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Tennis Elbow?
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 What Is Tennis Elbow?


Doctors first identified Tennis Elbow (or lateral epicondylitis) more than 100 years ago. Today nearly half of all tennis players will suffer from this disorder at some point. Interestingly though, tennis players actually account for less than 5 percent of all reported cases making the term for this condition something of a misnomer.

There are 2 additional strain related conditions which are often mistaken for Tennis Elbow. These being Golfer’s Elbow & Bursitis. Before we delve into the details of what Tennis Elbow actually is and options that are available for relieving & preventing the pain...let’s look at the distinguishing characteristics of each of these 3 ailments.

Tennis Elbow
(lateral epicondylitis)
Outside of Elbow
Cause & Symptoms

The onset of pain, on the outside (lateral) of the elbow, is usually gradual with tenderness felt on or below the joint's bony prominence. Movements such as gripping, lifting and carrying tend to be troublesome.

Golfer’s Elbow
(medial epicondylitis)
Inside of Elbow
Cause & Symptoms

The causes of golfers elbow are similar to tennis elbow but pain and tenderness are felt on the inside (medial) of the elbow, on or around the joint's bony prominence.

Bursitis
Back of Elbow
Cause & Symptoms

Often due to excessive leaning on the joint or a direct blow or fall onto the tip of the elbow.
A lump can often be seen and the elbow is painful at the back of the joint.


Symptoms Of Tennis Elbow

  • Recurring pain on the outside of the upper forearm just below the bend of the elbow; occasionally, pain radiates down the arm toward the wrist.
  • Pain caused by lifting or bending the arm or grasping even light objects such as a coffee cup.
  • Difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments).
  • Pain that typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several years.

The damage that tennis elbow incurs consists of tiny tears in a part of the tendon and in muscle coverings. After the initial injury heals, these areas often tear again, which leads to hemorrhaging and the formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Collagen, a protein, leaks out from around the injured areas, causing inflammation. The resulting pressure can cut off the blood flow and pinch the radial nerve, one of the major nerves controlling muscles in the arm and hand.

Tendons, which attach muscles to bones, do not receive the same amount of oxygen and blood that muscles do, so they heal more slowly. In fact, some cases of tennis elbow can last for years, though the inflammation usually subsides in 6 to 12 weeks.

Many medical textbooks treat tennis elbow as a form of tendonitis, which is often the case, but if the muscles and bones of the elbow joint are also involved, then the condition is called epicondylitis. However, if you feel pain directly on the back of your elbow joint, rather than down the outside of your arm, you may have bursitis, which is caused when lubricating sacs in the joint become inflamed. If you see swelling, which is almost never a symptom of tennis elbow, you may want to investigate other possible conditions, such as arthritis, infection, gout or a tumor.


Relief Of Tennis Elbow

The best way to relieve tennis elbow is to stop doing anything that irritates your arm — a simple step for the weekend tennis player, but not as easy for the manual laborer, office worker, or professional athlete.

The most effective conventional and alternative treatments for tennis elbow have the same basic premise: Rest the arm until the pain disappears, then massage to relieve stress and tension in the muscles, and exercise to strengthen the area and prevent re-injury. If you must go back to whatever caused the problem in the first place, be sure to warm up your arm for at least 5 to 10 minutes with gentle stretching and movement before starting any activity. Take frequent breaks.

Conventional medicine offers an assortment of treatments for tennis elbow, from drug injections to surgery, but the pain will never go away completely unless you stop stressing the joint. Re-injury is inevitable without adequate rest.

For most mild to moderate cases of tennis elbow, aspirin or ibuprofen will help address the inflammation and the pain while you are resting the injury, and then you can follow up with exercise and massage to speed healing.

For stubborn cases of tennis elbow your doctor may advise corticosteroid injections, which dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects. Another attractive option for many sufferers, especially those who prefer to not ingest medication orally, is the application of an appropriate and effective topical anti-inflammatory such as Penetrex.

If rest, anti-inflammatory medications, and a stretching routine fail to cure your tennis elbow, you may have to consider surgery, though this form of treatment is rare (fewer than 3 percent of patients). One procedure is for the tendon to be cut loose from the epicondyle, the rounded bump at the end of the bone, which eliminates stress on the tendon but renders the muscle useless. Another surgical technique involves removing so-called granulated tissue in the tendon and repairing tears.

Even after you feel you have overcome a case of tennis elbow, be sure to continue babying your arm. Always warm up your arm for 5 to 10 minutes before starting any activity involving your elbow. And if you develop severe pain after use anyway, pack your arm in ice for 15 to 20 minutes and call your doctor.


Prevention

To prevent tennis elbow:

  • Lift objects with your palm facing your body.
  • Try strengthening exercises with hand weights. With your elbow cocked and your palm down, repeatedly bend your wrist. Stop if you feel any pain.
  • Stretch relevant muscles before beginning a possibly stressful activity by grasping the top part of your fingers and gently but firmly pulling them back toward your body. Keep your arm fully extended and your palm facing outward.
     

Caution!

To prevent a relapse:

  • Discontinue or modify the action that is causing the strain on your elbow joint. If you must continue, be sure to warm up for 10 minutes or more before any activity involving your arm, and apply ice to it afterward. Take more frequent breaks.
  • Try strapping a band around your forearm just below your elbow. If the support seems to help you lift objects such as heavy books, then continue with it. Be aware that such bands can cut off circulation and impede healing, so they are best used once tennis elbow has disappeared.

Call Your Doctor If....

  • The pain persists for more than a few days; chronic inflammation of the tendons can lead to permanent disability.
  • The elbow joint begins to swell; tennis elbow rarely causes swelling, so you may have another condition such as arthritis, gout, infection or even a tumor.

Patient Profile - June, 2009

Tennis Elbow Patient
"...Though I'm fairly young, I have been afflicted with tennis elbow for several years, and had become accustomed to tolerating moderate pain almost constantly throughout the summer months when my outdoor activities are at their peak.

Then I started a new job, requiring me to keyboard for almost an entire eight hour workday. With the addition of long hours of data entry at a computer, I was now feeling pain down into my wrist and hand as well even to the point of being awakened from sleep whenever I moved. It hurt to turn the ignition key in my car, it hurt to use hairspray, it hurt to do anything with my right hand.

Preparing to visit my doctor for help, I did an Internet search for "tennis elbow" and found my way to the Penetrex website. I was very skeptical, but ordered Penetrex because of the no-risk guarantee. I applied the cream twice per day, once in the morning immediately after showering and once in the evening before bedtime.

To my surprise and delight within one week I had considerable relief from the pain. After one more week, I can honestly say my pain was hardly noticeable. The only change in my activities was the addition of the Penetrex. Penetrex is awesome, I recommend it highly!..."

Kimberly P.
Novi, Michigan


Successful Tennis Elbow Treatments 



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