Tennis Elbow Treatment

Dr. Shreedhar Archik

Tennis elbow at a glance

• Tennis elbow (also known as lateral epicondylitis) develops when the tendons and muscles in the elbow become inflamed from repetitive arm, forearm, hand or wrist movements.

• Improper technique in racquet sports has led to this condition being referred to as tennis elbow, but anyone with occupations or hobbies that require similar motions may develop tennis elbow.

• Symptoms include pain that increases with activity in the outside part of the elbow.

• At-home treatment should include rest, ice, compression and elevation, as well as wrapping the elbow. In severe cases of tennis elbow, physical therapy or surgery may be necessary.

If you are experience symptoms of Tennis Elbow or other elbow pain, contact us to request an appointment with one of our orthopedic specialists.

Causes of tennis elbow

Tennis elbow is an overuse injury caused by repetitive contraction of the forearm muscles to straighten the hand or lift with the palm side of the hand facing down – a backhanded motion typically seen in tennis. The repetitive stress causes the tendons or muscles that attach the forearm muscles to the outside of the elbow to become inflamed or develop small tears.

Despite its name, tennis elbow if fairly common and affects more than 200,000 people in the United States each year. Women and men are equally affected, although it is most common in people ages 30 to 50. Any repetitive activity that involves twisting of the wrist (such as using a computer mouse or screwdriver) can cause this condition.

A similar condition called golfer’s elbow refers to the same injury to the inside of the elbow.

Symptoms of tennis elbow

Symptoms of tennis elbow include pain and tenderness in the outside part of the elbow (the lateral epicondyle), which becomes more painful during intense use of the arm. Some people may experience pain only when they use their forearm and wrist for twisting movements (such as opening a jar).

If the condition has become severe, increased pain could also extend to the forearm and wrist and increase with everyday activities such as lifting and grasping objects.

Treatment of tennis elbow

Treatment of tennis elbow depends upon a variety of factors including how a patient’s injury occurred, any occupational risk factors, and recreational sports participation.

To relieve pain from tennis elbow, the activity causing the pain should be limited or stopped completely. Initial treatment should include the rest, ice, compression and elevation of the elbow with over-the-counter medication, such as ibuprofen, to relieve the pain. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

Wrapping the forearm just below the elbow or wearing a wrist splint to protect the injured muscles and tendons as they heal may also be necessary. In severe or long-lasting episodes, an injection of medication into the arm may relieve discomfort.

After a few weeks, exercise and stretching to strengthen the muscles will help prevent tennis elbow symptoms from returning, although recurrence of the condition once normal activity is resumed is common.

Learning proper technique when playing tennis, participating in sports or making adjustments to movement during other activities, as well as wearing a brace during the activity, will go a long way in preventing tennis elbow from developing again.

The American Academy of Orthopedic Surgeons estimates up to 95 percent of all tennis elbow cases heal on their own with proper at-home remedies. However, physical therapy or surgery may be recommended by your doctor if the pain does not go away or the condition does not improve after 6-12 months.

Cubital Tunnel Syndrome Treatment

Cubital tunnel syndrome at a glance

• Cubital tunnel syndrome, also known as ulnar neuropathy, is the compression or irritation of the ulnar nerve, which runs through the groove in the center of the elbow (in the area commonly referred to as the funny bone).

• Cubital tunnel syndrome is caused by repeat injury that causes scar tissue, pressure, or stress to the funny bone area, affecting the way the nerve operates and causing pain, similar to carpal tunnel syndrome in the wrist.

• Symptoms of cubital tunnel syndrome include pain, numbness, and tingling through the fingers.

• Treatment should start with conservative methods such as rest and stretching, but may require surgery for severe cases of cubital tunnel syndrome.

Causes of cubital tunnel syndrome

Similar to carpal tunnel syndrome, cubital tunnel syndrome is caused by repetitive pressure put on the ulnar nerve, which runs alongside the bone at the elbow. The elbow joint provides little padding, so the nerve is more susceptible to compression.

Compression can be caused by habitual activities such as leaning your elbows on a hard surface, and bending the elbow for long periods of time (such as during sleep). Additionally, tissue surrounding the nerve may become thicker through injury or the muscle may become larger, compressing the nerve at the elbow.

Cubital tunnel syndrome may also result from abnormal bone growth or fluid buildup in the elbow or from physical activity that puts pressure on the ulnar nerve.

A direct blow to the groove of the elbow can hit the ulnar nerve, commonly called hitting your funny bone.

Symptoms of cubital tunnel syndrome

When the ulnar nerve becomes pinched, it can cause pain, numbness and tingling in the elbow that can extend into the fingers, especially when the elbow is bent or pressure is applied (such as leaning on a hard surface) for extended periods of time. In more severe cases, loss of strength in the fingers and a decreased ability to grip with the hand or fingers may also develop.

Some people also experience the ulnar nerve moving over the boney part of the elbow when the arm is bent and straightened, which can increasingly irritate the nerve over time.

If the nerve has been compressed for several weeks, muscle wasting or the hand becoming locked in a claw-like position can occur, so it’s important to see a doctor if cubitsl tunnel symptoms persist.

Treatment of cubital tunnel syndrome

At home treatment for cubital tunnel syndrome should include rest, stretching and anti-inflammatory medicines. Other conservative methods may include using a splint to keep the elbow from bending (such as during sleep), avoiding unnecessary pressure on the elbow during daily activities, and wearing a pad over the elbow to protect the **** funny bone. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

If the ulnar nerve is under severe pressure, surgery may be necessary to release or reposition the nerve and alleviate symptoms. Surgical procedures include cubital tunnel release, ulnar nerve anterior transportation and medial epicondylectomy.

If you are experience symptoms or elbow pain associated with cubital tunnel syndrome, contact us to schedule an appointment with one of our orthopedic specialists.

Little League Elbow Treatment

Little league elbow at a glance

• Little league elbow (also known as pitcher’s elbow or medial apophysitis) is an overuse injury that affects children and adolescents involved in sports such as baseball that require a throwing motion (pitching).

• Little league elbow is caused by repetitive stress to the elbow’s ligaments and tendons from the muscles in the forearm pulling on the growth section of the elbow, and essentially is a form of tendinitis.

• Symptoms include pain, swelling and restricted motion.

• Treatment may include rest and ice, physical therapy, or surgery.

Causes of little league elbow

Little league elbow occurs when young baseball players (or participants in other sports requiring throwing) extend their arm in a throwing motion too hard or too often. Throwing a baseball (and similar motions) causes the forearm muscles to pull and stretch the soft tendons and ligaments in the medial epicondyle of the humerus (the part of the elbow that grows through adolescence).

With Little league elbow, the medial epicondyle of the humerus becomes overused, enlarged and, in more severe cases, torn. This condition worsens if activity is continued, and can pull the ligaments and tendons away from the bone, which can severely impact bone growth.

Symptoms of little league elbow

Symptoms of pitcher’s elbow include : 
• Pain on the inside (medial) part the elbow.
• Tenderness.
• Swelling.
• A restricted range of motion from the pain.
• The elbow joint becoming locked.

Treatment of little league elbow

If a child is experiencing symptoms of little league elbow, they should stop pitching immediately as this condition often becomes more severe with repeated stress and can lead to major complications.

Nonsurgical treatments include rest and applying ice to the painful or swollen area of the elbow for a few days, as well as over-the-counter medications for pain and physical therapy. Once the condition clears, changing or refining throwing techniques may help prevent future injury. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

If pain returns when pitching or throwing is resumed, further treatment is necessary and the child should stop the activity until the condition is healed.

Surgery may be necessary to reattach ligaments, remove loose bone, or perform bone grafting particularly in adolescents approaching or entering their teen years.

If you have a child who is experience pain and symptoms associated with Pitcher’s Elbow, contact us to request an appointment with one of our sports medicine specialists.
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Disclaimer: The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The information is provided solely for educational purpose and should not be considered a substitute for medical advice.