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Tennis Elbow: Causes, symptoms, and Treatment
28 Jun 2022

Normal Elbow Anatomy

In the human body, the elbow is the area that lies in the middle of the forearm and the arm that encircles the elbow joint. It allows the forearm and hand to move easily and properly.  In the elbow joint, there are three distinct sections are encircled by a familiar joint capsule. These three joints are present between the humerus of the upper arm, the radius, and the ulna of the forearm.
Our elbow is made up of three things:-

Ligaments

The lateral collateral ligament and medial collateral ligament are two ligaments that help in providing stability to the elbow and also assist in forming the joint capsule.

The lateral collateral ligament is also known as LCL and can be divided into three ligaments:-

1. Lateral ulnar collateral ligament- To make sure that the elbow does not rotate in an extreme way, the lateral ulnar collateral ligament helps in keeping a tab on that.
2. Annular Ligament- It helps in balancing the proximal radioulnar joint. 
3. Lateral radial collateral ligament- This ligament offers stability to the elbow against the inner and outer stress.

The medial collateral ligament is also known as MCL and can be divided into three ligaments:-

1. Posterior oblique ligament
2. Anterior oblique ligament- It makes sure that the elbow does not flex with regard to the body.
3. Transverse ligament

Nerves

In the elbow joint, the nerves primely move to the hand and forearm structures. The joint is basically a crossing space in the extremities of the body for the blood vessels and nerves. 

Blood supply

Radical and ulnar are two brachial arteries that is responsible for transporting blood from the shoulder to the elbow. These two travel over the front of the elbow.  
The moment the radial artery reaches the forearm, they start moving the thumb side towards the wrist and the ulnar artery moves through the pinky finger side of the forearm towards the wrist.

What is a tennis elbow?

Tennis elbow is a kind of swelling of the tendons that happen when tendons get overloaded which later results in potential tearing, degeneration, and inflammation. It typically influences tennis players who hold their rackets pretty firmly. Still, anyone can suffer from this issue.

Causes of tennis elbow

  • Playing Tennis, Squash, Badminton, Javelin, Discus, etc. Sports basically require continuous movement of the elbow.
  • Activities where the elbow is getting bent constantly.
  • Using tools while gardening, decorating, plumbing, etc. 
  • Doing something that demands continuous movement of hand and wrist.

Symptoms of tennis elbow

In tennis elbow, the symptoms slowly get noticeable and may get worse over the passing of time. Symptoms of having a tennis elbow are:-

  • When you extend your arm, you feel pain or stiffness that later can lead to tennis elbow pain.
  • Your elbow joint will get swollen as it will feel very soft when touched.
  • You may feel a burning sensation on the outer elbow that later moves to your wrist. 
  • When you try to hold a racquet, pen, or someone’s hand, you may feel a sense that your hand’s grip is getting weakened.

Tennis elbow treatment

There are chances that the tennis elbow can be better on its own as time passes. Yet, some cases required some extra effort or help to get the tennis elbow cure. There are a number of non-surgical and hardly invasive treatments for tennis elbow:-

  • Rest: In order to give tendons time to cure, one must require either lessen or completely avoid the activities for several weeks. 
  • Physical therapy: Physical therapy exercises can reinforce the forearm muscles as well as your grip. Massage or some muscle-stimulating techniques that may assist to lessen the discomfort and better the elbow’s functions.
  • Braces: The doctor may suggest wearing a counterforce brace as this helps in reducing the tension from muscles and tendons.
  • Steroid injections: The steroid injections help in providing ease from inflammation or joint pain. But it is crucial for the injections to be positioned in the right place. Due to this reason, the doctor performs these injections under ultrasound guidance.
  • NSAIDs: The Nonsteroidal anti-inflammatory drugs may facilitate inflammation and pain.
  • Minimally Invasive Tenotomy: Minimally invasive tenotomy is a procedure to separate the degenerative tendon tissue from inside the tendon. This method requires a needle device that has high pressured saline to make suction and hydro-resect the degenerative tendon tissue. This can be helpful when you want to avoid a larger surgical method.
  • Platelet-rich plasma therapy: Platelets are tiny cell pieces in the blood that helps in healing. In PRP therapy, the provider separates a tiny amount of blood and detached the platelets from other blood cells. They later inject it into the injured wounded place under ultrasound guidance. 

 In Tennis Elbow, surgery is only recommended if the non-surgical treatments are not able to reduce the symptoms for six to twelve months straight. The surgeon removes the damaged muscles & tendons; and replaces them with a healthy ones. These tendons and muscles are taken from different parts of the body. It will take four to six months for the elbow to recover. When the elbow recovers, it is advisable to wear a brace so that those symptoms will not return. 

Do’s & Dont’s after the tennis elbow pain treatment

Do’s 

Keep in mind to stretch the before, during, and after you carry out continuous arm activities.
If you are experiencing inflammation then apply ice, commercial cold packs, or frozen peas. 
If you are working constantly, try to take a few short breaks that will support you in healing better and faster.

Don’ts

While doing the desk work, make sure not to sit in a bad posture.
Make sure that you take a break from doing repetitive activities that requires your elbow.
Try to avoid the activities that cause pain. 
Make sure not to overwork yourself.

Why Dr. Darsh Goyal is the best choice for your Tennis elbow treatment?

Dr. Darsh Goyal is a renowned Orthopedic Surgeon who has experience of nearly two decades in knee and shoulder surgery. He has worked in some of the finest hospitals across the globe. He has successfully treated more than nine thousand patients. Dr. Darsh has received training from some of the most respected institutes worldwide - NHS England, Hss New York, USA, and Munich, Germany. He has written many books and international papers. Dr. Goyal’s Bones & Joint Centre is among the best centers for advanced Arthroscopy/Laser Surgery for knee and shoulder and Fast track Total knee Replacement.

FAQs

What happens if tennis elbow goes untreated?
Generally, tennis elbow does not result in any major issues. But if the situation keep up and remain untreated, then elbow and forearm can get out of motion. 
Can tennis elbow happen suddenly? Before tennis elbow happen, a certain number of symptoms can be noticable. These symptoms are the result of extreme use of hand and wrist for a very long time. These symptoms later result in the rise of the tennis elbow.

Can tennis elbow cure itself?
Yes, the tennis elbow can cure itself, as it usually happen in most cases. One the efficient ways to speed the healing of your tennis elbow is by taking a break from performing any activity that involves repetitive elbow movement. 

When should I see a doctor for tennis elbow?
It completely depend on the person. But it will be best if you visit the doctor when you start experiencing some symptoms that are the redflags for tennis elbow.
 
Why does tennis elbow hurt more at night?
At night, the relatively static body and the fall in the blood circulation can cause stiffness in the tendons and muscles that leads to extreme pain in the elbow when you wake up in the morning.