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Tennis Elbow

Tennis elbow (or lateral epicondylitis) is characterized by the inflammation of tendons connecting the forearm muscles to the exterior elbow, causing pain and discomfort. The condition results from joint overuse, especially in cases of repetitive motion. While tennis and other racquet sport players are significantly more susceptible to this ailment, any exhaustive action may be accountable for its eventual development. Continue reading for an overview of this common concern.

What Causes Tennis Elbow?

In most cases, tennis elbow is caused by overuse of the muscles, ligaments, and tendons in the elbow joint.* Composed of three bones – the humerus, radius, and ulna – the elbow joint is held in place by a complex system. The medial and lateral epicondyles form the bony bumps of the elbow where the muscles of the forearm attach. The Extensor Carpi Radialis Brevis (ECRB) tendon insertion is usually the primary site of injury and generally represents a partial tear that causes pain but does not weaken the tendon. This type of injury is marked by a lack of healing/inflammation in an area of injury and is referred to as an enthesopathy.

In addition to athletes, individuals participating in vigorous work or recreational activities may run the risk of developing tennis elbow. Professions exhibiting a higher than average rate of the ailment include: painters, plumbers, cooks, and autoworkers. This frequency is likely associated with the emphasis on weight-based repetition that characterizes these roles. Furthermore, individuals aged 30 to 50 years also show an increased prevalence for the development of tennis elbow.

What Are the Symptoms of Tennis Elbow?

The symptoms of tennis elbow are progressive in nature and often intensify over time. As the condition is not typically associated with a specific injury or traumatic event, pain will often begin as a mild discomfort or burning sensation at the lateral epicondyle. This pain may first present when you perform small tasks that require grip and wrist extension (e.g. extending the arm or opening a door).* As the condition progresses, you may experience weakness, which can make forearm activities difficult and increasingly painful. At this point, it may be time to consult a professional.

How Is Tennis Elbow Diagnosed?

In the diagnosis of tennis elbow, your experienced hand surgeon completes an in-depth analysis, including the completion of a medical history, as well as a series of strength, mobility, and resistance tests. If you have experienced a previous elbow injury, rheumatoid arthritis, or nerve disease, you should notify your physician at the time of assessment, as any of these factors may imitate the condition.  

If the initial examination suggests tennis elbow, additional tests, such as an x-ray or MRI (magnetic resonance imaging), may be recommended. These procedures will allow your doctor to assess the level of damage severity and determine the best approach for comprehensive treatment.

How Is Tennis Elbow Treated?

For the majority of patients suffering from tennis elbow, non-surgical intervention will prove advantageous. Recommended approaches may include: 

Surgery is generally not recommended until a significant trial of conservative management has been trialed as many cases (~90%) will resolve with conservative management. If surgical treatment is prescribed, your doctor will recommend the most suitable intervention approach, as based on your specific injury and activity needs. Surgery has a high rate of pain resolution but can have a prolonged recovery; as such, it is generally best to trial conservative management first.

What Is Recovery Like After Tennis Elbow Surgery?

While the risks associated with tennis elbow surgery are limited, you should contact your doctor immediately if any of the following symptoms occur:

Following your operation, you will likely be prescribed to wear a splint for at least one week, or until all associated sutures and dressings are removed. Once your splint is no longer needed, you should follow the regimen of at-home exercises and/or formal physical therapy outlined by your doctor. While you should be able to return to most physical activities within six months of operation, full recovery will depend on your post-operative adherence to treatment and care recommendations.

Why Choose Our Surgeons for Tennis Elbow Treatment?

Because tennis elbow can be a painful and debilitating condition, it is important to choose an experienced provider for your treatment. We advise you to place your care in the hands of a physician who has years of experience treating this concern and is familiar with a wide range of potential solutions. 

For instance, board-certified plastic surgeons AND Hand Surgeons Dr. Derek Rapp and Dr. Bruce Byrne are highly proficient in tennis elbow treatments. We would be happy to meet with you for a consultation to determine the best course of action for your needs.

Contact Our Practice

If you would like to schedule an appointment, we encourage you to contact our office.

Medical References*

Mayo Clinic
Penn Medicine 
American Society for Surgery of the Hand (ASSH)