Tennis elbow could take six months to heal
INJURIES to the lower limb account for around half of all sporting injuries with those to the knee and ankle the most common. However the pattern of injury is usually sport specific.
Not surprisingly elbow injuries are most commonly seen in throwing and racquets sports and occur in participants of all ages and abilities. Acute elbow injuries normally present with swelling and pain. As in all sporting injuries the mechanism of injury will give important clues as to the likely diagnosis.
Certain sports will result in particular injuries – racquet sports with tennis elbow, golf and bowling with pain on the inside of the elbow and griping sports such as canoeing and rock climbing with tendon problems. More chronic injuries result from overuse – the most common and well known is tennis elbow.
As those of you who have suffered from tennis elbow will know, this condition results in pain localised to the bony prominence on the outside of the elbow where the tendons of the extensor muscles of the forearm attach to the elbow.
Previously thought to be an inflammatory condition tennis elbow is now considered a degenerative condition caused by repeated trauma resulting in incomplete healing of the tears in the tendon and the growth of new blood vessels in the area, usually in the dominant arm.
In light of this new understanding steroid injections, one of the standard treatments for inflammation, are now rarely used as a treatment for this condition.
Tennis elbow results in pain during even simple tasks such as opening a door, shaking hands and gripping and affects the ability to work and carry out normal household tasks such as painting, ironing and even using a computer mouse.
Simple tests such as bending the wrist against resistance and local tenderness over the bony prominence on the outside of the elbow will confirm the diagnosis. Treating the condition starts with identification of the cause.
In racquet sports it can be the result of poor technique or poor equipment such as using a racquet which is too heavy or whose grip is too big/small. In work repetitive movements such as painting, typing or using a screwdriver are common precipitants, but often difficult to modify.
Initial rest, ice and painkilling medication will settle the acute symptoms and allow initial healing.
Prevention of reoccurrence will involve physiotherapy input, using an elbow brace or clasp and muscle strengthening programmes, acupuncture and friction treatment – all best supervised by an experienced sports physiotherapist.
Despite my earlier comments steroid injections are still used occasionally and surgery is normally left until other treatments have failed. The good news is that when the reversible factors are corrected the natural history of tennis elbow is a gradual resolution over six months.