Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery : (315) 251-3100
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Patient Education

Elbow Tendonitis

Tennis Elbow :: Golfer’s elbow

Tennis Elbow

Lateral Epicondylitis

Lateral epicondylitis, commonly referred to as tennis elbow, is an overuse injury that causes inflammation of the tendons that attach to the bony prominence on the outside of the elbow.  It is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and micro-tears in the tendons that attach to the lateral epicondyle.  The lateral epicondyle is the bony prominence that is felt on the outside of the elbow.

Patients with tennis elbow experience certain symptoms and they include:

  • Elbow pain that gradually worsens
  • Pain to the outside of the elbow that radiates to the forearm and wrist with grasping objects
  • Weak grip
  • Painful grip
  • Pain is exacerbated in the elbow when the wrist is bent back

Tennis Elbow is usually caused by overuse of the forearm muscles but may also be caused by direct trauma such as with a fall, car accident, or work injury.

Tennis elbow is commonly seen in tennis players, hence the name, especially when poor technique is used when hitting the ball with a backhand stroke.  Other common causes include any activity that requires repetitive motion of the forearm such as:

  • Painting
  • Hammering
  • Typing
  • Raking
  • Weaving
  • Gardening
  • Lifting heavy objects
  • Playing musical instruments

Your physician will evaluate tennis elbow by

  • Medical History
  • Physical Examination
  • Diagnostic procedures such as X-rays

Your physician will recommend conservative treatment options to treat the tennis elbow symptoms.  These may include:

  • Limit use and rest the arm from activities that worsen symptoms
  • Splints or braces may be ordered to decrease stress on the injured tissues
  • Ice packs to the elbow for swelling
  • Avoid activities that tend to bring on the symptoms and increase stress on the tendons
  • Anti-inflammatory medications and/or steroid injections to treat pain and swelling may be ordered
  • Occupational Therapy may be ordered for strengthening and stretching exercises to the forearm once your symptoms have decreased
  • Pulsed Ultrasound may be utilized to increase blood flow and healing to the injured tendons

If conservative treatment options fail to resolve the condition and symptoms persist for 6 -12 months, your surgeon may recommend you undergo a surgical procedure to treat Tennis Elbow called lateral epicondyle release surgery.  Your surgeon will decide whether to perform your surgery in the traditional manner or endoscopically.  Traditional surgery involves up to a 2” incision in the elbow area, whereas arthroscopic surgery involves one or two smaller incisions and the use of an arthroscope with a camera for viewing internal structures.

The television camera attached to the endoscope displays the image of the joint on a television screen, allowing the surgeon to look throughout the elbow joint at cartilage, ligaments, nerves and bone.

The benefits of endoscopic surgery compared to the alternative, open elbow surgery, include:

  • Smaller incisions
  • Minimal soft tissue trauma
  • Less pain
  • Faster healing time
  • Lower infection rate
  • Less scarring
  • Earlier mobilization
  • Usually performed as outpatient day surgery

Your surgeon will decide which options are best for you depending on your specific circumstances.

Golfer’s elbow

Golfer’s elbow, also called Medial Epicondylitis, is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and microtears in the tendons that attach to the medial epicondyle. The medial epicondyle is the bony prominence that is felt on the inside of the elbow.

Golfer’s elbow and Tennis Elbow are similar except that Golfer’s elbow occurs on the inside of the elbow and Tennis Elbow occurs on the outside of the elbow. Both conditions are a type of Tendonitis which literally means “inflammation of the tendons”.

Signs and symptoms

Signs and symptoms of Golfer’s Elbow can include the following:

  • Elbow pain that appears suddenly or gradually
  • Achy pain to the inner side of the elbow during activity
  • Elbow stiffness with decreased range of motion
  • Pain may radiate to the inner forearm, hand or wrist
  • Weakened grip
  • Pain worsens with gripping objects
  • Pain is exacerbated in the elbow when the wrist is flexed or bent forward toward the forearm

Causes

Golfer’s Elbow is usually caused by overuse of the forearm muscles and tendons that control wrist and finger movement but may also be caused by direct trauma such as with a fall, car accident, or work injury.

Golfer’s elbow is commonly seen in golfer’s, hence the name, especially when poor technique or unsuitable equipment is used when hitting the ball. Other common causes include any activity that requires repetitive motion of the forearm such as: painting, hammering, typing, raking, pitching sports, gardening, shoveling, fencing, and playing golf.

Diagnosis

Golfer’s Elbow should be evaluated by an Orthopaedic specialist for proper diagnosis and treatment.

  • Medical History
  • Physical Examination
  • Your physician may order an x-ray to rule out a fracture or arthritis as the cause of your pain
  • Occasionally, if the diagnosis is unclear, your physician may order further tests to confirm golfer’s elbow such as MRI, ultrasonography, and injection test

Conservative Treatment Options

Your physician will recommend conservative treatment options to treat the symptoms associated with Golfer’s Elbow. These may include the following:

  • Activity Restrictions: Limit use and rest the arm from activities that worsen symptoms

  • Orthotics: Splints or braces may be ordered to decrease stress on the injured tissues

  • Ice: Ice packs applied to the injury will help diminish swelling and pain. Ice should be applied over a towel to the affected area for 20 minutes four times a day for a couple days. Never place ice directly over the skin

  • Medications: Anti-inflammatory medications and/or steroid injections may be ordered to treat the pain and swelling

  • Occupational Therapy: OT may be ordered for strengthening and stretching exercises to the forearm once your symptoms have decreased

  • Pulsed Ultrasound: A non-invasive treatment used by therapists to break up scar tissue and increase blood flow to the injured tendons to promote healing

  • Professional instruction: Consulting with a sports professional to assess and instruct in proper swing technique and appropriate equipment may be recommended to prevent recurrence

Surgery

If conservative treatment options fail to resolve the condition and symptoms persist for 6 - 12 months, your surgeon may recommend surgery to treat Golfers Elbow. The goal of surgery to treat Golfers Elbow is to remove the diseased tissue around the inner elbow, improve blood supply to the area to promote healing, and alleviate the patient’s symptoms.

Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery
Todd C. Battaglia, MD, MS - Sports Medicine, Arthroscopy, Shoulder & Knee Surgery
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