TENNIS ELBOW Q: When I swing my tennis racket, for the back hand get severe pain in my elbow. Why? A: This is a complaint
I consult on frequently. Let’s review the subject. “Tennis elbow” is a term given to a spectrum of symptoms that result from an overuse or improper use the arm. Specifically it results from micro-tears and inflammation in the tendon that connects the extensor muscles of the forearm to the lateral epicondyle, (outer elbow). Any forced extension of the wrist results in pain localized at the lateral elbow. Tennis players and weight lifters, (free weights), often develop this common orthopedic disorder due to repeated stress and overuse. Anatomically tendons are strong, fibrous, band-like structures that connect the muscles to the bones. The contraction of a muscle brings about the direct pulling of the tendon producing a range of motion about a joint. Inflammation of the tendons secondary to overuse is known as
tendonitis. In tennis player this can be sudden or a chronic problem. Most often, in tennis and in any other activity, Tennis elbow occurs due to poor technique, inferior equipment or excessive playing. Evaluation of this problem includes a careful history and physical examination. The findings on physical examination usually provide the
diagnosis. X-rays are rarely necessary. Generally, the diagnosis can be made instantly by watching for facial grimacing when shaking the patient’s hand. Treatment involves rest, cold compresses (initially), non-steroidal anti-inflammatory agents, e.g. ibuprofen, naproxen, and very importantly proper stretching by actively “palmer flexing” at the wrist. Tendonitis recurrence can be reduced through muscle strengthening (after the acute pain has resolved). If a trial period of the above is not sufficient, then physical therapy or well applied corticosteroid injections are very helpful. Good lessons from a certified tennis instructor on how to properly grip the racket and develop a good swing technique is of vital importance. Dr. Luis J. Perez
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