Tennis and Golfers Elbow
 
 

Tennis and Golfers Elbow: How to deal with overuse injuries

 

Lateral epicondylitis or “Tennis Elbow” as it is commonly referred is an inflammation with associated pain around the outer part of the elbow.  Tennis Elbow become popular terminology years ago and was associated with a poor backhand stroke in tennis among amateur players.  Weaker players would extend the wrist during impact of the ball on the racket causing increased strain to the tendon structure attached to the outer elbow region.  This along with using a grip that was too small or large increased the incidence of pain and the terminology, “Tennis Elbow” was created.  This condition is also known as “mechanic’s elbow” or “painter’s elbow.  Lateral epicondylitis is more commonly seen in people with occupations that cause them to over use their arms.  It is an overuse of the muscles which are attached to the outer part of the elbow, the muscles that pull the wrist backwards.  Diagnosis of this condition is a fairly simple process in testing for tenderness over the outer part of the elbow and asking the patient to extend the wrist against resistance.  When both symptoms are painful, it is likely that you have tennis elbow. 

 

Medial Epicondylitis or “Golfers Elbow” as it is commonly referred is an inflammation with associated pain around the inner part of the elbow.  In youth baseball players, the condition is referred to as “pitcher’s elbow” which is a sign of poor mechanics in the younger pitcher that causes increased stress placed upon the inner elbow region.  Any position player can experience pitcher’s elbow if they do not properly condition and go through a throwing program before the beginning of a new season.  This condition is young athletes can progress fairly rapidly into a more serious condition if left alone.  Changing faulty mechanics when throwing and performing the proper stretches with ice can help prevent further progression.  The muscles that bend the wrist inward when used in a repeated and forceful manner cause tiny tears in the tendon area of the attachment to the inner elbow region.  Again, any occupation that causes repeated overuse of these muscles with gripping, grasping, and turning of the hand are found to be common activities that cause medial epicondylitis.  Golfer’s elbow is caused by the right hand overpowering the pull of the left hand through the golf swing as well as a high handicap golfer that hits the ball “fat” with the ground causing increased stress to the muscles and tendons.  Diagnosis of this condition is a fairy simple process in testing for tenderness over the inner part of the elbow and asking the patient to flex the wrist against resistance.  When both symptoms are painful, it is likely that you have golfer’s elbow.

 

Treatment of both of these conditions starts with rest from the activity that caused the symptoms to occur while allowing time to heal and applying ice to the inflamed area will help decrease pain and swelling.  Physical therapy can help to instruct the patient in proper stretching and strengthening exercises as well as using certain modalities such as ultrasound.  A new treatment technology that utilizes laser light is now available to help heal the injured tissue.  Early on, isometric exercises help to maintain muscle mass without over stressing tissue with progression into progressive resistive strengthening exercises to help increase strength and endurance of the muscles around the elbow.  Problems can be avoided by taking frequent breaks as you work, improving overall arm muscle condition, and limiting heavy pushing, pulling, or grasping.  Working on good mechanics in the tennis stroke and golf swing as well as working with younger athletes on good mechanics off the mound when pitching will help prevent these conditions as well.