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Monday medical: Don’t let tennis elbow keep you off the courts

While the ski lifts may have only stopped turning Sunday, an unusually dry and warm late season had many in the valley long to turn their attention to warm weather recreation. Tennis certainly ranks high on the list, and although indoor courts fuel a competitive, year-round community in Steamboat Springs, sun-filled days ensure a rapid return of the weekend warriors to the game.

Similar to skiing, cycling and trail running, rusty skills, unused muscle groups and pent-up excitement to return to the court can be cause for concern, and injuries should always be on one’s mind.

Dr. Bryan Bomberg, Steamboat Springs orthopedic surgeon, is used to seeing tennis players through his practice. He explains that common injuries associated with tennis include shoulder and rotator cuff injuries, stress fractures (or tiny cracks in bones), muscle tears and strains and the aptly named, “tennis elbow.”



Tennis elbow is a condition in which the extensors, or tendons in the forearm that connect to the elbow, become overworked, causing inflammation and pain.

“Tennis elbow is the classic injury. It has become ubiquitous in the tennis community,” Bomberg said. “You’re putting a long lever arm in your hand, and when you hit the ball, there’s an incredible force that is transmitted to the outer aspects of the elbow. It’s extremely common.”



By some estimates, as many as 50 percent of tennis players experience the condition at some point, and Bomberg said that in some circles where he’s discussed tennis injuries, almost everyone has experienced tennis elbow.

“Usually, you’ll first start to notice being sore after playing. It then migrates to pain in your backhand and, in its most severe form, literally just any grip strength causes pain,” Bomberg said. “Anyone who has had it knows you don’t even want to shake someone’s hand.”

Because tennis elbow is a result of overuse, the painful condition is much easier to treat in its earlier stages.

“If it’s starting to come on or if there is any inkling, you should evaluate it,” Bomberg said. “When it starts, it’s much easier to work with compared to when it’s become full blown.”

Bomberg stresses proper physical therapy in the prevention and early stages, in which establishing proper strength and stretching exercises — including forearm extension and grip strength exercises — can help condition the muscles and avoid the injury.

Additionally, using proper hitting technique and the right equipment play a vital role in staving off tennis elbow. Bomberg recommends meeting with a tennis pro if it’s been a while since you’ve brushed up on your skills or if you think your equipment may, in part, be causing the pain.

A simpler solution is to just take a few days away from the courts, which can really help tendons repair.

“Often we get some good weather, and we want to get outside, and some people start to go overboard,” Bomberg said. “They will play for hours, have sore muscles and go back and play tomorrow.”

For those with more painful or advanced tennis elbow, the condition can be more difficult to get under control quickly. Cortisone injections can help relieve pain and inflammation, and a technique called Platelet Rich Plasma therapy is being used as well.

“PRP treatment takes your blood and spins it. This concentrates the platelets, which have healing factors,” Bomberg said. “The thought is that if you concentrate these healing factors and inject it into an area that needs a healing response, it can be helpful.”

In its most severe forms, tennis elbow can require surgery to remove damaged tissue and repair and reattach tendons to the bone.

A little awareness can go a long way in the prevention of tennis elbow. Take steps to recognize the condition and prevent its progression. If you are experiencing pain as a result of playing tennis, schedule an appointment with a physical therapist or orthopedic surgeon.

Information from the Mayo Clinic and the American Academy of Orthopaedic Surgeons was used in this article.

Nick Esares is a marketing and communications specialist for Yampa Valley Medical Center.


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