What is tennis elbow?

Tennis elbow is inflammation or, in some cases, microtearing of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

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Anneliese Ruggeri

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Mr. Trevor Kwolek

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Dr. Bert Perey, MD, FRCPC, Orthopedic Surgeon, discusses tennis elbow causes and symptoms.

Quiz: Do You Understand Elbow Injuries?

Test your knowledge by answering the following questions:

Questions
True
False
1

Bursitis can cause elbow pain.

Explanation:
There are a number of causes of elbow pain, including ligament sprain, bursitis, bone injury or a nerve irritation local to the elbow or referred from the neck, upper back or shoulder.
2

Pain felt along the outer aspect of the elbow or forearm is known as golfer's elbow.

Explanation:
Pain felt along the outer aspect of the elbow or forearm is known as extensor tendinopathy, or more commonly referred to as tennis elbow. Pain experienced on the inner aspect of the elbow or forearm is typically known as flexor tendinopathy or golfer’s elbow.
3

Stretching the muscle may be an effective treatment for elbow pain.

Explanation:
There are a number of treatment options for elbow injuries and pain, including stretching the muscle or conditioning the muscle around the scar tissue to increase blood flow to the area to help heal.
4

Surgery is usually the first treatment for elbow injuries.

Explanation:
Surgery can be an option for elbow injuries, however, it’s usually reserved for patients who have undergone other treatments and still remain symptomatic beyond six months. Surgery involves excising the scar tissue around the area that’s painful and allowing blood flow to come in to heal this process.
5

A physiotherapist can help you create an appropriate treatment plan.

Explanation:
A physiotherapist can perform an assessment to determine an appropriate treatment plan to help you reduce pain and regain your normal strength and function.
(Answer all questions to activate)

Dr. Bert Perey, MD, FRCPC, Orthopedic Surgeon, discusses tennis elbow symptoms and treatment including surgical options.

Dr. Bert Perey, MD, FRCPC, Orthopedic Surgeon, discusses Tennis Elbow Surgery Success Rates

Dale Harris discusses options for easing tennis elbow pain.

Tennis Elbow Braces

Lateral epicondylitis, which is inflammation on the tendon bone attachment on the elbow, is commonly referred to as tennis elbow.

There are a variety of different options available out there. A couple of the products that we really like are these two products here. When trying on a tennis elbow brace, there are a couple of key features that you want to look for.

One of the most important things is finding a strap that puts pressure on the affected muscle group. So, you can do that with a gel pad, you can do it with an aerosol, you can do it with a little bit of foam.

That puts pressure on that affected muscle group. If you don’t have that pad all you’re really doing is restricting blood flow. So looking for that additional pad to put pressure on that affected muscle group either on the medial side, or on the – pardon me – on the lateral side or on the medial side.

These products work well in conjunction with icing, physiotherapy, stretching, modification of activities and also, wearing the strap during activities other than the one where you developed the injury.

When you’re ready to try on a tennis elbow brace, go to a local retailer in your area, and get an experienced fitter. Try on two or three different tennis elbow braces, and find the one that’s most effective for you. I think you’ll find that this will really help get through to tennis elbow.

Presenter: Mr. Dale Harris, Bracing & Equipment Specialist, Vancouver, BC

Local Practitioners: Bracing & Equipment Specialist

Surgical and non-surgical treatment options for tennis elbow .

There are numerous treatment options for tennis elbow. The problem is not many of them work well, and we really don’t have a solid treatment that can reliably get rid of the problem in an expeditious way.

Unfortunately, many patients with this condition will have it for a prolonged period of time. The good news is that with or without treatment, the natural course of this disease is to spontaneously go away. It may take several years in some patients, but it usually goes away.

What your doctor or your therapist can do, is help either deal with the symptoms while you have them, or perhaps help you get rid of them faster.

Some of the most basic treatment options involves therapy where you stretch the muscle, or maybe condition the muscle around the scar tissue. Some people think that that increases blood flow to the area to help resolve the scar in the same way as deep tissue massage around the area of the scar may help get rid of it.

Bracing is also helpful, usually in patients who have symptoms that are tolerable, but not so during sporting activities. So they would wear the brace during work, or sporting activities, or anything that causes an exacerbation of their symptoms.

Cortisone injection has been a popular way of helping patients, but there is data right now suggesting that even though you may get resolution of your symptoms from cortisone, it’s usually temporary and those patients getting cortisone often have more symptoms by one year than those who don’t. So currently the thinking is cortisone probably is not in your best interest in the management of tennis elbow.

The final treatment is surgery. Some patients who have prolonged symptoms of tennis elbow, have undergone all of the other models of treatment, and still remain symptomatic beyond six months, are possibly candidates for surgery.

Their principles of surgery involve excising the scar tissue around the area that’s painful, and allowing blood flow to come in to heal this process. So what you’re doing is you’re actually creating an inflammatory reaction, through surgery, to allow it to heal.

Surgeries can be done through small incisions, through cameras, through needles – there are multiple ways of doing it, and I would speak to your doctor about your options.

Presenter: Dr. Bertrand Perey, Orthopaedic Surgeon, New Westminster, BC

Local Practitioners: Orthopaedic Surgeon

Carl Petersen, physiotherapist, discusses golfer’s elbow in tennis.

Golfers (Tennis) Elbow

Golfer’s elbow in tennis is a generic term for pain felt on the medial aspect of the elbow and involves the flexor tendons and muscles of the elbow.

Often what you’ll find is they’ll be pinpoint tender and sore right on the medial epicondial and the forearm flexor muscles running down this side of the arm will as well be very stiff and tight and give pain often times going to the wrist.

Initial treatment should involve RICE, so applying ice is very, very important; but also if we get rid of some of the tension on the muscles, it helps to decrease the pull on to the tendon attachment.

Using a small ball like this and doing some massage work on it will help to decrease the tension on those muscles and decrease the pull on to the tendon attachment. To help treat golfer’s elbow, I think one of the most important things is to go and see a local physiotherapist. They can help you and give you stretches and strength exercises to overcome this common problem.

If you have questions about golfer’s elbow in tennis, contact your local physiotherapist.

Presenter: Mr. Carl Petersen, Physiotherapist, Vancouver, BC

Local Practitioners: Physiotherapist

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