Monday Medical: Treating tennis elbow
Don’t let the name fool you: Tennis elbow can be caused by activities other than playing tennis.
Painting, building, cooking, working at the computer, gardening and other repetitive tasks that make use of the forearm can bring on this fairly common type of tendonitis.
“The forearm muscles and tendons become damaged from overuse when you’re repeating the same motion again and again,” said Emily Tjosvold, certified hand therapist with SportsMed. “That leads to pain and tenderness on the outside of the elbow.”
It might start as nothing more than an ache near the bony bump on the outside of the elbow. But when ignored, the pain can spread into the forearm and wrist, becoming so bad that it’s difficult to do even simple tasks, such as gripping a toothbrush or shaking hands.
“Most people tell me, ‘I can’t even lift a coffee cup,’” Tjosvold said. “It can happen gradually. The pain increases on the side of the elbow, and as the activity increases, the pain increases.
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“Those activities include a backhand tennis stroke with poor technique, repeated use of a screw driver, lifting heavy objects — a variety of tasks. In more severe cases, pain can occur in such simple activities as holding a coffee cup or turning a door knob.”
Tennis elbow can develop when the forearm muscles used to straighten and lift your hand and wrist are contracted over and over. That repetitive motion may cause tiny tears in the tendons that attach the forearm muscles to the elbow.
As with all types of tendonitis, it’s important to address symptoms quickly. Even better is to avoid the overuse in the first place.
Tjosvold recommends warming up before tasks with a few simple movements and stretches and heat. Then, while you’re working or exercising, be sure to use your core, keep your elbows bent at your side. Use a light grip with tools, take frequent rest breaks and make sure to rely on larger muscles instead of the smaller muscles in your forearms and hands.
“Whether you’re building a fence or painting a house, you should avoid using a straight arm and bent wrist,” Tjosvold said. “Have your arms bent, hands in a more palm-up position, and you can avoid pain on the outside of your elbow.”
Once the activity is finished, apply ice for eight to 10 minutes to decrease inflammation.
When you first experience pain, it’s best to stop the aggravating motion and rest. If the pain persists, it’s likely time to visit your doctor. Hand therapy is one option, with treatments that may include gentle stretching and strengthening, education regarding how to position your arm during potentially irritating movements, adaptive lifting and movement techniques, massage to the forearm and the use of a splint.
An orthopedic surgeon may also recommend cortisone or platelet-rich plasma shots and possibly surgery.
“As with any sort of tendonitis, it’s best to address it right away,” Tjosvold said. “Once tennis elbow has become chronic, it takes longer to heal. But catch it early, and you can be back to your regular routine faster.”
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