Give Tennis the Elbow
Published 23 June 2014
Wimbledon 2014 will be without the Ladies British number 1 due to injury whilst last year’s championship suffered the most injury hit second round in its history.
It wouldn’t sound unreasonable to presume that a number of tennis players may have had their seasons or championships effected by struggling from the well known condition “tennis elbow”.
However, as it happens, “tennis elbow” is a relatively uncommon condition suffered by regular tennis players. The term “tennis elbow” was first used in a medical paper back in 1883 when a painful outer elbow injury was termed “lawn tennis elbow”.
The problems is caused by damage of an elbow tendon which was thought to be due to inflammation of the tendon causing the pain but nowadays the latest medical thinking is that the problem is more due to wear and tear of the tendon than actual inflammation. Any repetitive movements of the elbow can cause the condition and the person doesn’t have to spend as much time as Björn Borg on the court to suffer it’s disabling pain. Tendon problems remain one of the most difficult and frustrating conditions to suffer and treat within the field of sports medicine, whether it be an Achilles tendon, patella tendon (knee) or tennis elbow problem. Despite these conditions being common within the athletic and non athletic populations, a considered and planned treatment plan is required.
What are the symptoms of tennis elbow?
Tennis elbow causes pain on the outside of the elbow. It arises around a bony protuberance called the epicondyle of the upper arm (humerus) bone. Tennis elbow occurs as a result of small micro-tears occur in the tendon (the tendons of the fingers/ hand and wrist which work to extend i.e. straightening the fingers and bending upwards of the wrist), where it inserts onto this bony protuberance. This is then followed by a haphazard healing process.
Lifting of heavy items is often painful, however on closer inspection it is often the putting down of weight causes pain. Such tasks such as putting down a kettle full of water or the turning of a door handle are often painful. Repeated movements such as DIY using a screwdriver or long periods of working with a computer mouse can result in injury.
How does a doctor diagnose tennis elbow?
A range of movements and tests are carried out to confirm the diagnosis of tennis elbow. It is unusual for the need of any investigations, but if they are required an x-ray and ultrasound scan are most common. They tend to only be needed if treatment is failing to help.
What to try first?
Simple pain relief should be used and ice is also the patients “friend”. At times of increased pain an ice pack on the area, alternating 10-15 minutes with ice followed by 10-15 minutes without, then repeating this process again can help decrease the pain. Pain relief can be discussed with the sports doctor at Sports Medicine NE and also prescribed from clinic if required.
Avoiding activities which cause the pain is always sensible and will allow the tendon to heal whilst also preventing it from worsening.
Treatments available
At Sports Medicine NE we will always attempt to provide a quick and effective but also long term cure for your problems. This is why is likely a specific exercise program will be advised.
One form of exercises used are called eccentric exercises and involve a “lengthening” manoeuvre of the tendon to stimulate healing of the injured tendon. These exercises don’t require any complicated equipment and they can be done from the comfort of your armchair whilst Andy Murray picks up a second Wimbledon trophy! Splints to help rest the tendon are also available and can be very useful in allowing a sufferer to continue with their everyday activities.
A range of injection treatments have also been used to treat tennis elbow. These range from steroid injections which can give a quick resolution of pain but evidence has shown that the problem may recur following this type of injection. Dry needling under local anaesthesia as available at Sports Medicine NE is undertaken to cause bleeding around the injured tendon enabling the growth factors within the blood to stimulate healing. Injection of blood and platelets rich plasma form blood is thought to work in a similar way. No strong medical evidence exists as yet for blood injection treatments.
Shockwave therapy uses high energy sound waves to treat tennis elbow but it isn’t yet known how this technique works. Botulinum toxin injection has also been used but is not widely available. Surgery is the last option considered when other less aggressive treatments as discussed above have failed to settle the problem. There is still no guarantee that the problem will be cured even after surgery
A combination of the above treatments is often needed in order to settle down a tennis elbow problem.
What happens if no treatment is given?
Evidence suggests that tennis elbow will last somewhere between 6 weeks to 18 months. It is impossible to give an exact time period for individual cases. It is common for tennis elbow to recur in patients despite treatment given.
Contact us:
If you feel you may have tennis elbow or any other elbow problem we would be happy to see you at Sports Medicine NE in any of our clinics in Sunderland or Newcastle please just give us a call