatment is the Only Option
I most frequently treat tennis elbow with home exercise and stretching and advise modifying activity. Open or arthroscopic surgical treatment options are available as a last resort.
Tennis elbow is more common than people realize and can be extremely frustrating. But we are fortunate that there are so many treatment options available, and we are continuing to explore new and evolving methods in medicine to fix it.