Tennis elbow, or lateral epicondylitis, is an injury to the tendons along the outer elbow. The inflammation from this injury can cause pain, weakness, aching and tightness. The muscles that open the fingers and extend the wrist all combine to form a common tendon along the outside of the elbow. In tennis elbow, inflammation or tearing of this tendon causes pain with use of the hand and arm.
Tennis elbow, or lateral epicondylitis, is an inflamed or torn tendon on the outside of the elbow
What are the symptoms of tennis elbow?
Pain with grasping things, such as holding a cup, shaking hands, or lifting items
Aching that extends from the outside of the elbow down the forearm
Morning stiffness
Weakness of the hand and forearm
Tenderness when touching or bumping the outside of the elbow
What is the best treatment for tennis elbow?
An elbow strap can stabilize the injured tendon, decrease pain, and prevent further injury.
Rest and avoiding painful activities
Ice can decrease pain and inflammation
Elbow strap can stabilize the injured tendon and prevent further injury
NSAIDs such as Ibuprofen, Aleve, Tylenol, Acetaminophen and Aspirin can help calm the pain from inflammation
Cortisone or steroid injection can help with inflammation, and the bleeding caused by the injection can stimulate a local healing response
Stretches and physical therapy
What stretches are best for tennis elbow?
Stretches should focus on the wrist and forearm flexor and extensor muscles. A supple and well-stretched muscle tends to heal more quickly than a taught muscle.
Wrist extensor stretch:
Wrist extensor stretches for tennis elbow.
Hold your arm straight so the elbow doesn’t bend
Have your palm facing the floor
Use your other hand to bend the wrist down towards the floor
Your will feel a pulling sensation along the back of the forearm
Hold for 30 seconds
Wrist flexor stretch:
Wrist flexor stretches for tennis elbow.
Hold your arm straight so the elbow doesn’t bend
Have your palm facing the floor
Using your other hand, pull the fingers and wrist back towards you
Your will feel a pulling sensation along the inside of the forearm
Hold for 30 seconds
How long does it take to recover from tennis elbow?
Tennis elbow usually takes several months to resolve. Approximately 95% of the time it will heal within 6 months, but can occasionally go on for a year or longer. If symptoms have gone on over 6 months, sometimes an MRI of the elbow is obtained to evaluate the severity of the injury.
On the left shows a normal extensor tendon of the elbow. Notice the tendon (black on MRI) inserting into the bone. On the right shows a torn tendon. The tendon does not attach into the bone. Inflammatory tissue (white on MRI) blocks the tendon from healing back to the bone.
What is tennis elbow surgery?
Some severe cases of tennis elbow that have not healed with other measures may benefit from surgery. In some cases of tennis elbow, the tendon will tear off the bone at the elbow. The inflammatory tissue that develops here is painful and can block normal healing. Surgery involves removing the injured and inflamed portion of the tendon and suturing the remaining, healthy tendon back to the bone. Healing of the repaired tendon takes ~6 weeks. The forearm is usually temporarily weak and achy, and therapy is often helpful to restore strength and function.
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Dr. Schreiber is a board certified orthopedic surgeon specializing in hand, wrist, and elbow conditions. Dr. Schreiber practices at the Raleigh Orthopaedic Clinic in Raleigh, North Carolina.