Today I am going to do a sports specific article. I am going to focus on tennis and a very common injury for tennis players of all experience levels. The injury is Lateral Epicondylitis also known as Tennis Elbow. This injury is a very common overuse injury of the wrist extensors. Wrist extensors are primarily used on players backhand ground strokes, serves, and specifically kick serves. The pain, soreness, or swelling will be located on the outside and upper portion of the elbow. This discomfort is caused usually by micro tears within the tendon fibers. With these tears comes inflammation to the area. The tendons that are specifically injured are:
- Extensor Digitorum
- Extensor Carpi Radialis Longus
- Extensor Carpi Radialis Brevis
- Extensor Carpi Ulnaris
Tennis players are not the only people that are susceptible to this injury. Plumbers, carpenters, construction workers and any other professions that do any repetitive twisting motion commonly used with screwdrivers are also susceptible. Professions that use a computer mouse for a large portion of the day may also acquire this injury. If pain is felt at the elbow when the wrist is bent backwards like the position of revving a motorcycle engine, this is the most common indicator of tennis elbow. X-rays are rarely used in the diagnosis of tennis elbow due to the soft tissue nature of the injury.
Treatment may vary depending on severity. Ice for 15 min on and then 15 min off is always recommended for acute inflammatory type issues. Kinesio tape can prove beneficial for those who want to remain active and not restrict range of motion while still providing added support to the area. Kinesio tape also aides in the dispersion of inflammation and swelling in the area. For more severe cases a "tennis elbow" brace which more or less creates a new muscle insertion for the extensor tendons may be needed. These braces may not restrict ranges of motion but do tend to be uncomfortable due to the tension at which they must be applied. Graston therapy which is a form of soft tissue and muscle stripping can prove to be of great use during the healing process as it promotes proper healing and minimizes unorganized scar tissue formation. Graston also helps by increasing motion of lymph fluid specifically useful for inflammation and swelling in the area. Finally and most over looked is the nutritional aspect. The inflammatory reaction that occurs with tennis elbow is the primary pain generator. Omega-3 and proteolytic enzymes are very important for controlling and breaking down the inflammatory response. Everyone should consume about 2-2.5 grams of fish oil but when experiencing tennis elbow this is especially important to counter act the pro-inflammatory state as well as some form of proteolytic enzyme for the acute injury. We at Healthy US provide quality fish oil supplements as well as a proteolytic enzyme supplement for acute injuries by the name of Zymain both made by Anabolic Laboratories. Please check out our nutrition store for more information. For more information on the health benefits related to an anti-inflammatory lifestyle please refer to our previous blog article "Battle Against Inflammation" from a few days ago. Maximum recovery time for tennis elbow can be expected to be about 8 weeks for the most severe cases if patient is following their doctors medical advice as well as resting the area as much as possible.
- Regan WD, Grondin PP, Morrey BF. Elbow and forearm. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:chap 19.
- Enig MG. Know your fats. Silver Spring: Bethesda Press; 2000: p. 123, 142, 280-292.
- Harris WS. Fish oil supplementation: evidence for health benefits. Cleve Clin J Med. 2004;71(3):208-21.