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Tennis Elbow treatment

What is Tennis Elbow?

Tennis elbow is a painful overuse/degenerative condition of the common tendon of muscles on the outside of the forearm.  These muscles are active in gripping, and cocking the wrist backwards. This degeneration occurs where the tendon joins the arm bone (humerus), just above the outside of the elbow.

What causes it?

Tennis elbow is an overuse injury and is not necessarily caused by racquet sports. Mircrotears in the tendon become inflamed and often do not heal well. Specific treatment will assist healing in the majority of cases.

Treatment

Tennis Elbow treatmentThere are many treatment options. No one treatment is successful for everyone, thus making tennis elbow a frustration for the patient and the treating doctor at times. In our experience treatment options include:

  • Complete rest – this is usually unsatisfactory because a prolonged period may be required and symptoms may return with resumption of activity.
  • Icing and exercises - can be performed at home and is most successful if used in early cases.
  • Physiotherapy - results are sometimes slow.  If a cure is obtained it is more likely to be permanent. Research supports a graded strengthening but this needs to be continued on a regular basis for often more than 3-6 months and if there has been a long period of rest it may be longer.
  • Cortisone injection - has a bad reputation, which is probably undeserved. It relieves pain by relieving inflammation. In most cases it must be combined with an exercise programme to achieve a permanent result. Side effects may be, pain at the injection site for a couple of days and dimpling and pallor of the skin at the injection site. The serious side effects often associated with cortisone are related to intravenous or oral administration and do not result from limited use of local injections.
  • Acupuncture - is successful in some cases. The mechanism by which it works is not fully understood.
  • Surgery - performed by an experienced surgeon and is reserved for very resistant cases, usually present for more than two years. Figures suggest it is about 75% successful.
  • A tennis elbow brace and anti-inflammatory tablets may also be useful.
  • Platelet Rich Plasma Injections - The process involves blood being taken from a patient and spun down in a centrifuge to separate the components. The blood is then re-injected into the patient’s elbow. More information can be found at: http://www.prpinjection.com.au
  • Tennis Elbow Exercises

    1. 1. Stretching
      With arm straight, flex wrist using other hand. Perform 5 times, holding for 20 seconds, to strain not pain, before and after strengthening exercises.
      Stretching
    2. 2. Strengthening
      1. a. Bend wrist back against resistance. This can be from the other hand or using a weight
        Perform 15 repetitions, three times, with one minute between each set of repetitions. Perform these exercises twice a day.
        Bend wrist back
      2. b. Spread fingers apart with an elastic band around them
        Perform 15 repetitions, three times, with one minute between each set of repetitions. Perform these exercises twice a day.
        Spread  fingers
    3. Icing
      Ice the elbow for 15 minutes after exercises.

    Return to Tennis

    • Many recurrent tennis elbows associated with racquet sports are related to poor technique.  A particularly wristy backhand will often precipitate tennis elbow.  Thus coaching may be beneficial.
    • Ensure correct racquet grip size – proximal palmar crease to tip of ring finger, use of larger head size is questionable.
    • Avoid wet or worn balls.
    • Warm up exercises, e.g. 1) and 2a) above, then light hitting with attention paid to correct stroking of the ball, particularly the backhand.
    • Initially less powerful hitting.
    • Gradually increase the amount of tennis.
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