Tennis Elbow / Golfer's Elbow

Tennis Elbow is a very popular form of acute tendonitis that is most prevalent in tennis players over 40. Up to 50% of racket sports players develop this condition at some stage. It is a degenerative condition where tendon fibres attach the muscles of the forearm to the elbow. Sufferers generally complain of a severe, burning pain on the outside of the elbow, which gradually worsens and is exacerbated by gripping or lifting things.

When treating tennis elbow, rest the area (meaning do NOT play racket sports) and apply ice for 10-20 minutes at a time for at least 3 times a day. Do this to the injured area for 1 to 3 days. Moist heat may be used after the acute swelling has improved and rest prevents further muscle injury. Ice reduces initial inflammation and swelling while the moist heat circulates blood through the area to speed the healing process. Accelerate healing with the use of ultrasound applications over the affected area as it reduces swelling quickly and increases blood flow to the area. If the patient gradually starts flexing and mobilizing the area, the muscle may heal completely.

However, this is not what typical person does; they may ice once or twice and rest a bit, but most often just take some Advil or Tylenol then continue their racket sports. If the strain was minor their body may be able to heal the muscle fibers normally. Unfortunately, this is not the usual result because the injured muscle is being used instead of rested. Because of the stress on the muscle, their body heals the injured muscle fibers by binding them together with fibrotic adhesions (scar tissue). This is a normal defensive response, which prevents further damage to the injured area.

The patient should apply ultrasound treatment on the area up to three times daily. Ultrasonic energy naturally "works" the tendon, increasing its flexibily while softening and breaking down scar tissue; which is not something you want in your tendon. Scar tissue is inflexible (non-elastic), and can quickly lead to reinjury of the tendon down the road. If you choose to use steriod injections or are using steriod injections, do NOT treat the area with ultrasound until 30 days after the last injection. Steriod injections break down the tissue in the treated area in an attempt to get it to re-heal properly. Applying ultrasound over areas injected with steriods may increase the damage and can potentially tear the tendon.

The trick to any tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of tendon fibres as possible - something the MendMeShop Ultrasound is great at! Even with optimum healing there is always less elasticity in a previously injured tendon. The trick is to make sure you heal this the best you can, that way your chance of reinjury down the road is much lower than average, which is well over 50%.

The most common cause of an tendon inflammation (tenosynovitis or tendonitis) is overuse of the affected tendon. Rest of the affected tendon is all that is required in some cases. Other treatments such as anti-inflammatory drugs or a steroid injection are sometimes needed. Infection of a tendon is an uncommon cause but needs treatment with antibiotics if it occurs.

What is tenosynovitis and tendonitis?

• Tendonitis means inflammation of a tendon. (It is sometimes spelled as tendinitis.)
• Tenosynovitis means inflammation of the sheath that surrounds a tendon (the sheath is called the synovium). Tenosynovitis can be caused by calcium deposits, repeated strain or trauma, high levels of blood cholesterol, rheumatoid arthritis, gout, or gonorrhea.

Tenosynovitis and Tendonitis often occur together.

Tennis Elbow Symptoms and Golfers Elbow Symptoms

Lateral Epicondylitis (tennis elbow)

The onset of tennis elbow pain is normally gradual with tenderness or a dull ache felt in the tendons of your forearm muscles on or below the bony bumps on your elbow.

If you have tennis elbow, you will feel pain or discomfort when performing repetitive movements such as grasping, carrying objects (a tray, a baby or books), or twisting with your hands or wrists. Pain can also be experienced when your wrist or hand are straightened, when your palms are facing the ceiling, when you flex your wrist and fingers backwards while straightening your elbow, or when you rest your wrists on a tabletop or desk.

Pain will start on and around the bump on the outside of your elbow (lateral epicondyle). As time goes on this pain will start to radiate from the outside of your elbow down to your forearm and wrists.

Medial Epicondylitis (Golfers elbow)

If you have golfer's elbow, you will feel discomfort and pain when performing repetitive movements such as holding, squeezing, twisting with your hands or wrists, or curving your fingers as they hit a computer or piano. Pain can also be experienced when you try to pick something up with your palm down, when you flex your wrist and fingers forwards while extending your arm, or when you rest your forearms on a surface (while typing or grasping for something).

Pain will start on and around the bump on the inside of your elbow (medial epicondylite), and will eventually radiate from the inside of your elbow down to your forearm and wrists.

General Symptoms of Epicondylitis

In the beginning, this pain will often go away within 24 hours after an activity. However if not dealt with immediately, your pain and stiffness will get worse over weeks or months, to the point where you may feel soreness even when your arm is still. You can also experience a severe burning pain and atrophied forearm muscles (loss of muscle mass), which results in a weakened grip. If left untreated, you may experience extreme loss of motion and function of your elbow and forearm.

Should you seek medical attention?

This is up to your discretion; however any continued discomfort in your elbow should be investigated, as it can lead to long term damage. If you experience any of the symptoms below and have tried the initial conservative treatments (see tennis elbow treatments and golfer's elbow treatments), it is recommended that you seek professional medical attention:

• You are unable to carry objects, participate in activities or work due to the pain
• You have limited range of motion and are unable to bend, straighten or move your arm at all
• You are experiencing redness, heat or swelling in your elbow (swelling rarely occurs with tennis elbow, however it may indicate another condition)
• Your elbow looks deformed or you have significant bruising around that area
• You've experienced a traumatic accident and may have broken a bone
• You experience elbow pain that occurs at night while resting or persists beyond a few days
• Any other unusual symptoms

More Information

Tennis Elbow / Golfer's Elbow-Type Ailments

Lateral Humeral Epicondylitis (Tennis Elbow)
Tendonitis
Tenosynovitis

We encourage you to contact our office directly with any questions you may have regarding your condition or MendMeShop's therapeutic products.

Speak to a MendMeShop Advisor, toll free, at 1-866-237-9608. If you live outside Continental North America, call 1 (705)445-3505

Monday - Friday 8am to 9pm
Saturday - Sunday 11am to 6pm

Or contact us by email at service@mendmeshop.com.