Tennis Elbow
A condition where pain is experienced on the outside of the elbow where the muscles (tendons) of the wrist and forearm attach to a bony prominence of the elbow. Pain or tenderness is experienced due to the overuse of the forearm and wrist muscles.
The condition occurs in athletes as the name suggests, but is also common in people whose jobs/activities require repetitive movements that place strain on the muscles of the wrist and forearm where they insert at elbow level.
Due to continuous strain, inflammation occurs in the tendons resulting in pain on the outside of the elbow. Small tears can form in the tendon where it attaches to the bony prominence of the elbow.
Pain may radiate from the elbow into the forearm, making it difficult for a person to participate in activities like opening bottles and jars, shaking hands, opening doors and holding light objects.
Causes
It is common in tennis and other racquet sport players, but can occur in any profession where the muscles are under continuous strain and stress. Other professions that commonly suffer from tennis elbows include: painters, butchers, carpenters and plumbers.
Tennis elbow symptoms
- Pain/tenderness on the outside of the elbow
- Exaggeration of elbow pain when lifting the hand up or grasping and releasing objects
- Elbow stiffness in the morning with aching at night
- Inability to straighten fingers actively
- Pain in forearm muscles
Treatment options
Conservative management may be indicated by the treating doctor if the condition has not progressed too far. If the symptoms are persistent and cause functional limitations, surgery may be indicated.
Conservative treatment
The tennis elbow may be injected with cortisone by an orthopedic surgeon to reduce the inflammation.
Splinting
Splinting the wrist in extension or the elbow in flexion to rest the tendons and reduce the strain on the insertion of the inflamed muscles and tendons. This is usually more successful when accompanied by a cortisone injection from your referring doctor.
Surgical management
During surgery an incision is made over the elbow where the inflamed (instead of damaged) parts of the tendon are cleaned by removing any damaged tissue.
Post-operative management
- You will be immobilized in a post-operative dressing for 8 – 14 days.
- Your stitches may be either dissolvable or the doctor will remove them after 10-14 days.
- Although your post-operative dressing is removed after 8 – 14 days you are not allowed to lift any heavy weights or start using your hand or wrist in any strenuous tasks. Care should be taken to perform light functional tasks within pain limits for the first 4- 6 weeks after surgery.
- When your post-operative dressings are removed you may receive a splint to support the wrist and prevent strain on the muscles that straighten the wrist and hand. Your surgeon may also refer you to your hand therapist for a splint that allows elbow movement within safe limits.
Post-operative management
Aims of hand therapy
- Management of swelling and wound care.
- Splinting the wrist in extension to prevent strain on the muscles that straighten/lift the hand and wrist to allow adequate time for healing.
- Mobilisation of the wrist and elbow.
- Scar management.
After tennis elbow surgery patients may be followed up in hand therapy 4 – 5 times. Follow up appointments may vary from person to person depending on tissue healing and progress made in therapy.
*The above text is for information purposes only and should not be seen as health advice. Please consult with your medical practitioner should you require health advice or medical treatment.
After 6 weeks post-surgery the splint is removed and normal functional tasks may be resumed within pain limits. Return to sport activities that caused the condition, may only be possible after 3 – 6 months post-surgery.