Tennis Elbow

Causes of Tennis Elbow

Tennis elbow is a type of tendonitis and is common among athletes and those with physically demanding jobs that perform repetitive or strenuous activities. The reason playing tennis and other racquet sports are particularly susceptible to tennis elbow is from their repetitive arm, elbow, and wrist work.

Examples of common activities that can cause tennis elbow include:

• Playing racquet sports such as tennis, badminton or squash)
• Playing sports that involve throwing (javelin or discus)
• Repetitive use of other hand tools on a regular basis
• Using repeated hand motions in other professions (painters, butchers, mechanics, plumbers, carpenters)
• Activities that involve fine, repetitive hand and wrist movements (typing, sewing, dentistry)
• Activities that involve repeatedly bending the elbow (playing musical instruments like the violin, guitar or cello)

Tennis Elbow Symptoms

Symptoms of tennis elbow may include mild outer elbow pain that gradually worsens, pain and weakness from gripping objects, shaking hands, or turning a doorknob. There is usually no specific injury associated with the start of symptoms. Continued forearm activity can worsen pain and weakness.

Common signs and symptoms of tennis elbow (lateral epicondylitis) include:

• Pain or burning on the outer part of the elbow
• Weak grip strength
• Worsened pain with forearm activity (holding a racquet, turning a wrench, or shaking hands)
• Dominant elbow is most often affected

Diagnosis of Tennis Elbow

Before diagnosing tennis elbow, your doctor will ask you questions about when your symptoms began and ask questions to better determine how your symptoms developed, such as occupational risk factors or involvement in sports.

During a physical exam, your orthopedic doctor takes diagnostic tests to determine the root cause of your elbow pain. Your doctor may ask you to move your elbow, wrist and fingers of the affected arm in certain ways and possibly against resistance. Your doctor may also apply pressure to the affected area. Typically, your elbow surgeon can diagnose tennis elbow by a physical exam alone.

However, your doctor may order X-rays to rule out elbow arthritis. If you experience significant pain and weakness, it could indicate a torn or damaged muscle, and an MRI can help determine if there is tendon damage. An electromyography (EMG) of your elbow may determine if any nerve problems are causing your elbow pain.

Nonsurgical Tennis Elbow Treatment

Our goal is to treat tennis elbow in the least invasive way possible, and up to 85% of patients do not need surgery for complete relief. It’s important to avoid movement that caused your elbow pain in the first place.

Nonsurgical Treatments of Tennis Elbow Include:

• Rest, lifestyle modifications, and avoidance of strenuous physical activities.
• Applying ice to the affected area can help relieve pain.
• Taking a nonsteroidal anti-inflammatory (NSAIDs) such as ibuprofen or aspirin.
• Physical therapy (strengthening and stretching exercises to improve your functional mobility, flexibility, and stamina.
• An elbow brace or wrist splint can immobilize the affected arm and help it rest and heal better.
• Cortisone steroid injections may reduce swelling and relieve pain. PRP Injections is a biologic treatment designed to improve the damaged tissues. While the effectiveness of PRP is controversial and considered to be medically experimental, some studies have shown promising results for treating tennis elbow.

Surgical Tennis Elbow Treatment

Once you’ve exhausted all non-surgical treatments after 6 to 12 months without relieving your elbow pain, your elbow surgeon may recommend surgery.

Elbow surgery can be done in the traditional “open” technique or through elbow arthroscopy. These procedures have the same goal to remove the damaged tissue, but the difference is the open approach requires larger incisions and is more invasive than arthroscopic surgery.

• Open Surgery: During open surgery, a larger incision is made to access the damaged tendon to reattach the healthy portion to the bone. Your elbow surgeon will make an incision at the elbow to remove a small chip of bone to help increase blood flow to the area, promoting healing. Another approach is to release a small portion of the damaged tendon by severing its connection to the bone. This effectively reduces pain, but you will retain function and mechanical strength. The third technique is to repair the tendon through debridement, or cutting away the damaged part of the tendon to reattach it to the healthy portion to the bone.
• Elbow Arthroscopy: Arthroscopic elbow surgery is the less invasive approach and involves three to four tiny incisions made both the medial (inner) and lateral (outer) sides of the elbow. Patients who have arthroscopy generate less scare tissue, which also enables faster healing and more rapid rehabilitation which is important since elbow surgery is known to have a higher risk of causing stiffness after surgery, and arthroscopy can minimize this risk. Your elbow surgeon uses an arthroscope to clean out the damaged tendon. Generally speaking, no bone is removed using this procedure, however, some surgeons will scrape the elbow surface to stimulate your body’s own healing process by generating more blood flow to the affected area.

Trust the Elbow Surgeons at Newport Orthopedic Institute

Our board-certified, fellowship-trained Orange County elbow surgeons are skilled at treating Tennis Elbow. Get back to doing the activities you enjoy by scheduling a consult today with an elbow surgeon at NOI.

Do you have tennis elbow?
Call Newport Orthopedic Institute at (949) 722-7038.

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