By Lisa Thomas
The website www.health.harvard.edu describes tennis elbow as “the common term for lateral epicondylitis, an inflammatory condition of the tendon that connects the extensor muscles of the lower arm to a bony prominence on the outside of the elbow called the lateral epicondyle. The condition causes pain at the point where the tendon attaches to the epicondyle.”
For most of us who suffer from tennis elbow we describe it as a nuisance and at times a serious pain. It not only gets in the way of us playing a good game but it can show up when we are reaching for groceries in the supermarket or when we grasp someone’s hand to say hello.
It does not seem surprising that as many as half of all people who play a racket sport suffer from tennis elbow. This we can confirm as we look across the net at our doubles opponents and see any number of gadgets attached to at least one of them in an attempt to relieve the strain on their arms. Interestingly enough though, most people suffering from this type of tendon pain didn’t acquire it through playing tennis but rather as a result of some form of repetitive twisting or gripping motion. So our fellow sufferers could be violinists, dentists, gardeners and carpenters.
So what can we do to lessen the pain and reduce the risk of making the condition worse? Apparently Tennis Elbow is referred to as a self-limiting injury which means it is supposed to eventually get better without treatment. But to do that you have to first and foremost rest. Hard to do when all we really want to do is get out there and play, move and enjoy the game with our friends.
The NHS in the UK posted some ideas on recovery and prevention. Here are its top suggestions along with insights from Health.Harvard.edu. You might not like them all but nor do we like the pain and discomfort.
Rest — Tendons heal slowly so tennis elbow can last for weeks or months and in some cases more than a year. The most important thing you can do is rest the injured arm and avoid doing the activity that got you injured in the first place.
Avoid or Modify Activities — If you have tennis elbow then it makes sense to stop doing the activities that put strain on the affected muscles and tendons. It goes beyond tennis. Think about how you use your arms at work or regular tasks at home such as lifting. You may need to avoid these activities until the pain in your arm improves. Alternatively you might have to make modifications to what you do.
Ice — For initial treatment and pain relief apply ice to the epicondyle for 15 to 20 minutes every four to six hours for the first day or so.
Pain Killers — Oral over-the-counter pain relievers (for example ibuprofen, aspirin and acetaminophen) may also help, but because of the risk of side effects, these should not be taken for more than four weeks. Oral pain killers may ease mild pain and reduce inflammation and are best considered on your doctor’s advice.
Physiotherapy – Your doctor may recommend some physiotherapy as a treatment option if you are suffering more severe or persistent pain. A physiotherapist might use manual therapy techniques, such as massage and manipulation to encourage blood flow to your arm. They can also suggest exercises to keep your arm mobile and to strengthen forearm muscles
Orthotics – Some people find it useful to wear an orthotic around the forearm. Orthotics include braces, bands, splints or straps. Orthotics are usually considered a short term remedy.
Corticosteroid Injections – This has been interesting to read about and important to include here because I hear about its use amongst tennis players. Corticosteroids are a type of medication that contain man-made versions of the hormone cortisol. It seems that there is limited clinical evidence to support their use. They may help in the short-term, but their long term effectiveness has been shown to be poor. Much of the research points away from this as an option if you have tennis elbow. The injection may provide immediate relief but the suggestion is not to take that as a go ahead to return to playing tennis and aggravating it even more. Also according to Health.Harvard.edu repeated injections may cause tissue atrophy.
So really it comes down to old fashion rest, ice and, if you can tolerate them, a little bit of over-the-counter pain relief. More painful and persistent treatment is probably best served with medical attention.
About the author: Lisa Thomas is a 25-year communications consultant working globally with multi national high-tech and biotech companies. She is an avid tennis league player and mother of two high school varsity athletes. Lisa graduated from Griffith University in Australia and is now a 20-year resident of La Jolla, California.