Article:
Tennis Elbow Isn’t Just for Tennis Players

By Gita Pillai, MD

You don’t have to play tennis to get tennis elbow. The cause of tennis elbow, a pain on the outside of your elbow, can be playing tennis but also can be due to other activities including weight lifting, or carrying heavy bags. Tennis elbow is an overuse injury that will affect about half of the population by age 60. The risk of developing tennis elbow is directly related to your level of physical activity.

Typically, patients with tennis elbow have pain or weakness with gripping and pain when moving the elbow. The pain is located on the outside of the elbow, by the bony prominence. Symptoms can build gradually, but some patients who spend a day lifting heavy boxes can wake up with severe pain.

It was believed previously that tennis elbow was a form of tendonitis, inflammation of the tendon. Now it is known that the damaged area is actually a layer of tissue next to the tendon that is worn and frayed.

Most patients get better with time—really just rest—although it will take many months. Frequently, physical therapy is requested, although there is really no consensus on whether therapy relieves tennis elbow. Certain modifications to things you do during the day can help to rest your elbow. First, if you are feeling pain on the outside of your elbow, stop the activity you are doing and rest it. Secondly, to reduce stress on the elbow, lift things with the palm facing up instead of down.

Cortisone injections are often used when treating tennis elbow. If a patient’s pain gets better with one cortisone injection, there is a very good chance that the condition will resolve and surgery will not be needed. If a patient does not improve considerably after an injection and requires multiple injections, it is unlikely that the condition will get better without surgery.

Recently, platelet-rich plasma therapy has been in the news. Separated platelets from a patient’s blood are injected around the tendon in an attempt to encourage healing. Although there is a lot of research about the topic, currently there is no clear evidence that this treatment has higher success than traditional treatments.

The last course of treatment is surgery. The surgery can be performed in the traditional open procedure, in which the abnormal tissue is removed through a small incision. Or the surgery can be performed arthroscopically, in which a few small incisions are made, a camera is inserted, and the abnormal tissue is removed. Although only a small percentage of patients who have tennis elbow require surgery, they typically have good results following surgery.

The best thing for you to do if you start to feel pain on the outside of your elbow after a day of heavy lifting, carrying heavy bags, or even playing tennis is to rest it. Recognizing the pain early on and attempting to modify your activity before it worsens is important.

And remember: Lift with your palms up!

Orthopaedic Associates of Southern Delaware
Offices in Lewes, Millsboro, Milton and Ocean View
302-644-3311