Articles

Tennis Elbow

Seasonal Sports: Tennis

By Dr. Randall Culp
Reprinted here from the Summer/Fall 1997 "First Hand News"

It has been estimated that nearly 80% of tennis players experience pain on the outside of their elbows at some time during their playing years. It is so common that it has become known as “tennis elbow.” The scientific word is lateral epicondylitis, which refers to inflammation of the tendons in that area of the elbow.

Tennis elbow seems to be directly related to the frequency of play. The backhand stroke has been most frequently associated with pain, followed by the forehand stroke and the serve. The two-handed backhand appears to be less aggravating to the elbow. Some believe that a proper backhand, in which the shoulder leads during the swing, can lessen the severity of elbow problems.

Treatment of tennis elbow can be frustrating. Most competitive players are resistant to recommendations that require time away from play. Although immediate care for tennis elbow can lessen the pain, it does not necessarily cure the problem. If this is the case, one should seek the care of a qualified specialist.

Initial treatment is directed towards reducing inflammation on the outside of the elbow where tendons are used to extend the wrist for repetitive motions. This treatment would involve ice, rest, stretching and possibly a change of game style.

Appropriate racket handle size, lower string tension and a graphite design can mechanically reduce stress. In addition, a counterforce brace (tennis elbow strap) has been used effectively to reduce stress at the elbow. A strengthening program under the direction of a qualified therapist is often utilized during this aspect of the treatment protocol. If pain relief is not obtained with this regimen, a cortocosteroid injection may be helpful.

Surgical treatment in the tennis player represents a final alternative. This involves removing the inflamed tendon to allow for tendon healing.