When the arm muscles are overstressed, not only tennis players and golfers can contract the so-called tennis elbow (alternatively called golfer’s elbow). Craftsmen and professionals who work a lot on computers also risk painful tennis elbow.
What is tennis elbow?
Schematic diagram showing the anatomy of the arm in tennis elbow or tennis elbow. Click to enlarge. The terms tennis elbow and golfer’s elbow, also known generically as epicondylitits, refers to inflammation of the tendons and muscles around the elbow. Tennis elbow involves irritation of the outer muscles of the hand and finger, i.e. the extensor. Golfer’s elbow, on the other hand, refers to irritation of the inner muscles of the hand and finger, the flexor. Technically, the two symptoms are referred to as epicondylitis humeri radialis and epicondylitis humeri ulnaris, respectively. The syndromes received their popular names tennis elbow and golfer’s elbow because of their frequent occurrence among tennis players and golfers.
Causes
In tennis elbow, the causes are primarily due to overuse of the tendons that are connected to the bones in the elbow area. Not only the chronic overstimulation is causative for tennis elbow, but also an acute overload can lead to the painful inflammation of the tendon sections. For athletes in sports such as tennis, golf or table tennis, but also for volleyball players and rowers, the causes of tennis elbow are the constant repetition of monotonous movement sequences. In a large proportion of those affected, tennis elbow can be traced back to an occupational activity that involves one-sided and repetitive movements. This includes, for example, the constant use of the computer mouse. The repetitive movements place excessive strain on the corresponding muscles and tendons, leading to inflammation in the affected tissue. This leads to the pain that is severe for tennis elbow and golfer’s elbow.
Symptoms, complaints and signs
Contrary to what the name suggests, symptoms do not only occur in tennis players. All groups of people who perform monotonous movements with the arm are at risk. All sufferers have one thing in common: pain. It increases with strain. Doctors refer tennis elbow to complaints at the lateral epicondyle. Pain is felt in the area of the bony prominences of the elbow. It is by no means necessary for strain to be present. Signs are also present at rest. Third parties only have to touch the arm lightly, and a pressure pain already develops. Even the mere bending and stretching of the arm can become a pain. Some patients report a tingling sensation in the hand. The arms carry loads in everyday life. With tennis elbow, they can no longer perform this function after some time. There is a loss of strength. Lifting, reaching and carrying can become a painful experience. Even shaking hands becomes difficult. If tennis elbow is not treated professionally, patients often adopt a protective posture. This initially leads to a reduction in the symptoms. As a consequence, however, it promotes tension in other parts of the body. A far-reaching malposition is the result. After some time, the tennis elbow symptoms return.
Course of the disease
A tennis elbow disease usually runs a positive course. Initially, the affected person feels severe pain, especially during rotary movements and heavy loads on the hand and arm, which usually radiate from the elbow in the direction of the hand. If these tennis elbow symptoms remain unattended, the pain worsens in the long term. Even light activities, such as holding small objects or carrying light bags, can then be extremely painful for the affected person. In addition, tennis elbow worsens the strength in the arm and hand, so that a firm grip becomes visibly impossible. Without long-term treatment, the pain of tennis elbow and golfer’s elbow becomes a constant companion for those affected and leads to severe restrictions in everyday life. Only appropriate therapy can allow the inflammation to subside and cure tennis elbow.
Complications
Tennis elbow often occurs in people who put a lot of strain on one or both arms over a long period of time. The ligaments and tendons in the elbow wear out, so that the first pain occurs immediately after the load.If the corresponding arm continues to be heavily loaded, the pain will increase and various complications are possible. The pain may also occur at rest and an abscess may form. If this condition is not treated professionally, further complications can be expected. If the pus fluid enters the bloodstream, there is even a risk of blood poisoning. At the same time, a severe malaise occurs, as well as an elevated temperature. Treatment by an appropriate physician is advisable, otherwise even consequential damage may remain. However, if treatment is initiated at the first pain in the arm, then the above-mentioned complications can be combated or even avoided at an early stage. Thus, the following applies: Anyone who has the first signs of tennis elbow should seek medical and drug treatment at an early stage. In this way, possible complications can be averted at an early stage, so that a much more pleasant course can be expected.
When should you go to the doctor?
People who are exposed to monotonous movements in everyday life should perform compensatory movements at regular intervals. If mild discomfort and initial muscle irregularities occur, self-help measures taken at an early stage may already be enough to provide relief. A doctor is not always needed in these cases. If the symptoms are relieved after a restful night’s sleep or sufficient exercise and sporting activities, no medical treatment is necessary. A physician is needed if the affected person cannot bring about relief of the complaints with his or her own means. Persistent or increasing pain as well as impairment of movement possibilities should be presented to a physician. Regardless of whether the monotonous movements are caused by occupational or athletic activities, a clarification of the symptoms is necessary. It must be checked whether other disorders are present or whether it is a case of overload. The affected person needs medical help and should do physiotherapeutic exercises. Tension, pain as well as disorders of sensitivity should be presented to a doctor. In case of disturbances of blood circulation, a decrease in physical performance as well as the feeling of inner weakness, the affected person needs help. If everyday actions, such as lifting, carrying or holding objects can no longer be performed as usual, a visit to the doctor is necessary.
Treatment and therapy
The treatment of tennis elbow and golfer’s elbow can be done by different methods. On the one hand, there are various ways to treat tennis elbow non-surgically. For acute pain, short-term measures such as cooling and warming as well as massages of the wrist and arm muscles help. Anti-inflammatory and analgesic medications can also provide a short-term solution. These treatment attempts can be supported by immobilizing the arm with the help of a special splint. In the long term, however, permanent measures should be taken against tennis elbow. This includes, for example, physiotherapy. This includes certain stretching and strengthening exercises of the muscles. Wearing a bandage during strenuous activity can also help the symptoms of tennis elbow to subside. If improvement is not achieved through these various methods, surgery may be considered. There are several approaches to surgery for tennis elbow and golfer’s elbow. First, the doctor can separate the inflamed tendon from the bone so that it grows back in a different location. This results in lengthening and thus relieving the strain on the muscle strand. Second, the doctor can perform denervation surgery, which involves cutting the nerve cords. After surgery, tennis elbow should be treated with physical therapy.
Prevention
To prevent painful tennis elbow and golfer’s elbow, several measures are recommended. For one, monotonous movements should be avoided. Second, athletes should pay attention to proper technique during training and respond to mild symptoms as quickly as possible. For non-athletes, an ergonomically designed workstation and regular stretching exercises can relieve strain on tendons and muscles and prevent tennis elbow.
Aftercare
Keeping the arm still, not straining it, and cooling it – this is an effective way to provide aftercare for tennis elbow.In addition, compresses with chamomile flowers as well as curd or buttermilk also help. Rubs with arnica, sage, rosemary and St. John’s wort oil can also provide relief. After tennis elbow surgery, doctors recommend immobilization for about eight to fourteen days to prevent pain. Immobilization in an upper arm cast after surgery is also commonly practiced. But some patients don’t move their non-immobilized joints – such as fingers, thumbs or shoulders – enough while in a cast. This is wrong – movement of all joints that are not immobilized is necessary to optimally advance the healing process. Other doctors do not use plaster immobilization at all. They only recommend resting the operated arm for a period of fourteen days. After surgery, it is important to limit physical activity in the following days, which does not mean lying in bed. In fact, walking seems to be very important – if only to prevent thrombosis. On the other hand, sports activities of any kind should be avoided. Under no circumstances should the operated hand be held down for a prolonged period. Even with an upper arm plaster splint, it is important to move the fingers in the bandage – this helps to avoid swelling. In case of unnaturally severe pain as well as a tight feeling in the bandage or bleeding of the bandage, the doctor should be informed immediately.
What you can do yourself
The cause of tennis elbow can be found in an incorrect strain on the human skeletal and muscular system in the forearm. Often, this area is hardly moved for a long period of time and then subjected to excessive strain through sports activities or other physically intensive work. In everyday life, care should be taken to minimize the difference in a forearm that is hardly used compared to one that is heavily loaded. Since the difference in the load demands triggers the health impairments, the affected person can independently bring about various changes in everyday activities. It is helpful to consciously initiate low stress phases or to perform compensatory exercises. In addition, incorrect postures should be avoided. The movement sequences should correspond to the physical possibilities and are to be optimized. In addition, periods of rest should be taken during periods of high stress. Work on the computer or playing a musical instrument should be interrupted more frequently for the purpose of rest. In a physiotherapy session, various exercises can be learned that lead to an easing of everyday coping. Exercise sessions should be implemented in a disciplined manner outside of the sessions for improvement to occur. For athletes, a sufficient warm-up period is especially important. In addition, changing the duration of a workout can already lead to significant relief of symptoms.
