Holding Court: Getting Back Into the Swing of The Game While Avoiding Tennis Elbow

Spring is here and it’s time to get back on the tennis court! Tennis offers many positives—exercise, camaraderie, and friendly competition. And like any sport, it carries with it certain risks, the most common of which is tennis elbow. Fortunately, there are several ways to prevent it and many signs that indicate you may be experiencing the early stages of tennis elbow, allowing you to treat it before it worsens.

The signs and symptoms of tennis elbow are significant pain in the outer part of the elbow when gripping or lifting objects. Tennis elbow—also known as lateral epicondylitis—is caused by repetitive stressing of the forearm muscles. It is most commonly seen in athletes in the 25-to-50 year age group, and typically develops slowly with repetitive activity. If the inflammation stays persistent, micro-tears start to develop where the forearm tendons attach to the elbow.

When the symptoms worsen, even shaking someone's hand becomes a very painful process. On the tennis court, symptoms start to creep up when playing for extended periods of time without letting the elbow recover.

One should seek medical attention if the aforementioned symptoms persist for more than 1-2 weeks or if you start to lose flexibility of the elbow joint. Depending on the severity of injury there are several treatment options. The initial phase of treatment is a period of activity cessation, icing, and bracing. This is often followed by working with a physical therapist, focusing on stretching and strengthening of the tendons, and a two-week course of a non-steroidal anti-inflammatory. A cortisone injection of the elbow can be given to control the inflammation.

A newer injection technique that is becoming more and more common is a Platelet Rich Plasma (PRP) injection, where a small amount of the patient's own blood is spun down to isolate the blood's biologic factors that enhance the healing process. 90% of patients with tennis elbow will improve with conservative treatment.

To reduce your odds of developing tennis elbow, keep the following in mind:

1. Practice moderation by gradually increasing activity over a period of weeks. Warm up properly by stretching your forearm muscles before and after playing.

2. Keep a close eye on your form. A poor backhand technique where excessive wrist motion is used has been directly linked to tennis elbow.

3. From an equipment standpoint, a racket grip that is too small, strings that are too tight, and playing with wet, heavy tennis balls can all aggravate this condition.

Sami Khan, M.D. is a board certified Orthopaedic surgeon and is fellowship trained in Sports Medicine. His area of expertise is Arthroscopic and Reconstructive surgery of the shoulder, elbow, and knee. He is a former associate team physician for the New York Mets and also has written several textbook chapters on the management of shoulder, elbow, and knee injuries. Dr. Khan is in orthopaedic practice with Resurgens Orthopaedics - Johns Creek: 6335 Hospital Parkway, Suite 302.  Johns Creek, GA  30097.  Phone Number 404-575-4500.  Additional information about Dr. Khan can be found at www.resurgens.com.