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Lateral Epicondylitis
(Tennis Elbow) What is lateral
epicondylitis (tennis elbow)? Lateral epicondylitis (tennis elbow) is the name for a condition in
which the bony bump at the outer side of the elbow is painful and tender. The elbow joint is made up of the bone in the upper arm (humerus) and
one of the bones in the lower arm (ulna). The bony bumps at the bottom of the
humerus are called epicondyles. The bump on the outer side of the elbow, to
which certain forearm muscles are attached by tendons, is called the lateral
epicondyle. Lateral epicondylitis is also referred to as wrist extensor tendonitis. How does it occur? Tennis elbow results from overusing the muscles in your forearm that
straighten and raise your hand and wrist. When these muscles are overused, the
tendons are repeatedly tugged at the point of attachment (the lateral epicondyle).
As a result, the tendons become inflamed. Repeated, tiny tears in the tendon
tissue cause pain. Among the activities that can cause tennis elbow are tennis
and other racket sports, carpentry, machine work, typing, and knitting. What are the symptoms? The symptoms of tennis elbow are:
pain or tenderness on the outer side of the elbow
pain when you straighten or raise your wrist and hand
pain made worse by lifting a heavy object
pain when you make a fist, grip an object, shake hands, or turn door
handles
pain that shoots from the elbow down into the forearm or up into the
upper arm. How is it diagnosed? Your health care
provider will ask you about your daily and recreational activities. He or she
will examine your elbow and arm and will have you do movements that may cause
pain in the outer part of your elbow. Your provider may order x-rays of the
elbow. How is it treated? Treatment includes the
following:
Put an ice pack on your elbow for 20 to 30 minutes every 3 to 4 hours for
2 to 3 days or until the pain goes away.
You can also do ice massage. Massage your elbow with ice by freezing
water in a Styrofoam cup. Peel the top of the cup away to expose the ice and
hold onto the bottom of the cup while you rub the ice over your elbow for 5 to
10 minutes.
Wear a tennis elbow strap. This strap wraps around the forearm below the
elbow, acting as a new attachment site for the forearm muscles and keeping them
from pulling on the painful epicondyle.
Take anti-inflammatory medication.
Do the exercises recommended by your health care provider. Your provider
may also recommend physical therapy.
Your provider may recommend an injection of a corticosteroid medication
around the lateral epicondyle to reduce the inflammation.
In severe cases, surgery may be recommended. While you are recovering from your injury you will need to avoid
repetitive motion of the elbow and to change your sport or activity to one that
does not make your condition worse. For example, you may need to run instead of
play tennis. If you play tennis, your health care provider may advise you to use
a tennis racket with a larger grip. He or she may suggest improvements in the
way you hold or swing your racket. Try to lift objects with your palm facing up
to keep from overusing your lateral epicondyle. When can I return to my
sport or activity? The goal of rehabilitation is to return you to your sport or activity as
soon as is safely possible. If you return too soon you may worsen your injury,
which could lead to permanent damage. Everyone recovers from injury at a
different rate. Return to your sport or activity will be determined by how soon
your elbow recovers, not by how many days or weeks it has been since your injury
occurred. In general, the longer you have symptoms before you start treatment,
the longer it will take to get better. You may return to your
sport or activity when your are able to forcefully grip your tennis racket, bat,
or golf club, or do activities such as working at a keyboard without pain in
your elbow. In sports such as gymnastics, it is important that you are able to
bear weight on your elbow painlessly. It is important that there is no swelling
around your injured elbow and that it has regained its normal strength compared
to your uninjured elbow. You must have full range of motion of your elbow. How can I prevent tennis
elbow? To prevent tennis
elbow:
Use proper form during your activities, whether they are sports or
job-related. For instance, be sure your tennis stroke is correct and that your
tennis racket has the proper grip size.
Warm up before playing tennis or doing other activities that involve your
elbow or arm muscles. Gently stretch your elbow and arm muscles before and after
exercise.
Ice your elbow after exercise or work. In job-related
activities, be sure your posture is correct and that the position of your arms
during your work doesnt cause overuse of your elbow or arm
muscles. Written by Pierre Rouzier, M.D., for McKesson Clinical Reference Systems. Published
by McKesson Clinical Reference Sy~rns. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. sports Medicine Advisor 2002.2 Index Sports Medicine Advisor 2002.2 Credits Copyright © 1997-2002 McKesson Health Solutions LLC. All rights reserved. |
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