Tennis Elbow and Golfer's Elbow
By Brett Jameson, M.D.
During the summer months, many of us enjoy outdoor activities. For some tennis and golf become a favorite past time. Along with increased time spent participating in these activities comes the increased risk for overuse injuries.
Tennis Elbow and Golfer's elbow are both conditions that cause inflammation of the connective tissue in the elbow area. Often amateur and professional golfers and players who use rackets in their game are affected, but the injury can occur in anyone who uses frequent rotating motions involving the forearm. These conditions may also be referred to as tendonitis or epicondylitis.
The typical person with tennis elbow is between 35–50 years of age who reports the gradual onset of pain on the outside of the elbow. The condition of tennis elbow involves the tendons that are attached to the muscles that help the wrist and fingers bend back. At the elbow, a small tendon connects to the much larger extending muscles of the forearm. With repetitive use of the extending muscles, such as in hammering or playing racquetball, this small tendon becomes overworked and inflamed. If you have this condition, you will feel pain on the outside of your elbow. With time, the pain can become severe and occur at rest.
Both conditions have contributing factors. These can include, weak and/or imbalanced muscles, overuse, excessive use or repeated extension of the forearm or twisting of the wrist, using the wrong equipment (wrong size, incorrect grip, strings too tight, improper string tension, or poor techniques (using too much wrist action).
The most important step in treatment of tennis elbow and golfer's elbow consists of modifying or eliminating the activities that cause symptoms. Simple things like changing to a lighter weight racquet, golf club or over wrapping the handle to make it slightly larger can help decrease symptoms. Anti-inflammatories such as Aleve, Ibuprofen, or Motrin can be used for acute exacerbations. A tennis elbow strap worn just below the elbow during heavy-lifting or while playing tennis can help. Application of heat or ice (whichever works best) may relieve pain and inflammation. Once the pain has decreased, gentle stretching and forearm-strengthening exercises can be initiated. If symptoms persist, a steroid injection may be helpful with the last result being surgical treatment. For severe and long-standing cases that fail to respond to treatment, activity modification may have to be permanent.
When returning to sports or the activity that caused the symptoms, it is important to follow your doctor's recommendations and let pain be your guide as to how much you should do. Always warm up before and cool down after the activity. When returning to a sport, you need to get into the game gradually. Play less intensely for shorter periods of time when you first start back. Don't play competitively until the elbow heals. If tennis is the game of choice, rally for short periods of time and let the more difficult shots go. If golf is the game of choice, try putting and pitching before slowly working up to playing a few holes at a time and then to playing a complete course.