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Tony Lee's Professional Tennis School

Treating Tennis Elbow

Tennis elbow

Tennis elbow produces pain on the outside of your forearm near your elbow when you exercise the joint. Tiny tears in tendon tissue cause the discomfort. In some cases, you can get relief from a forearm support bandage (see inset) worn just below your elbow.

Tennis elbow (lateral epicondylitis) can be a frustrating condition to treat. Symptoms are often long lasting and may interfere with many sports and activities of daily living.

One of the main things physicians look at is what caused the problem. There usually is something faulty in a person's tennis or golf swing, technique in weight training, or the way he or she performs a job task that contributes to increased load and stress on the outside of the elbow where the muscles that lift up the wrist (wrist extensors) attach.

Tennis players increase their risk of injury by using poor techniques, such as incorrect grip, improperly bending the elbow when serving and hitting the ball late. An improper backhand is one of the most common causes of tennis elbow. Poor form includes leading with the elbow and using just upper body to hit the ball. In a proper backhand, the elbow stays in line with the racquet hand, while the feet, legs, hips, shoulders, and arms contribute to the stroke. One way to make the backhand easier on the elbow is to use two hands. With a two-handed stroke, the trunk and arms move together so the elbows don't have to do as much. If you use a one-handed backhand, use a grip that permits the inside of the thumb (not the bottom part) to stay in contact with the racquet handle. The, let your elbow drop down and away from your body as you swing. You may also suggest equipment changes to help prevent tennis elbow. Some tips include using a flexible racquet, string it with a "soft" string at the lower end of the manufacturer's recommended tension and using an elbow brace. Players should also use as large a grip as can comfortably be maneuvered, restring the racquet often and use new balls when playing.

Treating tennis elbow involves several steps. The first is to apply crushed ice bags or towels to the affected area for approximately 10-15 minutes a few times a day. Or, use solid ice in a paper cup to massage the injured area in a circular fashion. When applying ice directly to the skin, reduce icing time to six to eight minutes to protect the skin from burns. Avoid actions that reproduce pain at the elbow, such as picking up a coffee cup. Elbow inflammation should subside after a week or two of little to no use. Once the injury begins to improve, it's time to strengthen and increase the flexibility of the forearm. Two exercises to perform several times a day are squeezing a tennis ball and opening your fingers against the resistance of a rubberband. Players can also do three sets of 15 wrist curls, inverted wrist curls. Once the elbow and wrist feel better, it is important to return gradually to the game. At first, try to the avoid hitting backhands and reduce power of your serve. After play, ice the elbow. If symptoms are gone, gradually increase the intensity of your game over time. Remember to always warm up and stretch your forearms before play. Should tennis elbow pain be severe or long lasting, it is important to contact a physician about treatment.

A strap can help to take force away from the painful region. Corticosteroid medication can be administered locally with a modality called "iontophoresis" (driving the corticosteroid molecules under the skin via electrically charged particles), and occasionally an injection may be indicated to reduce inflammation. It's also critical to hold the wrist in a neutral and stable position during activities and exercises, especially when lifting.

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