A common medical condition with a very ironic name is ‘tennis elbow.’ The majority of patients diagnosed with this problem respond with surprise and a denial that they don’t even play tennis!
Officially called lateral epicondylitis, tennis elbow is the common term for the result of overusing the tendons in the forearm muscles that are found on the outside of your elbow. Because these muscles are most often used to make movements similar to those performed in tennis, the nickname was coined and stuck around to this day.
Racquet sports and activities that involve repetitive motions of the elbow can, over time, develop into tennis elbow. It’s a painful condition that limits your movements, but you don’t have to suffer for long. There are a lot of treatments you can do at home and with a physical therapist to help reduce the symptoms that go along with tennis elbow.
What is Tennis Elbow, Exactly?
To understand what’s going on below the surface of your skin and causing your pain, you have to learn a little about the anatomy of your elbow.
The elbow joint consists of three bones that work together to bend. These are your humerus, or upper arm bone, and your radius and ulna, the two bones in your forearm. The epicondylitis term of your diagnosis gets its name from the bony bumps you feel at the bottom of your humerus, or epicondyles. The one on the outside of the elbow is your lateral epicondyle – the site of the problem.
Your bones connect through the joint, but there is a complex system of muscles, ligaments, and tendons that work together to keep that joint functioning flexibly. When the muscles and tendons work too hard, they can become inflamed or overextended.
The forearm’s muscles and tendons connect to the lateral epicondyles to attach the muscles to your bone. These are called extensors, and it’s the Extensor Carpi Radialis Brevis (ECRB) that is usually the culprit in tennis elbow pain.
What Could be Causing My Tennis Elbow Pain?
While you don’t have to play tennis to end up with tennis elbow, visualizing the typical racquet movement might help you to pinpoint what it is you’ve been doing to overuse the muscles.
Tennis elbow is usually caused by damage to the ECRB muscle, which is used by your arm to keep your wrist stable when you straighten your elbow, like in the event of a tennis swing. Overusing this muscle creates tiny tears in the tendon attached to the lateral epicondyle. You probably won’t feel those tears right away, but over time, they will become inflamed and painful.
The science of erosion comes into play with these repetitive motions, too. The ECRB muscle is located in a sensitive position. Every time you bend and straighten your elbow, the muscle is pushed against those bumps in your arm.
This rubbing away eventually erodes the muscle and causes wear and tear. If you don’t do it frequently, your body can repair itself, but if it’s not given a break, that constant erosion becomes painful.
Causes of Tennis Elbow Pain
The damage from tennis elbow can happen even if you’re not an athlete. If your occupation or a hobby you have involves repetitive motion of the forearm muscle, you might find yourself with this condition eventually.
Some of the top causes of tennis elbow include:
- Jobs that require repetitive use of the forearm, like painters, cooks, or carpenters
- Your age, with the risk factor increasing for those between 30 and 50, likely because they participate in those repetitive motions without thinking about the consequences
- Athletic sports with repetitive motions, such as tennis, badminton, squash, javelin, and discus throwing
But sometimes this condition happens with no known reason. You may develop lateral epicondylitis without having a history of repetitive motions. When this happens, it’s considered to be insidious tennis elbow.
What are the Symptoms of Tennis Elbow?
In most cases, tennis elbow comes on gradually and you may not notice it as more than a mild irritation. Over weeks, sometimes months, the pain becomes worse until you can’t ignore it anymore.
Tennis elbow is almost always characterized by two main signs: a feeling of burning or significant pain on the outside of your elbow, and a loss of strength in your grip. When you use your forearm muscles, these symptoms probably worsen.
You may even notice that your hands shake when you try to do anything, even something as simple as holding a cup.
How is Tennis Elbow Diagnosed?
The signs of tennis elbow are similar to other conditions, like arthritis. Before your doctor settles on tennis elbow as a diagnosis, they may require you to have other tests first.
X-rays may be ordered to rule out arthritis in your elbow that could be causing the pain. If the pain is radiating from your neck, an MRI may be required to make sure there is not a problem like a herniated disc or another spinal issue causing the pain.
EMGs, or electromyography tests, are a common way to rule out compression on the nerves that could be the reason behind your symptoms. A diagnostic ultrasound is used to diagnose tennis elbow if the machine is available in your area.
All of these tests are customary methods of ruling out problems and diagnosing tennis elbow.
How is Tennis Elbow Treated?
The majority of patients diagnosed with tennis elbow are able to manage their conditions and recover without surgery. Your physician may recommend a combination of treatments such as:
- Resting the arm, particularly making sure to avoid using the forearm muscles, even if it means you have to stay out of activities or work for a few weeks
- Anti-inflammatory medications, non-steroidal, to reduce pain and swelling
- Physical therapy exercises performed by a licensed therapist who can monitor your usage and improvement, including modalities like ultrasound, ice application, and muscle-stimulation
- A brace to keep the forearm in place and allow the muscles and tendons to rest
If the pain continues to be severe and debilitating after a course of medication and physical therapy, surgical treatment may be your next option.
What is Involved in Surgery for Tennis Elbow?
Surgery is never the first option unless it’s an emergency. You may have to seek nonsurgical avenues of therapy for anywhere between six and twelve months before you’re considered to be a candidate for surgical intervention with tennis elbow.
There are a few different types of surgery that can resolve this problem for you, and most of them involve removing the diseased and atrophied muscle and reattaching a healthy muscle to the bone instead. The surgical procedure that is right for your condition will be decided by the surgeon based on the scope of the injury and your overall general health.
One of the most popular surgical options for tennis elbow is the F.A.S.T. Procedure. F.A.S.T. stands for focused aspiration of scar tissue. It’s an innovative, minimally invasive procedure that was originally developed through collaboration with the Mayo Clinic and then used for tennis elbow correction.
In the F.A.S.T. procedure, the tendon scar tissue is removed, and all the healthy surrounding tendon tissue is left undisturbed.
The surgery itself takes only about twenty minutes under a numbing local anesthesia, and recovery is usually fast. Many patients are able to go back to their regular activities the next day, with certain restrictions.
Diagnosed with Tennis Elbow? We Can Help!
If your physician has diagnosed you with tennis elbow, part of your treatment will include physical therapy. For those in the Chicago area, PhyxMe Physical Therapy and Chiropractic is the go-to place for all things spinal and muscular!
Call to schedule your appointment to see how we can help you recover from tennis elbow with conservative treatment and specialized care.