Commonly known as “tennis elbow”, lateral epicondylitis is an inflammation of the tendon fibers that attach the forearm extensor muscles to the outside of the elbow. More recently it is believed that tennis elbow is due to the degeneration of the wrist extensor tendons. Either way this affects the muscles that lift the wrist and hand. Pain may be felt where these fibers attach to the bone on the outside of the elbow or along the muscles in the forearm. Overuse of the muscles and tendons of the forearm and elbow are the most common reasons people develop tennis elbow. Repeating some types of activities over and over again can put too much strain on the elbow tendons. These activities are not necessarily high-level sports competition. Hammering nails, picking up heavy buckets, or pruning shrubs can all cause the pain of tennis elbow. Some patients, however, develop tennis elbow without any specific recognizable activity leading to symptoms.
- Splints: Your physician or therapist may fit you with a tennis elbow strap to provide support to the involved muscles. Remember not to fasten the strap too tight as this can cause more problems. You may also be given a wrist splint to wear to provide rest to the muscles and tendons that bend and straighten the wrist. If your elbow is extremely tender, you will be provided with a heelbo or cushion to prevent the elbow from being hit. Wear these devices as directed. You can’t get better unless you wear the splints properly.
- Ice and/or Heat Applications: Discuss with your therapist how to correctly apply ice or heat to the parts of your elbow and forearm that are involved. Icing can help reduce swelling/inflammation in the muscles and tendons that cause epicondylitis. Your therapist may also recommend heat to increase circulation in the area and decrease symptoms, especially if your condition is more chronic. Do not apply either for longer than 10 to 15 minutes at a time.
- Stretching and Strengthening: Your therapist will instruct you on proper stretching and strengthening techniques as prescribed by your physician. Stretching improves range of motion, increases circulation, and decreases muscle fatigue and swelling. Stretching the extensor muscle mass also provides tissue elongation to relieve muscle contractions. Strengthening helps build and tone the small muscles affected in epicondylitis, while hopefully decreasing pain and preventing a return of symptoms. Your therapist and physician will instruct you on what exercises to perform, when to begin them, and how often to complete the exercises.
- Sports: You may want to stop playing any racquet sports for now to allow adequate healing and reduction of pain. Also avoid sports such as baseball, bowling or golf until you are pain-free. Weight lifting and bike riding can also pose problems. For tennis players, your serve, racquet and ball all play important parts in your recovery, so be sure to speak about this with your therapist before resuming play.
- Rest: Now that you have sought medical attention, you only get one opportunity to rest the arm and decrease your symptoms. This doesn’t mean you should stop using your arm and put it in a sling. It does mean you need to stop doing the activities and movements that cause the inflammation and pain Follow the advice of your physician and therapist and discontinue activities that provoke pain. Look at what you do and how you do it, not only in your work setting but at home, too. Remember, while tendonitis occasionally occurs from a one-time incorrect movement, it usually occurs from overuse of a small muscle group. In other words, continual repetition of incorrect movements will eventually stress the body, setting the stage for pain and inflammation.
Keep in mind it took you awhile to get this way and it will take awhile to get better, so don’t get discouraged. You will need to be consistent and perform your home therapy program correctly. You will also need to modify the way you complete activities so they are pain-free. Just remember to be patient. After all, it’s the only body you have.
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