Tennis Elbow: Common Affliction for Athletes in Several Sports

By Mike Palmisano, MS, ATC

Tennis elbow is common in tennis, golf and other racquet sports involving gripping a handle. Most commonly, you'll find pain in the elbow, specifically the outside or lateral aspect of the elbow. Complaints include tenderness and sometimes swelling over the epicondyle (outer most aspect of the bone) on the lateral elbow. Lateral epicondylitis, more well-known as tennis elbow, is often seen in players with poor technique or those who play for extended time periods. Tennis elbow is most usually an overuse injury. This means that people who experience mild discomfort keep playing which leads to pain. Certainly, continuing to play but not taking measures to control the pain, makes this affliction worse.

Tennis elbow, though most often occurring over time, can also result from a single incident such as a miss-hit or breakdown in the timing sequence of a stroke.  The wrist extensor muscles begin or originate from the lateral aspect of the forearm. This muscle group is involved in grip activities and more so with moving the wrist back, such as in a tennis and golf swing before hitting the ball. On contact, the wrist extensor muscle group must contract to stabilize the racquet or club, which can cause some irritation at the origin. The irritation is caused from the stress on the muscle group, which at the origin is a tendon.

Tennis elbow pain can be persistent and further aggravated by gripping and lifting a coffee pot, or even a coffee mug. The condition can even eventually involve pain with a hand shake which involves gripping. It's important to contact a KORT clinic location and schedule a free screen to take steps to alleviate the stress on the elbow, which cause pain.

Tenderness to touch over the outside elbow area where the tendon begins off the bone and continues into the forearm muscle group that travels to the wrist is a sign of tennis elbow. By stretching the wrist extensors, which involves the elbow extended and bending the wrist down with the other hand, may elicit pain. A KORT clinician can show you how to stretch properly to alleviate pain.

Lastly, resisted wrist extension with the elbow straight (extended) often reproduces pain at the site outside the elbow, which confirms the affliction.   In severe cases, a resting splint is necessary to prevent overuse of using the wrist extensors. This restricts hand and wrist movements to allow for rest and combat overuse. Ice should be used at 15 minute increments a few times a day over the area of soreness. In addition, if necessary, a physician can prescribe anti-inflammatory medication. For treatment and rehabilitation, there are many more steps to reduce the pain, swelling or inflammation, and increase the strength and muscular endurance of the wrist extensor muscles. Also, it's important to strengthen other muscle groups to provide balance in all working muscles of the arm.

Many types of cuffs are popular — worn around the elbow (just below the joint). This helps dissipate the force of muscle contraction (from its point of origin or beginning) and cue the wrist extensors to contract in order to resist sudden stresses. Return to play should involve discussion with a professional clinician as well as your physician. Stretching at various times of the day and certainly before and after playing tennis is a must; as is continuation of some strengthening exercises which can be done at home on your own.

Mike Palmisano, MS, ATC, is an athletic trainer with Kentucky Orthopedic Rehab Team. He worked as a trainer with the U. of L. football program (1988 to 1992), and then joined KORT as their first athletic trainer. He now assists in sports medicine coverage at Spalding University and the Louisville Male football program. Also in the recent past he assisted Louisville Collegiate and the Louisville Fire Arena football team with sports medicine care and coverage. He has an undergraduate degree from the University of Pittsburgh and a master's degree from Syracuse University. Between the degrees, he spent the 1986 NFL season as an intern with the Philadelphia Eagles.