Tennis / golfer’s elbow is a form of tendonitis caused by overusing the tendons in the forearm. The tendons can become strained as a result of repetitive motions of the wrist and arm. The two conditions are very painful and are similar, except tennis elbow causes pain on the outside of the elbow while golfers’ elbow causes pain on the inside.
Despite its name, only around five out of every 100 people with the condition develop it from playing tennis or golf. A significant number do have elbow pain as a result of sporting activities, however.
The condition can occur in anyone whose work entails making repetitive wrist and arm movements, such as painters, plumbers, butchers, carpenters and, of course, sportsmen and women. You can also develop the condition if your forearm muscles are not used to performing certain activities such as decorating or gardening.
Straining the muscles and tendons in the forearm leads to a break down of collagen and can cause microscopic tears and inflammation around the lateral epicondyle, which is the bony lump on the outside of your elbow. Over time, these microscopic tears cause tendonitis and can become partial or full thickness tears.
Among the activities that can trigger tennis / golfer’s elbow are:
- Manual work such as plumbing or bricklaying
- Racquet sports like tennis or squash
- Throwing sports like javelin or discus
- Painting and decorating
- Activities that involve small, repetitive hand or wrist movements, such as typing or playing the piano
- Playing the violin or other activities that involve repeatedly bending the elbow
It is a common condition that most often occurs in 30-50 year olds. It may last one to two years and can often recur.
Symptoms include pain on the outside or the inside of the elbow as well as the forearm and in the back of the hand. This can range from mild discomfort to severe pain. It is often made worse by using your arm, particularly for twisting movements or gripping. The pain is most likely to be felt:
- Just below your elbow, on the outside or inside of your upper forearm
- When holding a pen or other small object
- When twisting the forearm, for example to turn a door handle
- When fully extending your arm
- When lifting or bending your arm
tennis / golfer’s elbow usually gets better on its own with painkillers, anti-inflammatories and rest, which is vital as it enables the tendons to heal. You should seek medical help, however, if your symptoms have lasted longer than six weeks. Ice packs applied for 15 minutes three or four times a day can help to reduce swelling and alleviate pain and you may also want to use tennis elbow clasps or taping to reduce symptoms. Physiotherapy may also help. A physiotherapist will evaluate movements that you perform repetitively as part of your job or sport and can teach you exercises that will help to avoid repetitive wrist motions wherever possible and stretch and strengthen the muscles of your forearm.
You may be offered an injection of platelet-rich plasma (PRP), which uses plasma from your own blood to encourage healing, or dry needling of the damaged tendon to promote healing. Ultrasonic tenotomy inserts a needle into the damaged portion of the tendon using ultrasound guidance. Ultrasonic energy vibrates the needle so swiftly that the damaged tissue liquefies. It is then suctioned out to enable the tendon to heal.
Surgery is very rarely used for tennis elbow although it may be used for other problems around the elbow such as ligament injuries.
Elbow arthroscopy – if your condition hasn’t improved after six to twelve months, you may be offered an elbow arthroscopy. During the procedure, small incisions are made in the skin through which a thin, tube-like instrument called an arthroscope is inserted. Small surgical instruments are used to remove damaged section of tissue. In some cases, this procedure may be performed using open surgery.