During the summer months, many people stay active by playing golf or tennis. These sports, however, carry a risk of injury to the tendons – bands of tissue that connect muscles to bones – in the elbow. This month’s AT Corner will explain how these injuries happen, how to treat them if they occur and, most importantly, how to prevent them. Common Elbow Injuries Tendonitis: Inflammation, pain and difficulty using the joint caused by repetitive activities and/or sudden trauma. Tendonosis: A degeneration (breakdown) or tear of tendons which occurs as a result of aging. Symptoms of tendonosis usually last more than a few weeks. Note: Your risk of tendonitis and tendonosis increases with age. They also occur more frequently in those who routinely perform activities that require repetitive movement, as this places greater amounts of stress on the tendons.

 Tennis elbow: Also referred to as lateral epicondylitis, this condition occurs when there is an injury to the outer elbow tendon.

 Golfers’ elbow: Also referred to as medial epicondylitis, this condition occurs when there is an injury to the inner elbow tendon. Note: Injuries to these tendons can occur in other sports and activities that use the wrist and forearm muscles. Most times, the dominant arm is the one affected.

Symptoms

• Pain that spreads from the elbow into the upper arm or down the forearm • Forearm weakness • Pain that can begin suddenly or gradually worsen over time • Difficulty with activities that require arm strength Treatment

Over-the-counter medications: NSAIDs, such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), or acetaminophen (Tylenol®) can provide pain relief. Ice: Apply ice or cold packs at least three times a day for as long as you have pain, swelling and inflammation. Arm brace: A tennis elbow brace or strap applies pressure to the muscles of the forearm, reducing pressure on the injured tendon in the elbow. The brace can be used while working or playing sports. Flexibility exercises, which can improve your arm's strength and ability to move:

For tennis elbow: While standing or sitting upright, hold your injured arm straight out in front of you with your palm down. With your other hand, grasp the hand of the injured arm, thumb pressing on the palm, and try to bend the wrist further. Hold for 30 seconds; repeat three times. Perform this stretch daily.

For golfer's elbow: While standing or sitting upright, hold your injured arm straight out in front of you with your palm up. With your other hand, grasp the hand of the injured arm, thumb pressing on the back of the hand, and try to bend the wrist further. Hold for 30 seconds; repeat three times. Perform this stretch daily.

Strengthening Exercises, which can increase musculature surrounding the elbow:

Wrist Flexion: With your forearm along a bench, hold a 1-2 lb. weight with the palm facing up. Flexing your wrist, bring the weight upward.

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Wrist Extension: With your forearm along a bench, hold a 1-2 lb. weight with your palm facing down. Extend the wrist to bring the weight upward. 

Tennis Ball Squeeze: Hold a tennis ball in the palm of your hand and gradually squeeze and repeat. Hold for about 6 seconds, and then rest. Repeat 12-15 times. Kinetic Chain: Hold a 1-2 lb. weight in your hand and reproduce the wrist and elbow motions of your sport. At the same time, brace your lower body and the core muscles of your back and abdomen. Replace the weight with a golf club or tennis racket and practice your swing without the ball.

How long will it take to heal? Most people respond well to treatment. You might have some pain during work or sports for up to 6-12 weeks. It is very important to ease back into your sport or activity once you are symptom-free. If you increase your activity level too quickly, you can injure yourself again.

Prevention

To prevent injury, it is important to maintain strength in your wrists and shoulders. Strong musculature surrounding the elbow decreases the load on smaller forearm muscles. To prevent overuse and strain in the elbow and forearm:

• Take frequent breaks from activities that require extensive hand/wrist motions • Avoid lifting objects with the arm extended • Reduce repetitive gripping and grasping with the hand and wrist • Decrease the overall tension of gripping • Avoid the extremes of bending and full extension • Keep the elbow in a partially-bent position while working or using weights

When using tools, • Wear gloves or add padding to increase the gripping surface • Use a hammer with extra padding to reduce tension and impact • Hold heavy tools with two hands

When playing tennis,

• Use a two-handed backhand • Use your entire body, starting with your lower half, moving through your core, up to your arm • Using proper swing technique, which will decrease the stress on your elbow and help reduce symptoms • Lower the string tension • Use the heaviest racket that does not affect your swing speed • Use softer strings • Use the largest grip that is still comfortable

When golfing,

• Apply grip tape or use an oversized grip on golf clubs

If you have any questions, please don’t hesitate to contact an athletic trainer at Thompson Health’s Sports Medicine Center by calling 585-396-6700.