Tennis Elbow


Understanding Tennis Elbow

The elbow is a hinge joint that connects the upper arm and lower arm. It consists of three bones: the humerus, radius, and ulna. Each bone is capped with cartilage and a complex array of ligaments and tendons from various muscles that cross over the joint. Tennis Elbow, or lateral epicondylitis, is an overuse injury and inflammation of the common extensor tendons of the forearm as they attach to the lateral epicondyle, or outside part of the elbow.

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  • Pain and tenderness over the outside of the elbow
  • Stiffness in the elbow joint, especially in the morning
  • Pain with your grip
  • Difficulty lifting heavy items, especially with your palm facing down

When to Seek Treatment

If you’re noticing symptoms associated with Tennis Elbow and suspect an issue, it’s crucial to consider consulting a board-certified specialist in order to obtain an accurate diagnosis and timely treatment. Early intervention can significantly improve your overall well-being and provide a broader range of treatment options, which may decrease as symptoms persist. The key to a successful and speedy recovery lies in addressing the root of the pain with your specialist as soon as symptoms arise.

While many people experience day-to-day pain, dismissing it as soreness, this may not be the case for everyone. If your pain persists for more than 10 days, it should be taken more seriously. Evaluate such prolonged pain with a specialist to identify the root issue and determine the appropriate treatment. Additionally, be attentive to other signs related to pain that should not be ignored, including pain accompanied by fever, pain associated with loss of bladder control, and weakness/tingling/numbness in your arms or legs.

It’s important to note that these are general guidelines based on our expertise over the past three decades, recognizing that each patient’s symptoms may be unique.

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Common Causes

You do not need to be a tennis player to get tennis elbow! Most often this injury is due to overuse, especially with repetitive activities from certain jobs, sports, or home activities. Over time, the gripping muscles and tendons on the outside of the forearm/elbow sustain forces that exceed their capacity leading to micro-injuries. You may not notice these at first, but given enough time, the tendon starts having larger tears, gets thick, swollen, and inflammation starts to settle in causing pain and decreased function.

Risk Factors

  • Repetitive gripping activities in sport, work, or daily life.
  • As we age tendons get stiffer, weaker, and more prone to injury
  • Smoking
Shadow of Woman Playing Tennis
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Diagnosing Tennis Elbow

A comprehensive history and physical examination is the most important piece to determine if the common extensor tendons are involved in your elbow pain. X-ray, MRI, and/or ultrasound are imaging modalities that allow us to see the tendons and surrounding tissues.

Treatment Options

  • Bracing may be needed to help of-load the tendon and facilitate healing
  • Physical therapy – To help build strength and improve function of the weak tendons.
  • Medications – NSAIDs or Tylenol may be recommended short term to help control symptoms while going through a physical therapy program
  • Steroid Injections – Strong anti-inflammatory medicine may be injected, typically under ultrasound guidance, to help reduce pain and inflammation in order to better facilitate physical therapy. Steroid injections are typically okay once for extremely painful elbows, but repeated injections are not recommended as they often weaken the tendon, leading to worse symptoms and outcomes down the road.
  • Regenerative medicine– Harnessing the body’s incredible power to heal itself, rebuild tissue, and avoid surgery. The best option is PRP to stimulate tissue healing and repair along with a course of physical therapy.
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