What is Tennis Elbow?
Tennis elbow is a condition characterized by pain on the outer part of the elbow joint's bony prominence (lateral epicondyle). Lateral epicondylitis, or tennis elbow, is an overuse injury that causes inflammation and small tears in the tendons that attach to this prominence (lateral epicondyle) in the elbow joint.
What Causes Tennis Elbow?
The tendons of the muscles that move the wrist upwards join from the forearm to the elbow and attach to the bony prominence in the elbow joint (lateral epicondyle). Tennis elbow occurs as a result of excessive use of the muscles that move the wrist upwards (dorsiflexion). Usually, a pathological disorder called angiofibroblastic hyperplasia in one of these muscles (extensor carpi radialis brevis) is responsible.
Tennis elbow is more common in tennis players, painters, hammer users, painters, heavy object lifters, long-term computer users, gardeners, and musical instrument players.
Tennis elbow is mostly due to incorrect technique usage. Holding a racket, hammer, or a tool in your palm while your wrist is in an upward (dorsiflexion) position for a long time puts extra stress and tension on your muscles. This leads to the development of tennis elbow (lateral epicondylitis). The tennis elbow condition due to incorrect technique usage is most commonly seen in beginners to tennis.
Tennis elbow can also develop as a result of hitting the outer prominence of your elbow (lateral epicondylitis) on a hard object (wall).
Incorrect Technique:
Correct Technique:
What are the Symptoms of Tennis Elbow?
Gradually worsening elbow pain
Pain on the outer side of the elbow, spreading to the forearm and wrist when gripping objects
Weak grip
Painful grip
Increased pain in the elbow when the wrist is bent backward
How is Tennis Elbow Diagnosed?
A diagnosis of tennis elbow is made after a comprehensive physical examination and listening to your medical history. Sometimes, radiological tests such as X-rays and MRI imaging may be requested.
How is Tennis Elbow Treated?
Non-surgical Methods for Tennis Elbow?
Activity Modification
Limit your activity, starting with less duration and fewer repetitions. If you play tennis for 1 hour three times a week, you can start by reducing it to 45 minutes twice a week. You should stop any movements that increase your pain.
Grip Technique Correction
Gripping objects with your wrist in a straight (neutral) position helps protect against the development of tennis elbow.
Use of Splint and Epicondylar Band
A splint and epicondylar band can be used to keep the wrist in a straight position. In my own practice, I can achieve partial improvement in patients who use it for a short period of time.
Ultrasound-Guided Injection Treatments
Applying injections of platelet-rich growth factors (PRGF) under ultrasound guidance is quite effective in the treatment of tennis elbow.
Why is Tennis Elbow Surgery Performed?
If tennis elbow does not heal with non-surgical methods and the symptoms of tennis elbow last for more than 6 months, surgery becomes an option.
How is Tennis Elbow Surgery Performed?
A surgery called lateral epicondylar release is performed. Surgery is considered a last resort. Only about 1 in 10 patients require surgery.
The goal of tennis elbow surgery is to remove the damaged (angiogenic hyperplasia) tissue in the ECRB (extensor carpi radialis brevis) tendon, one of the five tendons that attach to the outer part of the elbow joint (lateral epicondyle), and stitch the remaining healthy tissue together.
If the surgery is performed using an open technique, a 5 cm incision is made.
The surgery can be performed under general anesthesia or regional anesthesia. No hospital stay is required after the surgery.
What is the Recovery Process Like After Tennis Elbow Surgery?
The surgical wound heals 10-14 days after the surgery, and elbow movements are allowed after the surgery. You may have pain for 4-5 days, which can be managed with painkillers and cold applications. Following an exercise program to strengthen the area after the wound has healed is important.
