Elbow

Your elbow is a hinged joint made up of 3 bones: your upper arm bone (humerus) and the two bones in your forearm (ulna and radius). Muscles, ligaments, and tendons hold the elbow joint together, to form the joint capsule- a fluid filled sac that surrounds and lubricates the joint.

Muscles
The muscles in your forearm cross the elbow and attach to the humerus. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle, while the bump on the inside of your arm is called the medial epicondyle.

Ligaments
The important ligaments of the elbow consist of the medial collateral ligament (on the inside of the elbow) and the lateral collateral ligament (on the outside of the elbow). These ligaments work together to stabilise the elbow, holding the humerus, radius and ulna tightly together. Another ligament called the annular ligament holds the radial head tightly against the ulna.

Tendons
The tendons in your elbow attach muscle to bone. The biceps tendon attaches the biceps muscle on the front of your arm, and the triceps tendon attaches the triceps muscle to the back of your arm.

Nerves
The arm consists of nerves that travel down and move across the elbow. There are three main nerves: the radial nerve, the ulnar nerve and the medial nerve. These nerves are responsible for controlling your muscles and sensations, such as touch, pain and temperature.

Tennis Elbow

WHAT IS A TENNIS ELBOW?

Tennis elbow is inflammation of the tendons that join the forearm muscles on the outside of the elbow. The main cause of the inflammation is damage to the tendons due to overuse, such as repetitive gripping motions which causes strains and even microscopic tears in the tissues.

Despite the name, this condition is not limited to only tennis players but anyone can develop it.

WHAT ARE THE SYMPTOMS OF A TENNIS ELBOW?

The primary symptom of a tennis elbow is pain and tenderness on the outside of the elbow. Other symptoms include:

  • Pain when lifting or holding objects
  • Pain when making a grip, such as gripping a tennis racket or opening a door
  • Pain with movement of your hand or wrist, such as shaking hands or straightening your wrist

WHAT ARE THE CAUSES AND RISK FACTORS OF A TENNIS ELBOW?

The main cause of a tennis elbow is overuse of the tendons and muscles. Repeated use of the forearm muscles to grip objects can cause it to strain and tear, resulting in a tennis elbow.

Common repetitive usage of forearm muscles include:

  • Sporting activities such as tennis, squash and weightlifting
  • Occupations such as plumbers, painters and chefs

 

Another risk factor of developing a tennis elbow is age. Tennis elbow is most commonly seen in people who are between the ages of 30 and 50.

WHAT IS THE DIAGNOSIS OF A TENNIS ELBOW?

A history of the injury and a physical examination of the elbow will be conducted by the Doctor. To locate the source of pain, the doctor may get you to flex or straighten your arm, wrist and fingers.

Imaging tests will be taken, such as an x-ray or MRI scan to eliminate other possible conditions.

WHAT ARE THE TREATMENT OPTIONS FOR A TENNIS ELBOW?

Most patients recover from a tennis elbow with nonsurgical treatments. These include:

  • Resting the arm and avoid use of the elbow
  • Medications for pain relief such as acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for reduction of pain and swelling in the elbow
  • Steroid injections such as corticosteroid injections to reduce inflammation
  • Physiotherapy such as gentle stretching exercises to strengthen your muscles
  • Elbow supports such as a brace to protect and help your elbow heal

 

Should nonsurgical treatments fail to alleviate the symptoms of your tennis elbow after 6 to 12 months of rest and rehabilitation, surgery may be recommended.

Surgery involves the removal of the damaged muscle and replacing it with healthy muscle. There are 2 types of surgery:

  • Open surgery

This procedure involves an incision being made over the side of your elbow. The damaged part of the tendon is being removed, and the healthy portion is then reattached to the bone.

  • Arthroscopic surgery

This procedure involves the use of miniature instruments and a camera to remove the damaged part of the tendon via a few tiny incisions made over the elbow.

 

WHAT ARE THE RISKS AND COMPLICATIONS OF A TENNIS ELBOW SURGERY?

Even though the surgery is safe, complications may still occur. These include:

  • Infection
  • Damage to surrounding nerve and blood vessel
  • Loss of strength and flexibility
  • Further surgery may be needed

RECOVERY AFTER A TENNIS ELBOW SURGERY

Following a surgery for tennis elbow, you will be required to wear a splint for about 1 week. Thereafter, you will be put on a rehabilitation program where you will be doing stretching exercises to regain your muscle strength and restore your mobility and range of motion in your elbow.

After 4 to 6 months, you may return to physical athletic activity.

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