What is tennis elbow? Who is it seen in? What are their findings?

The medical name for tennis elbow is “lateral epicondylitis.” The common starting point of the muscles that pull the wrist backwards is the area called the “lateral epicondyle” on the outside of the elbow. Tennis elbow occurs as a result of small tears and degeneration in the muscle-bone junction in this region due to repetitive strains.

WHO CAN GET TENNIS ELBOW?

Although it occurs frequently in athletes engaged in racquet sports, the disease can occur in anyone who performs repetitive and challenging work with the wrist. Tennis elbow can be seen in all occupational groups that make compelling wrist movements for more than 2 hours a day. Tennis elbow occurs frequently, especially in painters, plumbers, carpenters, and even housewives who do intense housework. The most common age range is between 30-50 years old.

WHAT ARE THE FINDINGS OF TENNIS ELBOW?

The most important finding of tennis elbow is pain on the bony prominence on the outer edge of your elbow and radiating towards the forearm. Usually, pain increases with raising the wrist backwards against resistance. The most typical example of this is the pain felt in the elbow and extending towards the wrist when lifting a heavy jug or teapot. There may be weakness in the arm muscles along with the pain. The event may start after a single strenuous activity, or it may begin 24-72 hours after a long strenuous activity. The pain is of low intensity at first, and if strenuous activities continue, it gradually increases over weeks and months. In advanced cases, even shaking hands or turning the doorknob can be very painful.

WHAT ARE THE RISK FACTORS IN TENNIS PLAYERS?

The most important risk factor in tennis players is bad backhand technique. In addition, the small sweet spot area of ​​the racquet, excessive string tension and not using anti-vibration parts increase the risk. The handle (grip) of the racket is small for the size of the hand, and playing with heavy and wet balls can cause tennis elbow. Extremely challenging training and competition periods also increase the risk of injury. Some studies have shown that smoking increases the risk of tennis elbow. To protect yourself from tennis elbow, you must warm up well and do stretching exercises before sports. You should use the racket with the appropriate tension and correct your backhand technique. Your arm muscles should be strong enough and you should apply ice after strenuous activities.

HOW IS TENNIS ELBOW DIAGNOSED?

Your orthopedic doctor first evaluates the history of the disease, the way it occurred, and your sports habits, if any. After examining you, he or she may request X-rays of the elbow to differentiate other underlying diseases. These are usually sufficient to make a diagnosis. Magnetic resonance imaging and nerve conduction velocity studies (EMG) may be required in very rare cases to differentiate other diseases. If you have a rheumatic disease or neck hernia, you should tell your doctor.

HOW IS TENNIS ELBOW TREATED?

If your complaints are not very severe, the disease can be calmed by methods such as rest, ice application, and a break from sports. Short-term use of simple pain relievers such as Paracetamol (Parol, Tylol) or drugs such as Naproxen (Apranax, Naprosyn) Diclofenac (Voltaren) is beneficial. It will be enough for people who play racquet sports to use the forearm instead of the wrist during the backhand, warm up well and make the appropriate changes in their racquets. Appropriate exercise and stretching programs recommended by your doctor may be helpful.

There are dozens of different bands and elbow braces developed for the treatment of tennis elbow. Their common purpose is to reduce the load on the injured area. These are used when using your arm or during sports, they should be removed at rest. The bands should not be applied over the painful area, but to the point indicated by your doctor, approximately 10 cm away from the elbow.

If your tennis elbow persists despite four to six weeks of treatment, your doctor will offer different treatment options. One of the methods applied for many years is cortisone injection to that area. Unlike cortisone drugs that are taken orally regularly, the side effects of regional cortisone injections are very few. Cortisone injections are effective by reducing pain and swelling in that area. It can be repeated several times as needed. In recent years, new applications have started in the treatment of tennis elbow. These are shock wave therapy and PRP injections.

WHAT IS THE ROLE OF SHOCK WAVE THERAPY IN TENNIS ELBOW TREATMENT?

Shock wave therapy was first used to break up kidney stones. It shows its therapeutic effect with high-intensity sound waves applied from outside the body and focused on a region. Today, it is applied in many different areas in musculoskeletal diseases. One of them is the treatment of resistant tennis elbow. The blood flow increases in the shock wave area and the body’s natural healing mechanisms are activated. Several sessions are required.

WHAT IS THE ROLE OF PRP TREATMENT IN TENNIS ELBOW TREATMENT?

PRP (Platelet rich plasma) is a liquid obtained from the person’s own blood and called platelet rich plasma. 40 ml of blood taken from the patient is centrifuged with special devices and 2-3 ml of PRP is obtained. This fluid contains concentrated amounts of growth and healing factors. These factors activate the body’s natural healing and repair mechanisms. It has been widely used in the treatment of many muscle and tendon injuries in recent years. It is performed in the lateral epicondyle area under sterile conditions. In most cases, a single application is sufficient, sometimes 2 or 3 PRP injections may be necessary.

IS SURGICAL TREATMENT DONE ON TENNIS ELBOW?

85-90% of patients in tennis elbow heal with non-surgical methods. Surgical treatment is required in patients whose complaints do not resolve despite medical treatment and injections lasting at least six months. In surgical treatment, the degenerated tendon in the painful area is separated from the attachment site, the diseased area is cleaned and the tendon is repaired by suturing it again. It may be necessary to apply a plaster cast to immobilize the arm for a while after surgical treatment. Return to sports may be possible after 4 to 6 years.

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