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Tennis elbow is one of the most common sports injuries. It occurs on the outer part of the elbow making it to be tender and sore. As the name suggests, the condition mostly affects tennis players and other players of racquet sports. Actually, it is estimated that half of all tennis players will suffer from Tennis elbow at least once in their life time with those aged 35 to 40 being the ones in the highest risk. However, research has shown that almost anyone can get the injury. Tennis elbow is also referred to as shooter’s elbow, archer’s elbow or lateral epicondylitis in different books. Though this condition is associated with playing racquet sports, other day to day activities that make use of the same muscles may also cause it, Patient.co.uk. (2011). Lateral epicondylitis is an overuse injury on the common extensor tendon found at the lateral side of the elbow area.
Research has proved that players and people who use similar repetitive motions in their professions for many years are prone to this injury. The condition can also affect an individual after performing such activities especially if they are not used to. The patients experience acute pain in the elbow especially when they try to stretch the arm. The lateral epicondyle, the outer part of the elbow, also becomes tender with frequent stiffness around the region experienced mostly in the morning. The patient also experiences a lot of pain when gripping objects or moving the wrist. Other activities that stretch the tendon causing pain are pouring something like a gallon of milk or lifting something like a bag with the palm down (Boyer & Hastings, 1999).
Initially scholars thought that lateral epicondylitis was only caused by overexertion. However, discoveries have shown that direct hitting of the epicondyle or sudden and strong pulling of the arm may result in this injury. What happens to the common extensor tendon has only been explained in theories. For instance, Cyriax proposed that between the periosteum of the lateral epicondyle which is located on the humerous bone and the common extensor tendon, there exist both microscopic and macroscopic raptures brought about by the excessive use of the arm. These raptures could widen in situations where a player misses the tennis ball ending up overextending the arm. The microscopic tears could be harmless but as the increase in number and size, a mild pain on the elbow starts growing. He proved this by conducting operations on 39 patients of tennis elbow and found out that 28 of them had major raptures on the cuff of the tendon.
Other theories proposed that the radial nerve had more to do with tennis elbow than the common extensor tendon. This nerve supplying the upper limps is divided into branches, one going on to innervate the back of the hand just beneath the skin while the other deep branch becoming the posterior interosseous branch. On patients of tennis elbow, the later branch was noted to have constrictions. These were explained by the adhesions found on the radiohumeral joint capsule. However, patients who contracted tennis elbow through other activities other than playing racquet games seemed to have no problem with the radial nerve. It has also been proved that people with disorders like bicipital tendinitis or calcification on the rotator cuff are more prone to this condition (Kaminsky & Baker, 2003).
Though tennis elbow is seen very common, doctors have not yet reached a universal treatment technique that deals with the injury best. However, the first step to take on discovery of the problem is to stop or withdraw from the activity you are doing. It would only hurt more if a player keeps on playing or training after discovering mild pain on the elbow. In most cases the injury would even heal without medical attention if the player takes the necessary first aid procedures. Withdrawing from the activity and any other chores that may cause pain to the patient gives the elbow the required rest enhancing the healing process. Complete rest of the active arm is very important and one would better use their other arm even for the most minor activities like eating.
Cooling with icepacks regularly also helps a lot with the pain. Doctors have advised that one should use icepacks in intervals of two hours and for durations of about a quarter of an hour. In situations where the pain still persists, it is advisable to take anti-inflammatory painkillers. Ibuprofen has proved to be very helpful on easing the pain of this particular injury. Doctors also recommend anti-inflammatory painkillers that come as creams or gels due to their low level of side-effects, American Society for Surgery of the Hand. (2011).
One could also massage the region especially after two days and also stretch the muscles slowly to ease the tension of the region. This also helps to improve the flow of blood in the region increasing the rate of healing as well as reducing the tendency of swelling. In order to ensure good recovery after the pain is gone, one needs to exercise extensively and carefully before going back to playing. It is important to regularly stretch ones forearm which exercises the extensor muscles. This is best done with the palm down while the elbow straightened. One can also try to grasp the wrist of the injured arm while still holding it straight with fingers pointed to the floor. The grasp should only be firm enough to produce a slight tension on the outside of the forearm.
Regular squeezing of the stress ball increasing the grip strength of your hand is also very good. Lastly one should also work on the flexor muscles by leaning forward while seated and with the hands facing upwards on the knees, trying to lift some weights. Repeat this exercise 20- 25 times. One should also not ignore the general body fitness exercises like swimming, running, cycling among others. However, if the pain still persists, it becomes necessary for one to see a doctor or physiotherapist for proper diagnosis and treatment.
After resuming the playing, one should also one be careful not to hurt themselves again. Gradual build up of the tennis load is very important. One should begin by playing the mini-tennis which is always exclusively within the service lines. It is also necessary to avoid backhands and try hitting the ball with forehands only. Where backhands are unavoidable, the player should ensure that the racquet is double-handed. However, such incidences could be avoided if a slower court was used like the clay court. Topspins should be strictly avoided. These measures ensure that the player uses minimal strength in hitting the ball. It also helps to hit the ball while still in front of the body so as to use both the hand as well as the shoulders distributing the source of energy to shoulder muscles and the trunk. These measures should be abandoned gradually and within a period of less than two months one should be able to play as they used to depending with the severity of the injury.
Treatment strategies on tennis elbow could be grouped into two according to Boyer, M. I. & Hastings, H. (1999). There are the conservative techniques that do not involve any kind of surgery and the modern technique of surgery. Non-surgical techniques have been very successful in curing the injury. Firstly doctors could advise modification of the activity to involve less strength and stress on the elbow as it is described above for tennis players. This is applied for mild injuries. Medications meant to eliminate the pain could also accompany the activity modification strategy. Doctors may also use the tennis elbow brace worn slightly below the elbow around the muscle of the forearm. The brace reduces the tension in the common flexor tendon allowing it to heal (Vicenzino et al., 2007). Physical therapy on the same region helps serving the same purpose as the brace. On sever cases doctors use the steroids injections for up to three times. This medication is injected in to the region to prevent inflammation.
Before the doctors result into surgery, they also can use shock waves on the injured region which has also proved very helpful in recent studies. However, in some instances patients may not respond positively to these non-surgical treatment strategies which makes it necessary to conduct a surgery. This is advisable when the patient has gone for almost half a year with significant improvement. Surgery removes the affected (degenerated) tendon tissue. The procedure could be open also referred to as incision or the arthroscopy which the newest to be invented. However, in both surgical procedures one has to undergo physical therapy in the recovery process. In most cases patients would recover within four to six months after the surgery, Lucia, M. & Safran, R. (2007).
Preventing tennis elbow is not something one could do with certainty. We can only reduce the degree of risk by gradual build-up especially during training, warming up before beginning of matches and lengthy training sessions and use of the right equipment, racquet and balls as well as technique. Tennis elbow will only be a serious injury if not given the required attention when first discovered. Players should be willing to even quit a game since the condition can as well make them retire from the entire profession. Preventive measure can also help one avoid contracting it with a significant level of confidence (Lucia & Safran, 2007).