Tennis elbow

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What is a tennis elbow?

Tennis elbow is inflammation or small tears of the tendons joining the forearm muscles to the outside of the elbow. The forearm muscles and tendons become damaged from overuse after repeating the same motions, leading to pain and tenderness on the outside of the elbow. 

 

What causes tennis elbow?

Tennis elbow is most commonly caused by overuse of the elbow. It causes damage to specific forearm muscles and leads to inflammation and pain. As the elbow moves, the muscle rubs against bony bumps. It can cause wear and tear of the muscle over time.

Tennis elbow does not only occur in athletes. Many people with tennis elbow participate in work that requires repetitive and vigorous use of the forearm muscle or wrist extension. In racquet sports like tennis, incorrect stroke technique and equipment are risk factors. Most people who get tennis elbow are middle-aged. However, a person can develop it at any age.

 

Symptoms of tennis elbow

The severity of symptoms varies significantly from patient to patient. For some patients, the symptoms are not constant and may come and go. These include: 

  • Pain in the outer part of your elbow

  • Poor grip strength

  • Pain at night

  • Stiff elbow joint

 

The symptoms worsen with forearm activity. Tennis elbow typically affects your dominant hand where the repetitive movement occurs.

 

When should I seek medical help?

You should consult your doctor if you experience the following:

  • Severe pain, swelling and bruising around the elbow

  • Unable to move your elbow normally

  • Elbow pain does not improve after home care

  • Pain that occurs even when you are resting your arm

  • Increasing redness, swelling or pain in the injured area

 

Diagnosis

To diagnose tennis elbow, your doctor will take your case history and past medical history into account. Then they will perform a physical examination on your elbow and check to see if there is tenderness in your elbow or a deformity. Then, they will measure the range of motion of your elbow and test your arm strength. Specific tests include extending your wrist and fingers against resistance with a straight arm to see if this triggers pain. If it does, there is a high chance of tennis elbow. Your doctor may also examine your wrist, neck, and shoulder to determine if they cause your elbow pain.

 

Other investigations that may help your doctor confirm your diagnosis include ultrasounds or MRIs. Magnetic resonance imaging (MRI) and ultrasound can create better images of soft tissues and reveal small tears or stretched ligaments. They can also show fluid or inflammation in the elbow.

 

Treatment

The goal of treatment is to reduce pain and restore function. Using RICE protocol and other self-care methods can help you recover faster: 

  • Rest. Rest the injured elbow for a few days. Restrict all activities that cause pain in the elbow. 

  • Ice packs: Apply ice bags over the sprained elbow for 15-20 minutes every 2-3 hours.

  • Compression: An elastic compression bandage can wrap and support the elbow to reduce swelling. 

  • Elevation: Keep your sprained elbow elevated. Place a pillow under your arm to elevate your elbow. 

Other non-surgical treatment includes: 

  • Immobilization: A splint can help to stabilise the elbow joint.

  • Medications: Simple painkillers like paracetamol can help control pain. Non-steroidal anti-inflammatory drugs like aspirin, ibuprofen and naproxen can help reduce pain and swelling caused by inflammation.

  • Physical therapy: Strengthen your forearm muscles with exercises.

  • Surgery: Elbow sprains do not require surgery unless severe damage to the elbow or a complete ligament tear.

 

Prevention of tennis elbow

Here are some examples of ways to prevent tennis elbow:

  • Exercise regularly to improve muscle strength.

  • Use proper technique and the right gear during exercises, such as the right grip size for a tennis or golf racket. It can help avoid sports injuries.

  • Always warm up and stretch your muscles before exercising.

  • Stretch to keep your elbow joint mobile.