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من طرف amer_sadaqah الأحد يوليو 27, 2008 6:20 amTennis elbow, or lateral epicondylitis, is the most common injury in patients seeking medical attention for elbow pain. Exactly what causes tennis elbow is unknown, but it is thought to be due to small tears of the tendons that attach forearm muscles to the arm bone at the elbow joint.
The muscle group involved, the wrist extensors, function to cock the wrist back. Specifically, the extensor carpi radialis brevis has been implicated in causing the symptoms of tennis elbow.
What are the symptoms of tennis elbow?
Patients with tennis elbow syndrome experience pain on the outside of the elbow that is worsened by grasping objects and cocking back the wrist. The most common symptoms of tennis elbow are:
Pain over the outside of the elbow
Pain when lifting objects
Pain radiating down the forearm
The pain associated with tennis elbow usually has a gradual onset, but it may also come on suddenly. Most patients with tennis elbow are between the ages of 35 and 65 years old, and it affects about an equal number of men and women. Tennis elbow occurs in the dominant arm in about 75 percent of patients. Anyone can be affected, but tennis elbow is most commonly seen in two groups of people:
Manual Laborers
People who work with their hands are at greater risk of developing tennis elbow. Jobs that may lead to tennis elbow include plumbers, painters, gardeners, and carpenters.
Sports Participants
Sports participants, especially racquet sport players, are prone to developing tennis elbow. About a third of regular tennis players experience tennis elbow at some point in their careers. In addition to racquet sports, tennis elbow is seen in golfers, fencers, and other sports participants.
What is the problem occurring in tennis elbow?
No one knows for certain, but there are several ideas. It is known that tennis elbow is not simply an "inflammation" of the tendons around the joint. The problem is thought to be more of a degenerative process as a result of aging or repetitive use. The symptoms may be the result of an incomplete healing response in an area that does not have good blood flow and therefore has difficulty accessing nutrition and oxygen necessary for healing. This leads to degeneration of the tendon causing small tears.
When do I need to see the doctor for tennis elbow?
Bring the following symptoms to your doctor's attention:
Inability to carry objects or use your arm
Elbow pain that occurs at night or while resting
Elbow pain that persists beyond a few days
Inability to straighten or flex your arm
Swelling or significant bruising around the joint or arm
Any other unusual symptoms
How is tennis elbow treated?
There are several available treatments for tennis elbow. These usually start off conservatively and work up to more involved treatments. Non-surgical treatment is successful in over 90 percent of patients.
Lifestyle Modification
Lifestyle modification is important if tennis elbow does not resolve or if it recurs. With athletes, often an improvement in technique (see below) can resolve the problem.
Changing Stroke Mechanics & Racquet
Tennis racquets should be sized properly. Higher stringing tensions may contribute to tennis elbow. Playing on harder surfaces also increases the risk of developing tennis elbow. Stroke mechanics should be evaluated to ensure patients are hitting the ball in the center of the racquet; players should not lead the racquet with a flexed elbow. See a tennis pro/instructor for a swing and racquet evaluation.
Anti-inflammatory Medications
Anti-inflammatory medications are often used to help control pain and inflammation. The oral forms of these medications are easy to take and often help control inflammation and manage pain.
Cortisone Injections
If these conservative measures fail, a steroid (cortisone) injection is a reasonable option. If a person has tried more than two cortisone injections without relief, it is unlikely that additional injections will benefit the patient.
Elbow Brace and Exercises
An elbow orthosis, called an elbow clasp, can be worn. The theory behind using an elbow clasp is that the brace will redirect the pull of misaligned muscles. Patients often find relief of pain when using the clasp during activities.
Some simple exercises can also be helpful in controlling the symptoms of tennis elbow. These exercises should not cause pain, and those that do should not be done until pain resolves. By strengthening the muscles and tendons involved with tennis elbow, you can help prevent the problem from returning.
Surgery
There are several possible surgical treatments that have been successful. These include removing a portion of the damaged tendon or releasing the attachment of the affected tendon. A repair of the healthy portion of tendon is sometimes carried out as well.
Surgery to release the damaged tendon is usually successful, but rarely needed; about 95 percent of patients with tennis elbow can be treated without surgery. A variety of conservation treatments should be tried prior to opting for surgery.
The muscle group involved, the wrist extensors, function to cock the wrist back. Specifically, the extensor carpi radialis brevis has been implicated in causing the symptoms of tennis elbow.
What are the symptoms of tennis elbow?
Patients with tennis elbow syndrome experience pain on the outside of the elbow that is worsened by grasping objects and cocking back the wrist. The most common symptoms of tennis elbow are:
Pain over the outside of the elbow
Pain when lifting objects
Pain radiating down the forearm
The pain associated with tennis elbow usually has a gradual onset, but it may also come on suddenly. Most patients with tennis elbow are between the ages of 35 and 65 years old, and it affects about an equal number of men and women. Tennis elbow occurs in the dominant arm in about 75 percent of patients. Anyone can be affected, but tennis elbow is most commonly seen in two groups of people:
Manual Laborers
People who work with their hands are at greater risk of developing tennis elbow. Jobs that may lead to tennis elbow include plumbers, painters, gardeners, and carpenters.
Sports Participants
Sports participants, especially racquet sport players, are prone to developing tennis elbow. About a third of regular tennis players experience tennis elbow at some point in their careers. In addition to racquet sports, tennis elbow is seen in golfers, fencers, and other sports participants.
What is the problem occurring in tennis elbow?
No one knows for certain, but there are several ideas. It is known that tennis elbow is not simply an "inflammation" of the tendons around the joint. The problem is thought to be more of a degenerative process as a result of aging or repetitive use. The symptoms may be the result of an incomplete healing response in an area that does not have good blood flow and therefore has difficulty accessing nutrition and oxygen necessary for healing. This leads to degeneration of the tendon causing small tears.
When do I need to see the doctor for tennis elbow?
Bring the following symptoms to your doctor's attention:
Inability to carry objects or use your arm
Elbow pain that occurs at night or while resting
Elbow pain that persists beyond a few days
Inability to straighten or flex your arm
Swelling or significant bruising around the joint or arm
Any other unusual symptoms
How is tennis elbow treated?
There are several available treatments for tennis elbow. These usually start off conservatively and work up to more involved treatments. Non-surgical treatment is successful in over 90 percent of patients.
Lifestyle Modification
Lifestyle modification is important if tennis elbow does not resolve or if it recurs. With athletes, often an improvement in technique (see below) can resolve the problem.
Changing Stroke Mechanics & Racquet
Tennis racquets should be sized properly. Higher stringing tensions may contribute to tennis elbow. Playing on harder surfaces also increases the risk of developing tennis elbow. Stroke mechanics should be evaluated to ensure patients are hitting the ball in the center of the racquet; players should not lead the racquet with a flexed elbow. See a tennis pro/instructor for a swing and racquet evaluation.
Anti-inflammatory Medications
Anti-inflammatory medications are often used to help control pain and inflammation. The oral forms of these medications are easy to take and often help control inflammation and manage pain.
Cortisone Injections
If these conservative measures fail, a steroid (cortisone) injection is a reasonable option. If a person has tried more than two cortisone injections without relief, it is unlikely that additional injections will benefit the patient.
Elbow Brace and Exercises
An elbow orthosis, called an elbow clasp, can be worn. The theory behind using an elbow clasp is that the brace will redirect the pull of misaligned muscles. Patients often find relief of pain when using the clasp during activities.
Some simple exercises can also be helpful in controlling the symptoms of tennis elbow. These exercises should not cause pain, and those that do should not be done until pain resolves. By strengthening the muscles and tendons involved with tennis elbow, you can help prevent the problem from returning.
Surgery
There are several possible surgical treatments that have been successful. These include removing a portion of the damaged tendon or releasing the attachment of the affected tendon. A repair of the healthy portion of tendon is sometimes carried out as well.
Surgery to release the damaged tendon is usually successful, but rarely needed; about 95 percent of patients with tennis elbow can be treated without surgery. A variety of conservation treatments should be tried prior to opting for surgery.
