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By Stephenie Karony

Wednesday, November 8, 2000

Serving up help
for tennis elbow

Question: What causes tennis elbow and what are my options for treatment?

Answer: Lateral epicondylitis or elbow tendinitis is often referred to as tennis elbow. Tennis elbow is an inflammation of the muscles and tendons that attach at the elbow. It's usually caused by repetitive stress to these muscles and tendons. In severe cases micro tearing may also occur.

Tennis elbow can develop in anyone who uses the muscles that extend the forearm excessively. Individuals whose work requires them to use a tool repetitively are at a high risk of developing the conditions.

Among tennis players there are a number of possible causes: repeated use of the backhand stroke, using a racket handle that's too small for one's grip, gripping the racket handle too tightly, or having strings that are too tight on the racket.

There is also another similar joint disorder called medial epicondylitis. The most common name for this condition is golfer's elbow or pitcher's elbow. The main cause of this condition is excessive stress on the wrist forearm muscles combined with repeated tension on the elbow joint.

Golfers, pitchers and racquetball players are at a high risk of medial epicondylitis. This condition is associated more with sport activity than is tennis elbow. Of the two, tennis elbow is more common than golfer's elbow because tennis elbow is often attributed to job related joint stress.

Symptoms of both lateral and medial epicondylitis are the same. The elbow hurts. The pain can even radiate down the forearm, and if you don't take immediate steps to fix the problem, it will intensify with continued use. The pain is sometimes accompanied by swelling or tenderness.

If the condition is left untreated, movements such as flexing or extending the wrist, as in picking up a cup of coffee, can become difficult. At its worst, the joint will hurt, become inflamed and a feeling of catching or sticking may even develop. You're in real trouble if you let it go this far.

General treatment of both disorders is: Avoid all activities that aggravate the affected area. Ice the elbow joint for 20 minutes, several times throughout the day; this helps control the pain and inflammation. An over-the-counter anti-inflammatory is also recommended. When the swelling subsides, start doing some simple range of motion exercises. Once the pain is gone, start some strength and flexibility exercises.

It's at this point that you'll need to follow some specific guidelines, from a doctor, physical therapist, or other qualified professional. Healing protocols vary depending on the type and severity of the injury.

Your return to activity should be slow. If you jump back in at the level you were at when the injury occurred, re-injury is almost certain.

There are a variety of devices that can be worn to help protect the elbow joint. Braces, sleeves, joint wraps, and air bands can all help alleviate the stress placed on the muscles that insert at the elbow.

Of course the best way to avoid major problems is to prevent them from occurring in the first place. But if they do occur, early detection and treatment is your first line of defense. Always maintain good form when moving the elbow and wrist; faulty movement mechanics are often at the heart of these types of injuries. Develop strong muscles in the arm, and keep those muscle limber with regular stretching routines. Allow your body to rest as much possible.

If you enable an overuse injury to re-establish itself , you'll be setting the stage for a lifelong chronic problem.

Health Events

Stephenie Karony is a certified health
and fitness instructor, a personal trainer and the author of
"Body Shaping with Free Weights." Send questions to her at
P.O. Box 262, Wailuku Hi. Her column appears on Wednesdays.

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