Tennis Elbow Proper treatment can get you on the court again By Annette M. Zaharoff, MD
Many people who play sports such as tennis, racquetball, and golf can develop elbow pain. “Tennis elbow” is really an injury to the tendon or epicondyle (attachment site of the tendon to the bone). Anyone who uses their forearm muscles to perform repetitive twisting movements, gripping, and extending of the hand and wrist may develop an injury to the elbow tendons (i.e. carpenters, computer keyboard work). After repetitive use of these muscles, the tendon can become overworked and inflamed producing pain on the outside of the elbow.
A number of factors may predispose someone to this injury.These include:

1. Weak muscles and or muscle imbalance around the shoulder,
elbow, and wrist.

2. Playing excessively in racket sports or using the forearm too
much in everyday activities like the computer.

3. Poor technique –too much wrist action, poor ball control.

4. Improper equipment-incorrect grip size, tight strings, or too
stiff a racket.
Pain is usually located on the outside (thumb side) of the elbow. Initially, pain may be present only during the sport activity. As the injury progresses however, pain may occur with simple activities such as opening a door, lifting a briefcase, and shaking hands.
Treatment begins by modifying your activities to prevent further aggravation of your injury. Ice should be applied three times daily for ten to fifteen minutes. Medication for inflammation may be used. Discuss this with your sports medicine physician. Occasionally, a localized cortisone injection may be necessary for more intense anti-inflammatory effects.
Appropriate physical therapy prescribed by your physician may be very beneficial. A variety of anti-inflammatory treatments may be applied by the therapist. A safe progression into therapeutic exercises for stretching and strengthening the forearm muscles may then be instituted. Your sports medicine will re-evaluate you to determine your treatment steps.
A brace may help to support the tendon area. It may be worn during all activities early on. Later, it may be necessary to wear during your sports activities until your rehabilitation is complete.
When your physician has cleared you to return to your sport, you should start slowly. In tennis, rally for short periods. Take a lesson from your pro to assess your strokes and equipment. Avoid competition until the elbow is completed healed.
If you are experiencing any pain around the elbow, the sooner you find out what is causing it, the sooner you can begin an appropriate treatment plan and get back to the court. For specific questions about your problem, contact your sports medicine physician for help.