Health Talk: Tennis elbow

At times, even the best of players may fall prey to an injury they never cared to check. Tennis elbow is one such injury which can affect anyone and, if overlooked, may lead to chronic pain refraining the injured from lifting or gripping objects.

As the name suggests, playing tennis is one of the main causes of tennis elbow, but many other activities that involve repetitive actions of the hand or wrist, like using a screwdriver, hammering, painting, raking, and weaving, can also lead to the injury.

Tennis elbow mainly affects the outer surface of the elbow bone. It is caused due to overuse of the forearm muscle. Researchers believe that two most common causes of the condition are lateral epicondylitis and radial tunnel syndrome.

Lateral epicondylitis is caused due to repeated contractions of the forearm muscle. The forearm muscle is in action when the arm is raised or straightened. The main areas affected in the injury are the muscle and tendon areas, which are attached to the outside bony formation of the elbow.

Doctors suggest that lateral epicondylitis may be a degenerative process as a result of aging or repetitive swinging of the arm. Constant rubbing of the bone against the muscle causes abrasion of the tissues. This creates an area that has a smaller chance of healing because it has insufficient access to nutrients and oxygen due to inadequate blood flow. Consequently, there is a degeneration of the tendon demonstrated by small tears and inflammation.

The second reason behind tennis elbow, radial tunnel syndrome, is the compression of a nerve fiber within the forearm. This is the main nerve involved in operating several muscles around the hand and wrist.

Regardless of how the patient acquires tennis elbow, the first few weeks are almost disabling. In the beginning, when the injury is fresh, patients experience sudden pain that radiates from the outside of the elbow into the forearm and wrist. The pain worsens when the person squeezes something in his or her hand or turns a doorknob. If the wrist is moved with force, or is strained by any attempt of stabilizing it by force, the pain can become almost unbearable.

It takes just a few weeks for the pain to get worse, to such an extent that it may hurt even when a person’s arm is still.

Men and women are equally likely to suffer from tennis elbow. Tennis elbow usually affects the dominant arm of an individual. For example, a right-handed person will more likely be injured in the right hand, though in around 25 percent of the cases, it may affect the non-dominant arm.

Tennis elbow is commonly seen in two groups of people — manual laborers and sports participants, especially racket sport players. Interestingly, 95 percent of the reported cases are of non-players.

Maha Mahmoud, a junior in the Tepper School of Business, shared her experience with tennis elbow as a teen.

“I suffered from tennis elbow after I served assuming an incorrect posture,” Mahmoud said. “It took an entire month of regular physiotherapy, and absolutely no tennis, for me to recover.”
For tennis players, it is best to have a professional review their playing technique in order to prevent tennis elbow. Players should have the whole body involved in the stroke by swinging the racket with the whole arm and not just the part of the arm from the wrist to the elbow.

It is important to build strength and keep the wrist straight during any lifting activity. Ice compressions after heavy use can prevent tennis elbow. After all, prevention is better than cure.
Having said that, the PRICE study (which stands for the key concepts protection, rest, ice, compression, and elevation) conducted by a group of researchers in Belfast, Northern Ireland, U.K. promotes these notions as curing agents of tennis elbow.

The study suggests that an injured person should protect the arm by not using it very often, giving it rest, giving it an ice massage, compressing it with an elastic wrap or bandage, and holding the elbow above heart level to limit swelling.

Once the acute inflammatory phase passes, physiotherapy to strengthen and to increase flexibility of the arm is recommended. Surgery is very rare but it may be the only alternative in some cases. The inflamed tendon is trimmed, or it may be surgically released and then attached again to fix the damage.

Tennis elbow is not that difficult to acquire. It can affect virtually anyone who uses his or her dominant arm very frequently. The best defense is to know about it, take the necessary precautions, and play safe.