The Star (St. Lucia) - - HEALTH - PRO­TEC­TION:

For ten­nis fans ev­ery­where, Wim­ble­don is an im­por­tant date in their cal­en­dar. For many, the very idea of Wim­ble­don con­jures up vi­sions of straw­ber­ries and cream. For a rel­a­tive few, how­ever, what will come to mind is the prob­lem med­i­cally known as lat­eral epi­condyli­tis, com­monly re­ferred to as ten­nis el­bow. By what­ever name, it de­fines in­flam­ma­tion of the ten­dons on the out­side as­pect of the el­bow, caused by over-use and repet­i­tive move­ments.

Ten­nis is not the only cause though. In fact, only about 5% of ten­nis play­ers will ex­pe­ri­ence symp­toms and usu­ally only those that play more than three times a week, and for longer than 30 min­utes’ du­ra­tion. Any repet­i­tive ac­tiv­ity that uses the same ac­tion can cause LE; for ex­am­ple: electricians, me­chan­ics, gardeners, pain­ters and car­pen­ters of­ten com­plain of the same symp­toms. The most com­mon symp­toms are weak grip, pain or burn­ing felt on the out­side of the arm, some­times ra­di­at­ing up to the shoul­der or down to the wrist. Pain is usu­ally wors­ened by shaking hands, hold­ing a racket, turn­ing a screw­driver or wrench or any grip­ping move­ment

There are four known stages and it is usu­ally not un­til a per­son reaches the fourth stage that they seek help:

• Stage 1 – Slight pain a few hours af­ter the ag­gra­vat­ing ac­tiv­ity.

• Stage 2 – Pain im­me­di­ately af­ter the ag­gra­vat­ing ac­tiv­ity.

• Stage 3 – Pain dur­ing the ag­gra­vat­ing ac­tiv­ity, which in­creases in in­ten­sity af­ter the ac­tiv­ity.

• Stage 4 – Con­stant pain which lim­its all ac­tiv­ity.

The man­age­ment of LE de­pends on the stage and sever­ity of symp­toms. The first treat­ment pro­to­col should al­ways be PRICE:

The best way to pro­tect the mus­cles and joints, re­duce pain and speed up heal­ing in LE is to use a brace. In most cases a sim­ple ten­nis el­bow strap will give re­lief from symp­toms and al­low pain-free move­ment. The strap should be placed just be­low the area of pain. It acts to re­duce the ten­sion on the mus­cles, al­low­ing more func­tion whilst the in­jured area is re­cov­er­ing.

REST: Avoid any move­ment that re­pro­duces your pain. It does not mean stop mov­ing com­pletely. Quite of­ten, to­tal im­mo­bil­i­sa­tion can cause more dis­abil­ity. If you are able to move with­out wors­en­ing your symp­toms, then keep mov­ing. Wear­ing a brace may help but try to avoid ex­treme move­ments, over­bend­ing or stretch­ing. ICE: As soon as you are able to, use ice. Ice can help to re­duce pain and swelling. Af­ter the ini­tial in­jury it is rec­om­mended to use ice for 20 min­utes ever 2-3 hours.

COM­PRES­SION: Wear­ing an elas­tic ban­dage can help re­duce swelling and also pro­vide sup­port.

EL­E­VA­TION: If you find your el­bow is swelling up, rest with you arm sup­ported higher than your shoul­der. This will as­sist the body’s cir­cu­la­tion, re­duc­ing the amount of fluid ac­cu­mu­lat­ing at the point of in­jury.

If your symp­toms do not re­solve, phys­io­ther­apy can help but in some cases an in­jec­tion may be needed or, in ex­treme cases, surgery.

Whether you have suf­fered from ten­nis el­bow be­fore or just want to min­imise the risk of de­vel­op­ing this painful con­di­tion, there are steps you can fol­low to help pre­vent the prob­lem: • Avoid repet­i­tive move­ments.

• Take reg­u­lar breaks.

• Where it is not pos­si­ble to avoid risks, min­imise the ef­fects where pos­si­ble or wear a brace.

• When us­ing tools, use ones with a wider han­dle, whether it is a ten­nis racket or a ham­mer. You can also add pad­ding around the han­dle to ab­sorb the shock.

• When play­ing ten­nis, try to use a two-handed back hand.

• Do strength­en­ing and stretch­ing ex­er­cises on a reg­u­lar ba­sis.

There are other con­di­tions that have sim­i­lar symp­toms so it is rec­om­mended that you seek ad­vice from your doctor or phys­io­ther­a­pist to rule out any other cause or se­ri­ous pathol­ogy.

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