Dr. Myles Samotin on TENNIS ELBOW
I am currently treating a lot of tennis players and I am seeing a lot of tennis elbow. Tennis elbow formally known as lateral epicondylitis is an inflammation of the tendons as they insert onto the lateral epicondyle, which is on the outside right above the elbow joint. It comes from repetitive motion activities, stress, overuse, and sometimes just activities of daily living. This problem usually presents as pain on the outside of the elbow. Sometimes it radiates up, but often times it radiates down to the forearm. Some twisting, lifting, some use of the arm and the elbow can be painful and can be extremely disabling.
When this problem is caught early, generally it is simply an inflammation of the tendons in the location where they attach to bone. When this problem is advanced, the tendons could be extremely inflamed and even could be partially torn and have unhealthy tissue that has become a permanent part of the tendon. In the early stages, treatment usually starts with activity modification meaning rest for instance; if you are a tennis player playing tennis 7 days a week probably cutting that or eliminating that for a while will allow this problem to get better.
Continuing to play tennis at an undiminished rate or any other activity will more it more difficult to get it better. A cortisone shot not into the tendons but around the tendons stops the inflammatory process and can increase comfort dramatically. Sometimes rest or physical therapy is beneficial. Often a brace or support that sits right below the elbow on the proximal forearm can stop some of the muscle forces that go up to the elbow and can give relief as well. Conservative treatment may take time to work, but generally it is effective for an early condition. If the condition is advanced, an MRI may be in order to actually see what the pathology is. If the pathology fails to get better with conservative therapy, a quick outpatient surgery with an incision about 1 inch in length is the surgical answer to restore you to better elbow health.