Tennis elbow is a type of tendinitis —
swelling of the tendons — that causes pain in the elbow and arm. These
tendons are bands of tough tissue that connect the muscles of your lower
arm to the bone. Despite its name, you can still get tennis elbow even
if you’ve never been near a tennis court. Instead, any repetitive
gripping activities, especially if they use the thumb and first two
fingers, may contribute to tennis elbow. Tennis elbow is the most common
reason that people see their doctors for elbow pain. It can pop up in
people of any age, but it’s most common at about age 40.
Anatomy
Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.
Muscles, ligaments, and tendons hold the elbow joint together.
Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm. Your forearm muscles extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone. They attach on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).
Modified from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003.
The Causes of Tennis Elbow
Tennis elbow usually develops over time. Repetitive motions — like gripping a racket during a swing — can strain the muscles and put too much stress on the tendons. That constant tugging can eventually cause microscopic tears in the tissue.
The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.
Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.
Tennis elbow might result from:
> Tennis
> Racquetball
> Squash
> Fencing
> Weight lifting
It can also affect people with jobs or hobbies that require repetitive arm movements or gripping such as:
> Carpentry
> Typing
> Painting
> Raking
> Knitting
Symptoms of Tennis Elbow
Location of pain in lateral epicondylitis.
Reproduced with permission from Griffen L (ed): Essentials of Musculoskeletal Care, Third Edition. © American Academy of Orthopaedic Surgeons, 2005.
The symptoms of tennis elbow include pain and tenderness in the bony knob on the outside of your elbow. This knob is where the injured tendons connect to the bone. The pain may also radiate into the upper or lower arm. Although the damage is in the elbow, you’re likely to hurt when doing things with your hands.
The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.
Common signs and symptoms of tennis elbow include:
> Pain or burning on the outer part of your elbow
> Weak grip strength
The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or
shaking hands. Your dominant arm is most often affected; however both arms can be affected.
Tennis elbow may cause the most pain when you:
> Lift something
> Make a fist or grip an object, such as a tennis racket
> Open a door or shake hands
> Raise your hand or straighten your wrist
Tennis elbow is similar to another condition called golfer’s elbow, which affects the tendons on the inside of the elbow.
To diagnose your tennis elbow, your doctor will do a thorough exam. He or she will want you to flex your arm, wrist, and elbow to see where it hurts. You may also need imaging tests, such as an X-ray or MRI (magnetic resonance imaging) to diagnose tennis elbow or rule out other problems.
Doctor Examination
Your doctor will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.
Your doctor will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your doctor.
During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.
Tests
Your doctor may recommend additional tests to rule out other causes of your problem.
Treatment for Tennis Elbow
The good news about treatment is that usually tennis elbow will heal on its own. You just need to give your elbow a break and do what you can to speed the healing. Types of treatment that help are:
Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.
Non-steroidal anti-inflammatory medicines. Drugs like aspirin or ibuprofen reduce pain and swelling.
Wrist stretching exercise with elbow extended.
Equipment check. If you participate in a racquet sport, your doctor may encourage you to have your equipment checked for proper fit. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm, which means that the forearm muscles do not have to work as hard. If you use an oversized racquet, changing to a smaller head may help prevent symptoms from recurring.
Physical therapy. Specific exercises are helpful for strengthening the muscles of the forearm. Your therapist may also perform ultrasound, ice massage, or muscle-stimulating techniques to improve muscle healing.
Brace. Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.
Counterforce brace
Steroid injections. Steroids, such as cortisone, are very effective anti-inflammatory medicines. Your doctor may decide to inject your damaged muscle with a steroid to relieve your symptoms.
Extracorporeal shock wave therapy. Shock wave therapy sends sound waves to the elbow. These sound waves create “microtrauma” that promote the body’s natural healing processes. Shock wave therapy is considered experimental by many doctors, but some sources show it can be effective.
Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.
The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs. Talk with your doctor about the options. Discuss the results your doctor has had, and any risks associated with each procedure.
Open surgery. The most common approach to tennis elbow repair is open surgery. This involves making an incision over the elbow.
Open surgery is usually performed as an outpatient surgery. It rarely requires an overnight stay at the hospital.
Arthroscopic surgery. Tennis elbow can also be repaired using tiny instruments and small incisions. Like open surgery, this is a same-day or outpatient procedure.
Surgical risks. As with any surgery, there are risks with tennis elbow surgery. The most common things to
consider include:
> Infection
> Nerve and blood vessel damage
> Possible prolonged rehabilitation
> Loss of strength
> Loss of flexibility
> The need for further surgery
Rehabilitation. Following surgery, your arm may be immobilized temporarily with a splint. About 1 week later, the sutures and splint are removed.
After the splint is removed, exercises are started to stretch the elbow and restore flexibility. Light, gradual strengthening exercises are started about 2 months after surgery.
Your doctor will tell you when you can return to athletic activity. This is usually 4 to 6 months after surgery. Tennis elbow surgery is considered successful in 80% to 90% of patients. However, it is not uncommon to see a loss of strength.
Recovering from Tennis Elbow
Of course, what you really want to know is when you can get back to your regular activities after having tennis elbow. That depends on your individual case and the extent of the damage to the tendon. People heal at different rates.
Whatever you do, don’t rush your recovery. If you start pushing yourself before your tennis elbow is healed, you could make the damage worse. You are ready to return to your former level of activity when:
> Gripping objects or bearing weight on your arm or elbow is no longer painful.
> Your injured elbow feels as strong as your other elbow.
> Your elbow is no longer swollen.
> You can flex and move the elbow without any trouble.
How to Prevent Tennis Elbow
The key to preventing tennis elbow is to avoid overuse. Stop if you feel any elbow pain during an activity.
You may also bring on tennis elbow by using the wrong equipment, like a golf club or tennis racket that is too heavy or that has a grip that is too large. Bad technique — like using the wrong posture for a swing — can also lead to tennis elbow. You should also:
> Stretch and warm up before any sport or activity that will exercise your elbow or arm.
> Ice your elbow after exercise.
Consider surgery if:
> Your elbow is still sore and painful after more than 6 to 12 months of tendon rest and rehab.
> Your doctor has ruled out other possible causes of elbow pain, such as nerve problems, arthritis, muscle injury, or injury to another tendon.
> Your corticosteroid shots have given good short-term pain relief, but the pain has returned.
> You can’t do normal daily activities and job tasks because of elbow pain.
During surgery, a doctor will most likely cut (release) the tendon, remove damaged tissue from the tendon, or both. In some cases, tendon tears can be repaired.
After surgery, rehab is needed to restore flexibility and strength in the forearm.
Tennis Elbow: Should I Have Surgery?
There is no strong medical research that shows that one type of surgery is better than another or that surgery is better than other treatment.
The success of surgery depends in large part on the amount of time and effort you put into a rehab program.
Physical rehab is combined with tendon rest to restore flexibility and build muscle strength. Rehab is needed after surgery too.
Relieving pain.
> Maintaining good overall physical fitness.
> Exercises, including warm-ups , stretching , and strengthening.
> Learning new techniques for certain movements; using equipment that best suits your ability, body size, and strength; and limiting activities that require grasping or twisting arm movements.
> Retraining and ergonomic changes at your work site. For more information, see the topic Office Ergonomics.
Physical rehab combined with tendon rest is the main tennis elbow treatment. Corticosteroid shots are only considered if several weeks of rest and rehab have not reduced symptoms. Surgery may be considered after 6 to 12 months of nonsurgical treatment.
If the type of work you do is causing your injury, an occupational therapist may help you change how you are working or the kind of work that you do.
Wrist flexor stretch
Extend your arm in front of you with your palm up.
1. Bend your wrist, pointing your hand toward the floor.
2. With your other hand, gently bend your wrist further until you feel a mild to moderate stretch in your forearm.
3. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.
Wrist extensor stretch
1. Repeat steps 1 to 4 of the stretch above, but begin with your extended hand palm down.
Ball or sock squeeze
1. Hold a tennis ball (or a rolled-up sock) in your hand.
2. Make a fist around the ball (or sock) and squeeze.
3. Hold for about 6 seconds, then relax for up to 10 seconds.
Repeat 8 to 12 times.
4. Switch the ball (or sock) to your other hand and do 8 to 12 times.
Wrist deviation
1. Sit so that your arm is supported but your hand hangs off the edge of a flat surface, such as a table.
2. Hold your hand out like you are shaking hands with someone.
3. Move your hand up and down.
4. Repeat this motion 8 to 12 times.
5. Switch arms.
6. Try to do this exercise twice with each hand.
Wrist curls
1. Place your forearm on a table with your hand hanging over the edge of the table, palm up.
2. Place a 1- to 2-pound weight in your hand. This may be a dumbbell, a can of food, or a filled water bottle.
3. Slowly raise and lower the weight while keeping your forearm on the table and palm facing up.
4. Repeat this motion 8 to 12 times.
5. Switch arms, and do steps 1 through 4.
6. Repeat with your hand facing down toward the floor. Switch arms.
Biceps curls
1. Sit leaning forward with your legs slightly spread and your left hand on your left thigh.
2. Place your right elbow on your right thigh, and hold the weight with your forearm horizontal.
3. Slowly curl the weight up and toward your chest.
4. Repeat this motion 8 to 12 times.
5. Switch arms, and do steps 1 through 4.
The first group is anyone involved with athletics such as tennis players, golfers, cricket players, volleyball players, baseball players, football players, bowlers, lacrosse players or any other sport that involves using equipment that requires using a tight grip on an object.
The second group of people is anyone involved in manual labor or blue collar work. These individuals tend to use their arms a lot performing repetitive task over an extended period of time. The constant gripping and squeezing causes extreme pressure and strain on the extensor tendon. It eventually tears and this is when you feel pain in your elbow.
So how do you properly and fully recover from tennis elbow? Most people take a little time away from their sport or activity but their symptoms usually come back just when they thought they had this injury under control.
It does not even take that long. Sometimes, after just a few months, the pain returns. This is the truth: if you do not seek the right kind of treatment, the condition can seem rather irreversible. If you seriously want to get some relief, you need to make a commitment to never give in to this terrible injury.
Of course many people resort to taking anti-inflammatory pills and pain medication but the problem with this is that you have to take the pills every 3-4 hours and they do nothing to address the root cause of your injury.
What about elbow braces? To be honest, all these devices do is give you a “feeling” of support but instead of making your injured tendons and muscles stronger, they actually make them weaker!
There is no magic pill you can take to cure this injury. Unfortunately far too many people choose to ignore their symptoms until it gets so bad that a complete tear occurs and they have to undergo surgery.
It’s important that you look for the following signs:
> Tightness and stiffness in your arm. You may discover that your arm is hard to straighten fully – especially early in the morning.
> As the tear gets larger in your tendon, you may notice some swelling and inflammation. It’s important that you apply to ice if you notice inflammation and swelling. Do this at least twice a day for 10-15 minutes.
> And thirdly, if your elbow pain gets worse when you make a fist or even when you shake hands with someone, then you could be suffering from chronic tennis elbow.
So how can you completely recover from tennis elbow so it never comes back?
It involves just 5 simple steps that you can do at home, without the need for any exercise equipment or expensive medical gadgets.
Simply click here to see a video that will reveal these 5 easy steps to you, so you can get started in eliminating your tennis elbow right now!
Geoff Hunt is a Certified Personal Fitness Trainer and Exercise Rehab Specialist from Vancouver, Canada. He suffered from tennis elbow for 7 years but cured it on his own from home.
To learn more, watch this free presentation to Discover how to eliminate tennis elbow in as little as 72 hours from the comfort of home.
Answer: Yes, there are a number of excellent anti-inflammatory herbs. The 3 most important are:
* Turmeric (Curcuma longa): Turmeric accounts for the yellow color of curry and American mustard and has a specific sharp often bitter flavor.
Turmeric can be used for many inflammatory disorders such as:
– arthritis
– tendonitis
– auto immune conditions.
Many doctors and health professionals usually recommend taking 400 to 600 milligrams of turmeric tablets/capsules 3X per day or you can follow the instructions on the product label.
If you can get whole turmeric it has been proven to be more effective than isolated curcumin. Seek out curmumin that is made up of 95% curcuminoids.
It is not uncommmon for the full benefits of curcumin to take effect It can take up to 2 months for the full effects of taking curcumin to run its course and gain control of your inflammation and swelling.
Warning: If you suffer from gallstones or bile duct dysfunction do not consume curcumin. Also, pregnant women shouldn’t use it without the consent of their family doctor.
* Ginger: Powdered dry ginger is an excellent anti-inflammatory. Take one to two capsules (500 to 1,000 mg) twice a day with food.
As with turmeric, you won’t get the full effect for about two months.
* Boswellin: This is the extract of the herb Boswellia, used in Ayurvedic medicine and available in capsule form.
It may be useful for generalized inflammatory conditions such as fibromyalgia. The dosage is two capsules twice a day unless the product label directs differently.
You can take all of these herbs in combination.
Many herbs also contain antiphlogistic characteristics. Many herbs can be used as the sole or supplementary therapy in auto-immune diseases or as complementary corticosteriod therapies which allow sufferers to ingest smaller doses or shorter rounds of corticosteroids. It’s not uncommon in today’s day and age to various treatment methods to involve both alternative and conventional treatment options which is sometimes referred to as integrative medicine.
I highly recommend you get off the ibuprofen ASAP, as the side effects to taking it on a daily could potentially, in the long run, be dangerous to your health. Remember if you are looking for more information tennis elbow, be sure to check out the internet’s #1 selling treatment system for relief of tennis elbow – http://TennisElbowTips.com/
Source: http://treatmenttenniselbow.com/tennis-elbow-lateral-epicondylitis
Anatomy
Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.
Muscles, ligaments, and tendons hold the elbow joint together.
Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm. Your forearm muscles extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone. They attach on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).
Modified from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003.
The Causes of Tennis Elbow
Tennis elbow usually develops over time. Repetitive motions — like gripping a racket during a swing — can strain the muscles and put too much stress on the tendons. That constant tugging can eventually cause microscopic tears in the tissue.
Overuse
Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.
Activities
Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle.Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.
Age
Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.Tennis elbow might result from:
> Tennis
> Racquetball
> Squash
> Fencing
> Weight lifting
It can also affect people with jobs or hobbies that require repetitive arm movements or gripping such as:
> Carpentry
> Typing
> Painting
> Raking
> Knitting
Symptoms of Tennis Elbow
Location of pain in lateral epicondylitis.
Reproduced with permission from Griffen L (ed): Essentials of Musculoskeletal Care, Third Edition. © American Academy of Orthopaedic Surgeons, 2005.
The symptoms of tennis elbow include pain and tenderness in the bony knob on the outside of your elbow. This knob is where the injured tendons connect to the bone. The pain may also radiate into the upper or lower arm. Although the damage is in the elbow, you’re likely to hurt when doing things with your hands.
The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.
Common signs and symptoms of tennis elbow include:
> Pain or burning on the outer part of your elbow
> Weak grip strength
The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or
shaking hands. Your dominant arm is most often affected; however both arms can be affected.
Tennis elbow may cause the most pain when you:
> Lift something
> Make a fist or grip an object, such as a tennis racket
> Open a door or shake hands
> Raise your hand or straighten your wrist
Tennis elbow is similar to another condition called golfer’s elbow, which affects the tendons on the inside of the elbow.
To diagnose your tennis elbow, your doctor will do a thorough exam. He or she will want you to flex your arm, wrist, and elbow to see where it hurts. You may also need imaging tests, such as an X-ray or MRI (magnetic resonance imaging) to diagnose tennis elbow or rule out other problems.
Doctor Examination
Your doctor will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.
Your doctor will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your doctor.
During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.
Tests
Your doctor may recommend additional tests to rule out other causes of your problem.
X-rays
These may be taken to rule out arthritis of the elbow.Magnetic Resonance Imaging (MRI)
If your doctor thinks your symptoms are related to a neck problem, an MRI scan may be ordered. This will help your doctor see if you have a possible herniated disk or arthritis in your neck. Both of these conditions often produce arm pain.Electromyography (EMG)
Your doctor may order an EMG to rule out nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of tennis elbow.Treatment for Tennis Elbow
The good news about treatment is that usually tennis elbow will heal on its own. You just need to give your elbow a break and do what you can to speed the healing. Types of treatment that help are:
> Nonsurgical Treatment
Approximately 80% to 95% of patients have success with nonsurgical treatment.Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.
Non-steroidal anti-inflammatory medicines. Drugs like aspirin or ibuprofen reduce pain and swelling.
Wrist stretching exercise with elbow extended.
Equipment check. If you participate in a racquet sport, your doctor may encourage you to have your equipment checked for proper fit. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm, which means that the forearm muscles do not have to work as hard. If you use an oversized racquet, changing to a smaller head may help prevent symptoms from recurring.
Physical therapy. Specific exercises are helpful for strengthening the muscles of the forearm. Your therapist may also perform ultrasound, ice massage, or muscle-stimulating techniques to improve muscle healing.
Brace. Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.
Counterforce brace
Steroid injections. Steroids, such as cortisone, are very effective anti-inflammatory medicines. Your doctor may decide to inject your damaged muscle with a steroid to relieve your symptoms.
Extracorporeal shock wave therapy. Shock wave therapy sends sound waves to the elbow. These sound waves create “microtrauma” that promote the body’s natural healing processes. Shock wave therapy is considered experimental by many doctors, but some sources show it can be effective.
>Surgical Treatment
If your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.
The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs. Talk with your doctor about the options. Discuss the results your doctor has had, and any risks associated with each procedure.
Open surgery. The most common approach to tennis elbow repair is open surgery. This involves making an incision over the elbow.
Open surgery is usually performed as an outpatient surgery. It rarely requires an overnight stay at the hospital.
Arthroscopic surgery. Tennis elbow can also be repaired using tiny instruments and small incisions. Like open surgery, this is a same-day or outpatient procedure.
Surgical risks. As with any surgery, there are risks with tennis elbow surgery. The most common things to
consider include:
> Infection
> Nerve and blood vessel damage
> Possible prolonged rehabilitation
> Loss of strength
> Loss of flexibility
> The need for further surgery
Rehabilitation. Following surgery, your arm may be immobilized temporarily with a splint. About 1 week later, the sutures and splint are removed.
After the splint is removed, exercises are started to stretch the elbow and restore flexibility. Light, gradual strengthening exercises are started about 2 months after surgery.
Your doctor will tell you when you can return to athletic activity. This is usually 4 to 6 months after surgery. Tennis elbow surgery is considered successful in 80% to 90% of patients. However, it is not uncommon to see a loss of strength.
Recovering from Tennis Elbow
Of course, what you really want to know is when you can get back to your regular activities after having tennis elbow. That depends on your individual case and the extent of the damage to the tendon. People heal at different rates.
Whatever you do, don’t rush your recovery. If you start pushing yourself before your tennis elbow is healed, you could make the damage worse. You are ready to return to your former level of activity when:
> Gripping objects or bearing weight on your arm or elbow is no longer painful.
> Your injured elbow feels as strong as your other elbow.
> Your elbow is no longer swollen.
> You can flex and move the elbow without any trouble.
How to Prevent Tennis Elbow
The key to preventing tennis elbow is to avoid overuse. Stop if you feel any elbow pain during an activity.
You may also bring on tennis elbow by using the wrong equipment, like a golf club or tennis racket that is too heavy or that has a grip that is too large. Bad technique — like using the wrong posture for a swing — can also lead to tennis elbow. You should also:
> Stretch and warm up before any sport or activity that will exercise your elbow or arm.
> Ice your elbow after exercise.
Tennis Elbow Surgery
Most cases of tennis elbow are treated without surgery. Less than 5 out of 100 cases require surgery. You and your doctor might consider surgery if several months of tendon rest and rehabilitation (rehab) haven’t stopped the pain or returned the flexibility and strength to your forearm.Consider surgery if:
> Your elbow is still sore and painful after more than 6 to 12 months of tendon rest and rehab.
> Your doctor has ruled out other possible causes of elbow pain, such as nerve problems, arthritis, muscle injury, or injury to another tendon.
> Your corticosteroid shots have given good short-term pain relief, but the pain has returned.
> You can’t do normal daily activities and job tasks because of elbow pain.
During surgery, a doctor will most likely cut (release) the tendon, remove damaged tissue from the tendon, or both. In some cases, tendon tears can be repaired.
After surgery, rehab is needed to restore flexibility and strength in the forearm.
Tennis Elbow: Should I Have Surgery?
Surgery choices
Surgery for tennis elbow involves cutting (releasing) the tendon and removing damaged tissue from the tendon. In some cases, tendon tears are repairable (reattached) if the repair can be done without overtightening the tendon. These procedures can be done both arthroscopically and through a larger incision (open surgery) or with a combination of the two techniques.What to think about
There are different approaches to surgery for tennis elbow, such as where to enter the elbow and what type of reconstruction or repair on the tendon is done. Surgical technique is determined by the type, location, and severity of the injury and by the doctor’s preference and experience.There is no strong medical research that shows that one type of surgery is better than another or that surgery is better than other treatment.
The success of surgery depends in large part on the amount of time and effort you put into a rehab program.
Other Treatment
Other treatment for tennis elbow pain includes physical rehabilitation (rehab), acupuncture, topical nitric oxide, shock wave therapy, and transcutaneous electrical nerve stimulation (TENS).Physical rehab is combined with tendon rest to restore flexibility and build muscle strength. Rehab is needed after surgery too.
Other treatment choices
A physical rehab program includes:Relieving pain.
> Maintaining good overall physical fitness.
> Exercises, including warm-ups , stretching , and strengthening.
> Learning new techniques for certain movements; using equipment that best suits your ability, body size, and strength; and limiting activities that require grasping or twisting arm movements.
> Retraining and ergonomic changes at your work site. For more information, see the topic Office Ergonomics.
Complementary or alternative medicine treatments
Complementary or alternative treatments are sometimes used along with traditional therapy to treat tennis elbow. Although there is no solid scientific evidence that these therapies relieve pain and restore elbow flexibility and strength, some people report them as helpful. Complementary or alternative treatments may include:- Acupuncture. Small studies report tennis elbow relief after acupuncture treatment. But there is not enough strong evidence to support or refute this treatment.
- Topical nitric oxide. In a patch form, nitric oxide is applied to the elbow to speed recovery. This medicine has been used as a treatment for tennis elbow for a short time. One study showed positive results.
- Transcutaneous electrical nerve stimulation (TENS). TENS is sometimes used to treat tennis elbow, usually in a physical therapy setting.
- Extracorporeal shock wave therapy. A review of shock wave therapy for tennis elbow had conflicting findings. Some studies reported that shock wave therapy improved tennis elbow recovery. But others found that it offered no therapeutic benefit when compared to placebo treatment.
What to think about
A physical rehab program not only helps heal injured tendons and muscles but also helps prevent further injury.Physical rehab combined with tendon rest is the main tennis elbow treatment. Corticosteroid shots are only considered if several weeks of rest and rehab have not reduced symptoms. Surgery may be considered after 6 to 12 months of nonsurgical treatment.
If the type of work you do is causing your injury, an occupational therapist may help you change how you are working or the kind of work that you do.
Wrist flexor stretch
Extend your arm in front of you with your palm up.
1. Bend your wrist, pointing your hand toward the floor.
2. With your other hand, gently bend your wrist further until you feel a mild to moderate stretch in your forearm.
3. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.
Wrist extensor stretch
1. Repeat steps 1 to 4 of the stretch above, but begin with your extended hand palm down.
Ball or sock squeeze
1. Hold a tennis ball (or a rolled-up sock) in your hand.
2. Make a fist around the ball (or sock) and squeeze.
3. Hold for about 6 seconds, then relax for up to 10 seconds.
Repeat 8 to 12 times.
4. Switch the ball (or sock) to your other hand and do 8 to 12 times.
Wrist deviation
1. Sit so that your arm is supported but your hand hangs off the edge of a flat surface, such as a table.
2. Hold your hand out like you are shaking hands with someone.
3. Move your hand up and down.
4. Repeat this motion 8 to 12 times.
5. Switch arms.
6. Try to do this exercise twice with each hand.
Wrist curls
1. Place your forearm on a table with your hand hanging over the edge of the table, palm up.
2. Place a 1- to 2-pound weight in your hand. This may be a dumbbell, a can of food, or a filled water bottle.
3. Slowly raise and lower the weight while keeping your forearm on the table and palm facing up.
4. Repeat this motion 8 to 12 times.
5. Switch arms, and do steps 1 through 4.
6. Repeat with your hand facing down toward the floor. Switch arms.
1. Sit leaning forward with your legs slightly spread and your left hand on your left thigh.
2. Place your right elbow on your right thigh, and hold the weight with your forearm horizontal.
3. Slowly curl the weight up and toward your chest.
4. Repeat this motion 8 to 12 times.
5. Switch arms, and do steps 1 through 4.
Can You Ever Fully Recover From Tennis Elbow?
There are certain groups of individuals who are considered “high risk” when it comes to developing tennis elbow.The first group is anyone involved with athletics such as tennis players, golfers, cricket players, volleyball players, baseball players, football players, bowlers, lacrosse players or any other sport that involves using equipment that requires using a tight grip on an object.
The second group of people is anyone involved in manual labor or blue collar work. These individuals tend to use their arms a lot performing repetitive task over an extended period of time. The constant gripping and squeezing causes extreme pressure and strain on the extensor tendon. It eventually tears and this is when you feel pain in your elbow.
So how do you properly and fully recover from tennis elbow? Most people take a little time away from their sport or activity but their symptoms usually come back just when they thought they had this injury under control.
It does not even take that long. Sometimes, after just a few months, the pain returns. This is the truth: if you do not seek the right kind of treatment, the condition can seem rather irreversible. If you seriously want to get some relief, you need to make a commitment to never give in to this terrible injury.
Of course many people resort to taking anti-inflammatory pills and pain medication but the problem with this is that you have to take the pills every 3-4 hours and they do nothing to address the root cause of your injury.
What about elbow braces? To be honest, all these devices do is give you a “feeling” of support but instead of making your injured tendons and muscles stronger, they actually make them weaker!
There is no magic pill you can take to cure this injury. Unfortunately far too many people choose to ignore their symptoms until it gets so bad that a complete tear occurs and they have to undergo surgery.
It’s important that you look for the following signs:
> Tightness and stiffness in your arm. You may discover that your arm is hard to straighten fully – especially early in the morning.
> As the tear gets larger in your tendon, you may notice some swelling and inflammation. It’s important that you apply to ice if you notice inflammation and swelling. Do this at least twice a day for 10-15 minutes.
> And thirdly, if your elbow pain gets worse when you make a fist or even when you shake hands with someone, then you could be suffering from chronic tennis elbow.
So how can you completely recover from tennis elbow so it never comes back?
It involves just 5 simple steps that you can do at home, without the need for any exercise equipment or expensive medical gadgets.
Simply click here to see a video that will reveal these 5 easy steps to you, so you can get started in eliminating your tennis elbow right now!
Geoff Hunt is a Certified Personal Fitness Trainer and Exercise Rehab Specialist from Vancouver, Canada. He suffered from tennis elbow for 7 years but cured it on his own from home.
To learn more, watch this free presentation to Discover how to eliminate tennis elbow in as little as 72 hours from the comfort of home.
Natural Anti Inflammatory Options For Tennis Elbow Treatment
I routinely receive emails from tennis elbow sufferers, and one of the most common inquiries I receive is, Geoff – if anti-inflammatories are so bad for me and they only mask my tennis elbow pain, Are there any Herbs that I can take that acts as an anti-inflammatory instead of taking ibuprofen?
Answer: Yes, there are a number of excellent anti-inflammatory herbs. The 3 most important are:
* Turmeric (Curcuma longa): Turmeric accounts for the yellow color of curry and American mustard and has a specific sharp often bitter flavor.
Turmeric can be used for many inflammatory disorders such as:
– arthritis
– tendonitis
– auto immune conditions.
Many doctors and health professionals usually recommend taking 400 to 600 milligrams of turmeric tablets/capsules 3X per day or you can follow the instructions on the product label.
If you can get whole turmeric it has been proven to be more effective than isolated curcumin. Seek out curmumin that is made up of 95% curcuminoids.
It is not uncommmon for the full benefits of curcumin to take effect It can take up to 2 months for the full effects of taking curcumin to run its course and gain control of your inflammation and swelling.
Warning: If you suffer from gallstones or bile duct dysfunction do not consume curcumin. Also, pregnant women shouldn’t use it without the consent of their family doctor.
* Ginger: Powdered dry ginger is an excellent anti-inflammatory. Take one to two capsules (500 to 1,000 mg) twice a day with food.
As with turmeric, you won’t get the full effect for about two months.
* Boswellin: This is the extract of the herb Boswellia, used in Ayurvedic medicine and available in capsule form.
It may be useful for generalized inflammatory conditions such as fibromyalgia. The dosage is two capsules twice a day unless the product label directs differently.
You can take all of these herbs in combination.
Many herbs also contain antiphlogistic characteristics. Many herbs can be used as the sole or supplementary therapy in auto-immune diseases or as complementary corticosteriod therapies which allow sufferers to ingest smaller doses or shorter rounds of corticosteroids. It’s not uncommon in today’s day and age to various treatment methods to involve both alternative and conventional treatment options which is sometimes referred to as integrative medicine.
I highly recommend you get off the ibuprofen ASAP, as the side effects to taking it on a daily could potentially, in the long run, be dangerous to your health. Remember if you are looking for more information tennis elbow, be sure to check out the internet’s #1 selling treatment system for relief of tennis elbow – http://TennisElbowTips.com/
Source: http://treatmenttenniselbow.com/tennis-elbow-lateral-epicondylitis
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