What are Tennis elbows and Golfer's elbows? How should you treat them?

What is Tennis Elbow?

Everyone has probably heard of tennis elbow but do people understand what that really means? Tennis elbow better known as it’s medical term lateral epicondylitis refers to a painful condition of the elbow mainly caused by overuse. The muscle that is the main culprit is the extensor carpi radialis brevis (ECRB).  It is labeled as “Tennis Elbow” because of the repetitive backhands that happens in the sport of tennis.  Just because these conditions are labeled by a sport doesn’t mean the normal person can’t get them.  Actually, it’s just the opposite the majority of people suffer from tennis elbow because of working a normal job. Usually, deskbound workers who suffer from poor ergonomics and repetitive wrist extension can suffer from this condition.  Typical signs and symptoms consist of:

• Pain on the outside of the elbow
• Pain with twisting your arm (turning doorknob or opening jar)
• Stiffness with extending your arm
• Swelling at the elbow

What is Golfer’s Elbow?

On the other side of the elbow the medial side there is a condition called “golfer’s elbow” better known as medial epicondylitis which is just the opposite motion, and this affects the flexor tendons of the elbow.  Golfer’s tend to get this condition from the impact of their swing.  This also happens a lot to individuals who play baseball and is otherwise known as thrower’s elbow.    Typical signs and symptoms consist of:

• Pain and tenderness along the inside of the elbow
• Stiffness and difficulty with making a fist
• Weakness in grip
• Possible numbness and tingling

Management and Treatment for Tennis elbow

Typical management of lateral epicondylitis is dependent on severity and pain level.  Ice and NSAID’s are usually the first line of defense^1.  Another way to relieve tension and stress load by using a counterforce strap (Cho-pat).  These straps are typically used during activity such as playing tennis or golf.  Physical Therapy is important to start right away to get a thorough evaluation to determine specific set of exercises and/or manual therapy to improve symptoms.  Surgery should be last resort and many times surgeons will want patients to try conservative approach for 6-12 months before resorting to surgery. This procedure usually consistent of debridement of the tendon and/or release of tendinous origin at the lateral epicondyle.¹

Treatments for Golfer’s Elbow

The majority of treatments for golfer’s elbow is of the non-surgical variety including:

• Physical Therapy (ROM, strengthening, eccentrics, manual therapy)
• Activity motivation (Reducing load, body mechanics and ergonomics)
• Shockwave therapy (Energy waves to affected tissues)
• Cortisone Injection (To decrease inflammation)
• Cold therapy (Cold tub, ice contrast)

The majority of cases are resolved with non-surgical treatments however there is a small percentage that needs surgical treatment which consists of:

• Medial epicondyle release (surgeon cleans up the tendon and only removes damaged tissue

Is this a problem for the New Sport of Pickleball?

Pickleball is the new craze that is taking over the recreational sports landscape.  Pickleball courts are popping up everywhere and part of the reason is you can have four pickleball courts in one tennis court. However, because it is a racket sport tennis elbow (lateral epicondylitis) can still happen just like in tennis.  One major difference between tennis and pickleball is the size of the racket and ball.  Because the ball is more of a whiffle ball type players tend swing harder to make more of an impact which can lead to more repetitive injuries.  Symptoms will present in a similar fashion as it does with tennis.  One way to reduce chances of getting lateral epicondylitis is to ramp up your volume slowly over a period of time to avoid drastic increase of strain to the muscles and elbow. Anytime you increase load too fast there is risks for injury because the capacity in muscles and tendons are not there yet.

What are some bracing options?

One way to reduce tension and force onto the tendon/elbow is to disperse the force by wearing a type of elbow band which applies direct pressure on the tendon reducing the load to the tendon. This will allow a person to stay active with their sport and not be in as much pain.  Another way to get relief in the elbow is by wearing an arm sleeve compression which improves blood flow which can enhance healing. Lastly, wearing an elbow sleeve/brace can reduce the strain on the elbow with the added compression.

※Insert Zamst-Elbow-Band-x-Tennis.mp4 video

Tennis and golfer’s elbow can happen to almost anybody and especially athletes when the game demands so much time from them.  One thing we know is that if pain starts it’s best to start early and take care of it before it gets worst.  Bracing can be a great option for prevention, early stages of tendonitis or late-stage recovery and return to the court or course. 

Zamst Offers Zamst Elbow Band which can be used for both inner and outer side elbow strain.  One thing we know is Zamst provides a unique blend of comfort and support to keep you playing the sport you love.

ABOUT THE AUTHOR

EVAN JEFFRIES is a physical therapist with a Doctorate in Physical Therapy (DPT) from the University of St. Augustine for Health Sciences.  He is also the owner of Evolving Motion and has vast knowledge of the musculoskeletal system and has treated many orthopedic conditions by bringing a proactive approach to healthcare and lifestyle.  Recently he has also been active on social media as an injury analyst mainly in related to injuries NBA players have sustained.   Evan can be followed on his social media accounts.

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1. Buchana BK, Varacallo M. Tennis Elbow (Lateral Epicondylitis). Treasure Island (FL):StatPearls Publishing 2018 Jan.