Summer is now upon us, and one of the most popular summer recreational sports for people is tennis. Tennis is fun, social, and relatively inexpensive – all you need is a pair of sneakers, a racket, and a ball! Unfortunately, along with tennis comes a myriad of possible injuries - one of which is tennis elbow. Tennis elbow, or lateral epicondylitis/epicondylosis/epicondylopathy, is a term for describing an overuse injury to the muscles on the outside of the forearm that results in elbow pain. Typically, people will get tennis elbow in their dominant arm, but it can also occur in both arms or in the non dominant arm. Because “tennis elbow” is a common term to describe an injury, many people can be given this diagnosis without ever having lifted a tennis racket! In fact, less than 5% of tennis elbow diagnoses are strictly related to playing tennis. Anyone who performs frequent or repetitive arm, elbow, and wrist motions (such as assembly line workers, carpenters, electricians, athletes, golfers, bowlers, gardeners, or house/office cleaners) can be subject to getting this injury. Here is what you need to know about tennis elbow.

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   Symptoms of tennis elbow include pain that slowly increases at the outer aspect of the elbow, pain that increases with gripping activities – for example, opening jars, turning doorknobs, shaking hands, or writing, and pain with activities that involve using the arm with force (such as lifting or hitting a backhand shot in tennis). Pain can be reproduced by pressing on the muscles on the outside of the elbow. It was commonly believed until recently that the tendons on the outside of the elbow were inflamed and therefore painful (and thusly given the name “lateral epicondylitis”). However, recent research has demonstrated that there may actually be no inflammation present in the tendons and instead is more related to a degenerative process and repetitive use, and the names “lateral epicondylosis” and “lateral epicondylopathy” have been used more frequently to accurately describe the condition. Regardless of the name, your elbow hurts and you want to know where to go and what to do about your elbow pain.

   A diagnosis of tennis elbow is not made by blood tests or x-rays – in fact, x-rays performed on patients with tennis elbow are almost always normal! Instead, a diagnosis of tennis elbow is made by a doctor’s physical examination. Keep in mind that many other conditions may masquerade as elbow pain and a thorough examination by an orthopedic specialist is imperative in correctly diagnosing this condition.

   Tennis elbow is generally successfully treated by physical therapy. Typically, a physical therapist will tell you to rest the elbow and/or purchase a tennis elbow brace – also called a counter-force brace (which will put gentle pressure on the painful muscle in order to decrease pain with activity), perform massage, use ice, and instruct you in specific stretching and strengthening exercises. However, the real nitty-gritty of the treatment will be up to the physical therapist’s expertise. Physical therapy can significantly decrease your pain and get you back to pain-free activity much more quickly than forgoing treatment. Your doctor may prescribe medication or prescribe injections; however, this is up to the discretion of your physician and depending on your medical status and the severity of the condition may or may not be beneficial in the treatment of tennis elbow.

   After your tennis elbow heals, prevention of future injury will be paramount to avoiding this injury in the future. Using proper equipment, wearing your brace, performing the exercises as prescribed by your physical therapist, icing your elbow and resting when your elbow is sore can significantly reduce your risk of another episode of tennis elbow. Approximately 90% of patients recover with conservative treatment; however, for those who do not recover, surgical intervention is an option that your orthopedist will discuss with you.

   The take home message is this: enjoy being active this summer! If you should notice a nagging elbow pain, see your doctor and start treatment as soon as possible. With the right program, you will be back in the groove in no time!

--Allison Gibb, DPT